Vulvar Dystrophies

The vulva is the area outside the opening of the vagina. This area can develop white spots of thick or thin skin called dystrophies. Dystrophies are all harmless. They do not grow in size or develop into cancer. A healthcare provider can help if you think you have a white area. Sometimes a sample of the skin called a biopsy will be needed to make sure of this diagnosis.

There are two types of dystrophies depending on the type of skin involved. In general, the thickened type is a result of irritation. You can be any age when this develops, although it occurs most commonly in older women. It often starts with itching or burning in the area. If this irritation continues, the skin will develop a white, thickened surface with some cracking and even bleeding.

To reduce the irritation in the area, you may want to avoid these things:

• tight underwear

• perfumed laundry detergent or fabric softener sheets

• feminine sprays or perfumes

• scented toilet paper, and for some women

• acidic fruits and vegetables such as oranges and tomatoes

Even if the trigger for the irritation is found, a cortisone type cream may need to be applied twice a day for several months. Stopping the itch is key, so over-the-counter Benadryl may also help.

Thin skin dystrophy is mostly found in menopausal women. The cause is not known. Itching and pain with sex may be the first symptom.

A healthcare provider may recommend a cream that is put on the area three times a day for several months. It is reduced to one or two times a day for months once the area improves. The treatment usually needs to be continued at least once a week for the patient's lifetime. Doing this will keep this problem from returning and prevent scarring.

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