What is the treatment for white lesions of the vulva?

Vulvar white lesions may occur when one's immunity is reduced, there is a lack of sex hormones, or the sex hormone receptors are decreased. If vulvar white lesions appear, do not scratch them. You can use suitable cleaning products to clean them and choose breathable clothes to keep the vulva area dry. You can also use medication for treatment.

Causes

The exact cause of white lesions of the vulva is unknown. It may be related to the following factors: genes, autoimmunity, sex hormone deficiency or decreased sex hormone receptors, etc. Vulvar squamous epithelial hyperplasia may be related to vulvar moisture and long-term stimulation by secretions, leading to vulvar itching and repeated scratching.

examine

Biopsy should be performed on areas with fissures, ulcers, bumps, nodules, or roughness. Multiple biopsies are sent for pathological examination to determine the nature of the lesion and rule out early cancer. In order to ensure appropriate sampling when vulvar squamous epithelial hyperplasia is suspected, the affected area can be first painted with 1% toluidine blue, and then scrubbed with 1% acetic acid to decolorize it after it dries. Any area that does not discolor indicates the presence of naked nuclei. If a biopsy is performed at this location, there is a high possibility of finding atypical hyperplasia or even cancer.

Clinical manifestations

The main symptom is severe itching of the vulva. The itching may last from 2 to 3 months from onset to treatment, or even up to 20 years. The severity of the itching is not affected by season or day or night. Patients with vulvar squamous hyperplasia may experience more severe itching. If accompanied by trichomoniasis or candidal vaginitis, the secretions will be more, and the local burning, stinging and itching are related to the damage or infection of the skin and mucous membranes. There is varying degrees of local hypopigmentation of the skin and mucous membranes, often with edema, chapped skin and scattered superficial ulcers.

treat

1. General treatment

Pay attention to keeping the vulva clean and dry. Do not use irritating drugs or soaps to clean the vulva. Avoid wearing non-breathable synthetic underwear and do not eat spicy or allergenic foods. For those with severe itching symptoms leading to insomnia, sedatives, sleeping pills and anti-allergic drugs can be added.

2. Medication

Commonly used drugs for vulvar lichen sclerosus include pyruvic acid ointment, compound vitamin A ointment and progesterone ointment. Alternatively, glucocorticoid ointments or immunotherapy may be used. Drugs can improve symptoms but cannot cure the disease, and long-term use is required. Lichen sclerosus in young girls may heal on its own by puberty, and pyruvate ointment is generally not used for treatment to avoid virilization. 1% hydrocortisone ointment or 0.3% progesterone ointment can be applied, which can relieve most symptoms, but long-term follow-up is required.

Vulvar squamous epithelial hyperplasia can be treated with topical corticosteroids to control pruritus. Treatment is effective for most patients, but long-term medication is required.

3. Physical therapy

Suitable for patients who are ineffective with drug treatment or whose condition is serious. Microwave therapy, carbon dioxide laser and helium-neon laser, Bohm light, high-frequency electric knife, local electrocautery therapy and liquid nitrogen local cryotherapy, etc.

4. Surgery

Surgical treatment is only suitable for patients with severe conditions and those who have failed to respond to repeated medication or physical therapy. Surgery is required when vulvar squamous hyperplasia is suspected to be malignant.