How do I fix my vulval eczema?

January 8, 2016 9:52 PM

I've seen four dermatologists, and followed their advice, but my vulval eczema hasn't gone away. Maybe you can help?

I've had vulval eczema for 10 months. I've seen four dermatologists, and followed their advice:
- wash my vulva with cool water only, no soap;
- apply Silic 15 barrier cream gently to my vulva after every time I urinate;
- use Advantan fatty ointment (steroid cream);
- cotton undies only;
- pat dry gently with ultra soft hypoallergenic facial tissues instead of toilet paper;
- use omo sensitive laundry liquid for all my clothes, give undies an extra 3 rinse cycles;
- wear dresses and skirts only, never ever trousers;
- never ever wear pantyhose.

I've also:
- started taking several probiotics, including one targeted at eczema
- quit coffee
- continued to avoid dairy and wheat

What else can I do to fix my eczema? At its worst, it makes it painful to sit, and it severely limits my sex life.

posted by A sock, a sock! My kingdom for a sock! to Health & Fitness (15 answers total)

I've had severe eczema most of my life on a different delicate place: my eyelids. My dermatologist prescribed Elocon, another steroidal cream. It works within days every time for me, in various places where the eczema flares up. Might be worth asking if they'll prescribe that. (It's... kind of contra-indicated for the eyes, but I've been using it about every other week for 20 years.)

Might be worth a shot, even though you've tried a different topical.
posted by disillusioned at 10:49 PM on January 8, 2016

I'm sorry you're going through this. I don't have a tried and true answer for you, but you may find a few more anecdotal remedies through the People's Pharmacy. They recommend, among other things, oolong tea and a few different oils. Good luck!
posted by hydra77 at 12:47 AM on January 9, 2016

I'm not sure how your skin will react to it, but Epsom salt soaks pretty much resolved my chronic vulvar skin irritation (plus white cotton undies, no soap, no fragrance, etc, but you're doing that already). Once or twice a day at first, then every couple of days, then once a week, and now it's only if I feel my skin get especially irritated.

Steroids made it dramatically worse for me and my vulvar pain specialist ignored that and persevered for more than a year. So be careful that you're not reacting to that too.
posted by lydhre at 1:01 AM on January 9, 2016 [1 favorite]

I'm sorry; that's terrible! Have you tried going without underwear under dresses/ skirts and at night?

For other parts of the body, daily bathing with a moisturizer applied directly afterward is helpful.
posted by metasarah at 4:37 AM on January 9, 2016

Might coconut oil be soothing? It's vulva- and vaginafriendly, can serve as a really nice lube (if you are not using latex condoms), and will often decrease rashes and itching, also if these are eczema-related.
posted by Too-Ticky at 4:54 AM on January 9, 2016 [1 favorite]

Do you use pads? They can be extremely irritating. If you are you could try switching to a silicone cup or to using reusable cotton pads.

Stress is also a known cause, finding some form of emotional support may help if that is applicable.
posted by Requiax at 5:12 AM on January 9, 2016 [2 favorites]

Do any of those derms specialize in gynecological problems? If not I'd give that a try before ruling out going to see a fifth (ugh, I know) doctor. Also seconding Requiax; stress can be a trigger in many autoimmune conditions.
posted by Room 641-A at 6:32 AM on January 9, 2016

You poor thing, this is pretty much the worst. A few ideas:

- Have you tried a steroid cream rather than an ointment? I find the thick, greasy texture of Advantan fatty ointment quite irritating but I've had good luck with Diprosone cream for a similar ailment.

- You'd want to check with your dermatologist/s, but I have read about bathing in a very dilute bleach solution as a remedy for some types of eczema.

- If you're having any sex, might something like lube/condoms/partner's fluids be causing irritation? pH balance can be thrown off by semen so if you are having unprotected sex with a male partner between flareups, perhaps try using condoms? Or change condom/lube brands if you're using them?

- Perhaps try switching your shampoo/body wash to something ultrabland and dermatologist approved - since rinsing in the shower washes everything everywhere there's a chance one of these products could be causing irritation.

- Seconding that reusable cotton pads are much less irritating than disposable pads and tampons. Menstrual cups are great too but there's a bit of a learning curve, and I'd be inclined not to try them for the first time when you're already experiencing so much genital discomfort.
posted by escapepod at 6:57 AM on January 9, 2016

Do see a Gyn. There are systemic diseases accompanied by vulvar skin issues. When my Vulvodynia was at its worst, I wore no underwear (and no trousers), and that helped a lot.
posted by Jesse the K at 7:48 AM on January 9, 2016 [1 favorite]

It might be beneficial to go on a sugar fast for a few months while upping your intake of alkaline veggies to see if you've got an underlying pH issue going on. Ditto on avoiding all glycerin based lube and condoms with spermicide. Trojan brand condoms wreck my lady bits to pieces for weeks so I've put a ban on them, personally.
posted by Hermione Granger at 9:25 AM on January 9, 2016

I have had this for many years. Now it flares up only occasionally, and in a minor fashion. First, I keep the area affected shaved. (I think this is about reducing the moisture there, and if this isn't something you do already, keeping the hair there very short works just as well.) (I use Dr. Bronner's lavender soap as a shaving facilitator, but you might want to use an oil that is even less problematic, like olive oil or something.

Also, triamincinolone is the only thing that ever really works for me. I use it only once when I feel a flare up coming on, and it tamps it right down. I used it religiously in the beginning to get rid of it.

Edit: Also yeah, cotton undies, no soap ever, and all that other stuff you're trying too.
posted by RedEmma at 11:05 AM on January 9, 2016

You might have a latex allergy. Try underwear that has no elastic at the legs.
posted by Oyéah at 9:57 PM on January 9, 2016

I had that, it sucked. The itching would keep me up at night, and it always eventually starts bleeding at some point (could not leave it alone). I would suggest Low Dose Naltrexone which helped a lot of my immune issues. After 3 years on it, I still get eczema flare ups (probably due to food allergies) but they go away quickly and don't hang around forever at least. Creams never did much for me.

It is hard to get a regular GP to prescribe naltrexone for allergies despite the research on it, unless you have MS. Some people get it from naturopaths. Memail if you need more info about this

Also doing a sugar free (no table sugar) diet for a little while really cleared up my skin rashes, and acne, but is impossible to do indefinitely. The sugar cravings would get pretty bad. Finally, you may still be allergic to something in your environment, food or water. (Unless you're just allergic to everything in some degree like me, then you are just kind of allergic doomed, sorry) :>
posted by everyday_naturalist at 12:14 AM on January 10, 2016

yes, I would look for a gynecologist who specializes in vulvodynia or chronic vaginitis, a specialist like this may have a different perspective and new ideas.
posted by treehorn+bunny at 8:02 PM on January 12, 2016

corn starch to keep the area dry - no talc, no baby powder, no scented dusting stuff.
Get Tacrolimus/Protopic for the outbreaks rather than the steroids
Use nothing with fragrance, that includes body wash, soap, shampoo, laundry detergent. Nothing.
If you need to take a bath use only oats tied up in a fabric satchel or cheesecloth - no soaps bubbles bath bombs etc
No lubricant that is not vagina PH friendly, and use sparingly away from the breakouts. Condoms should be used "dry" and add your own lubricant rather than buying lubricated kinds.
posted by SassHat at 9:14 PM on January 17, 2016