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Vulva Care

The Ochsner Gynecology Department offers a unique clinic specializing in the evaluation, diagnosis and treatment of vulvovaginal problems. Chronic and recurrent burning, itching and pain are frustrating and unsettling for many women. You will benefit from a consultation in our office if you experience any of these problems: vaginal pain, itching or burning; vaginal dryness; chronic recurrent discharge; inability to place a tampon; or inability to have sexual relations because of pain.

We specialize in the evaluation and treatment of the following diseases:

  • Vestibulodynia
  • Vulvodynia
  • Vaginal discharge
  • Lichen sclerosus
  • Lichen simplex chronicus
  • Lichen planus
  • Desquamative inflammatory vaginitis
  • Vulvar intraepithelial neoplasia

What is Vulvovaginal Disease?
Vulva self exams enable you to be aware of changes that should be communicated to your healthcare provider. Treatment is most successful when a problem is evaluated at an early stage. Vulva pain can exist in the area of the vestibule or vaginal entrance (Vestibulodynia) or the vulva outside the vestibule (vulvodynia). The causes are either identifiable or unknown. The known causes are irritants such as soaps, scented pads, lotions, vaginal discharges, infections or even medications that cause an irritation of the skin (dermatitis). The unknown causes occur in a group of patients with no signs of irritation. Though the cause is unknown the complaints can be controlled.

What is Vaginal Discharge?
Vaginal discharges can be simple and easily treated or complex and difficult to both diagnose and treat. Itching is not always due to yeast (Candida). The diagnosis is made by wet prep (looking at vaginal secretions under a microscope) and by cultures.

What is Lichen Sclerosis?
Lichen sclerosus is a skin disorder that affects the skin of the vulva. The cause is unknown, and the disorder occurs in all age groups. Skin changes are associated with lichen sclerosus, but a biopsy is sometimes needed to confirm diagnosis. Treatment is designed to stop itching and heal the skin irritations caused by scratching. If a sore or ulcer develops that does not heal, it needs to be biopsied. Careful regular followup with your healthcare provider is necessary for adequate control of symptoms.

What is Lichen Simplex Chronicus?
Lichen simplex chronicus is an extremely common skin inflammation problem that results in intense itching of the vulva skin. The cause may be an itch that becomes a rash or a rash that itches. The clinical appearance is the same in both cases. Examination shows evidence of intense rubbing, skin thickening, and occasionally breakdown of the skin. The treatment for itching and scratching is not dependent on the cause of the condition.

What is Lichen Planus?
Lichen planus is a disease of unknown cause that results in irritation of the mucous membranes of the mouth and vagina. Because it can resemble other vulvovaginal skin conditions, a biopsy may be needed for a diagnosis. Scarring can cause narrowing of the vagina. As with lichen sclerosus, careful regular follow-up with your healthcare provider is necessary for adequate control of symptoms.

What is Desquamative Inflammatory Vaginitis?
Desquamative inflammatory vaginitis is not an infection but an irritation (inflammation) of the surface cells of the vagina. It is characterized by a discharge, vaginal redness, soreness of the opening of the vagina, splits in the skin, and discomfort with intercourse. The cause is unknown. The inflammation is treatable, but recurrences are common.

What is Vulvar Intraepithelial Neoplasia?
Vulvar intraepithelial neoplasm (VIN) is a type of precancerous vulva skin abnormality. The human papilloma virus (HPV) has been linked to this precancerous skin change. The symptoms are itching and burning. Raised brown, pink, white, or grey skin changes can be associated with VIN. The diagnosis is made by examining the area with a special scope or magnifying lens plus a biopsy. The treatment is surgical removal or laser destruction of the skin abnormalities.

Why are self-exams important?
Vulva self-exams enable you to be aware of changes that should be communicated to your healthcare provider. Treatment is most successful when a problem is evaluated at an early stage.