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Vulva skin conditions are usually not hard to treat, as long as you aren't trying too hard to treat the wrong condition. Inflammation of the skin of the vulva can be worrisome, especially if you're sexually active. Here are some basic rules for treating cracked, red, irritated, or bleeding vulva skin.

1. Look for simple changes first. 

Sometimes it's something you do every day that is most of the problem. Scratchy clothing can cause vulvar irritation. Activities that cause constant rubbing of the skin of the vulva like spinning or bicycling in tight workout clothes can cause constant inflammation. Scented or colored toilet tissue may contain chemicals that cause allergies or aggravate eczema. Fabric detergent can be a problem if clothes aren't thoroughly rinsed. If your washing machine doesn't run its rinse cycle properly, you can get a bad case of itchy redness and inflammation. Wear cotton underwear, or no underwear at all when you are at home. These sorts of things aren't always a problem, and they are almost never the whole problem, but simple changes sometimes make a big difference.

2. Don't treat yeast infections you don't have. 

If yeast isn't the problem, an antifungal cream isn't the solution. The propylene glycol or alcohol in the antifungal cream, however, can dry and irritate your skin. It's OK to try an over the counter product for yeast infections once, but if it doesn't work the first time, then maybe you don't have a yeast infection and you should treating something else.

3. Wash vulvar skin gently. 

You can scrub the itch away. Bubbly soaps (and yes, bubble bath) will dehydrate your skin, leaving it flaky, peeling, and itch-prone. Cleanse the area with your fingertips. Don't scrub it with a scratchy washcloth. And don't use the same washcloth twice without washing it in hot water and sending it through the dryer first. You don't want to reinfect your labia every time you bathe or shower.

4. Be on the lookout for eczema on vulvar skin. 

We usually think of eczema as something that breaks out on the hands or face, but it can break out on the vulva, too. On other parts of the body eczema usually causes a pattern of itch, redness, inflammation, oozing, and crusting. The skin of the labia may not crust. If you have eczema, some things may set off immediate irritation:

  • Adult or baby wipes.
  • Bubble bath, detergent, soap, shampoo, and/or conditioner.
  • Chemically treated clothing.
  • Deodorants, perfume, or talcum powder.
  • Douches, yogurt, or probiotics.
  • Essential oils, even lemon and lavender.
  • Lubricants and spermicide.
  • Nylon underwear.
  • Panty liners and adhesives.
  • Rubbing alcohol.
  • Tannins and other astringents.

There are other common personal hygiene and household products that may cause a delayed reaction that doesn't show up for 2 or 3 days:

  • Benzocaine.
  • Chlorhexidine (in K-Y jelly and some feminine hygiene products).
  • Imidazole (treatment for yeast or fungal infections).
  • Latex (from condoms or other products).
  • Tea tree oil.

Some herbal essences and essential oils cause irritation only a day or two after you use them.

When any of these substances sets off inflammation, the only treatment that works is gentle care. Use only mild soap in your bath or shower. Pat skin dry. Don't rub it dry. Treat itch with ice packs, not creams or lotions. 

5. Sometimes the problem you need to treat is psoriasis. 

Psoriasis is a condition in which skin cells multiply too rapidly and become red and itchy before they dry out into a silvery hard patch. Elsewhere on your body, you might treat psoriasis with vitamin D, anthralin, or psoralen, or maybe an herbal remedy called scruffy pea (which is a natural source of psoralen). Don't use them on vulvar skin. Psoriasis of the vulva is something you probably need a doctor to treat.

Lichen planus

Lichen planus is a condition that can affect the skin of the vulva, mouth, and other parts of the body that are caused by an overactive immune system. On most of the body, it causes itchy purple bumps that are streaked with white. On the vulva, it redness, rawness, or maybe a white lacy pattern. It is it not treated, it can permanently alter the skin. Unfortunately, lichen planus usually has to be treated with steroids that you get from a doctor.

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