Where to apply your steroids

[cactusvl]

We get asked a lot in our support group as to where to apply the steroids.
Is it all over the vulva and perianal area , only where WE can see and feel symptoms (itching, white patches, tears etc)
Also For maintenance (once or twice a week) where do we apply the steroids? All over or just where we had signs and symptoms before.
Knowing LS can cause the clitoris to become buried and labia stick together do we apply steroids there to help slow down or stop progression.

[Dr Nevianna Bordet]

Thank you for your post. The topical steroid should be applied where the LS is active. So if a patient has LS inflammation only over the opening of the vulva (Introitus) then the steroid should only be applied here. Some women have a "figure of 8" presentation and there is LS active in the vulva, over the perineum and around the anus - they need to apply the steroid to all those areas. The twice per week maintenance should be used where the LS was active before but you can self-examine every few months using a mirror and if you see (or feel - itch and/or soreness) that the LS is coming back in a new area, then the steroid needs to be applied here. I hope this is helpful but if you are not sure where to apply it and how much to use, please ask your doctor as they can examine you and show you exactly where the inflammation is active. Not all patients with LS will have symptoms. Some have fusion/ scarring with no itch or discomfort. This is not common. These patients need more regular examination and need to apply the steroid over the areas that are changing.