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I’d like to check if there’s anything else I should be doing please. I am waiting for an appointment at the vulva clinic (West Wales). I was referred in Autumn 2023.
In May 2023 I developed a soreness in my vagina and on my vulva. My GP prescribed Hydromol to wash with, Sudocrem as a barrier and YES moisturiser. I briefly tried Dermol (wrongly advised to put it inside my vagina not on my vulva) then Ovestin cream which I reacted badly to. I then started using Vagirux pessaries, initially daily then reducing to three times then twice a week.
I am prone to auto-immune conditions. In 2017 I had an ileostomy for ulcerative colitis and now have a stoma. I take Budesonide to ward off hepatitis.
I saw a Gynaecologist privately in December 2023. He thought it was probably LS but wanted to do a biopsy under general anaesthetic before suggesting treatment. After discussion with my GP I decided against this as I bleed and bruise easily and preferred to try a proper treatment regime with Dermovate while waiting for an NHS appointment at the vulva clinic.
On 22nd March 2024 the symptoms were a bit better (coinciding with a reduced dose of Budesonide from 6 mg to 3 mg daily). I started using Dermovate cream, intending to do twice a day for a month, then once a day for a month and then hopefully reduce to twice weekly.
My symptoms improved. The redness on the vulva has almost gone but there is still some soreness inside the vagina and around the opening.
After joining a very informative Facebook page run by Lichen Sclerosus & Vulval Cancer UK Awareness in mid May I changed to using Dermovate Ointment (instead of cream), applying it after a shower. I intend to do it after a bath in the near future but at the moment I have a wound in my ankle and can’t submerge it in water so can’t bathe. I now rub the ointment in for 90 seconds.
Questions:
I think my labia etc have shrunk so I have increased my Vagirux to alternate days from three times weekly. Is this right?
Can I apply the Dermovate ointment on the soreness inside my vagina (if I can reach)? I currently only use it on my vulva.
Is it OK to use Sudocrem as a barrier in the long term? Ive been using it for a year. If not, what else would you advise?
What else would you advise in general?
Thank you,
Pamela

Dear Pamela,
Thank you for your post. I will try to answer your questions:
Questions:
I think my labia etc have shrunk so I have increased my Vagirux to alternate days from three times weekly. Is this right?
Without examining you, it is hard to say why your labia have shrunk. This can be age-related or due to inflammation if you indeed have LS. I am afraid that in both situations, topical oestrogen will not have much of an effect. It makes the vagina less dry so can help with discomfort and sexual intercourse, and can sometimes help with urinary symptoms. It does not change the anatomy.

Can I apply the Dermovate ointment on the soreness inside my vagina (if I can reach)? I currently only use it on my vulva.
Without examining you, I do not know why you are sore so I would recommend a doctor advises on this after they can have a look to see why you are sore. Dermovate can be used inside the vagina. Usually lichen planus affects the inside while lichen sclerosis tends to be more on the vulval skin, perineum and around the anus (peri-anally)

Is it OK to use Sudocrem as a barrier in the long term? Ive been using it for a year. If not, what else would you advise?
Sudocrem is fine if you are getting on with it. All creams have preservatives and some of the ointments such as Hydromol ointment, Epaderm ointment, Cetraben ointment etc. tend to be a good choice as they have very few ingredients so less likely to cause irritation or allergy in the sensitive vulval area.

What else would you advise in general?
Please have a look at resources such as the BAD information on LS for further advice:
https://www.bad.org.uk/pils/lichen-scle ... n-females/

I hope this is helpful.