Last month I was in Chicago learning from the best of the best of dermatologists and gynecologists who specialize in abnormal conditions of the vulva and vagina. I want to reiterate here some of the most important take home points they taught us. Be very kind and very gentle with your genitals.
Please do not use regular soaps or washcloths, only gentle fingers and water to clean around the outer lips. If you must use soap, then please use either Dove, Cetaphil, Basis or Vanicream. NEVER use the brands “Always” pads, “Vagisil” cream, any benzocaine product, or any baby wipes since they have chemicals that cause significant irritation in many women. The ONLY acceptable wipes are called “Water Wipes” and are available at Target and Walgreen’s. Try to not wear panty-hose and thongs in general, and leave off underwear at night. Douching is never a good idea.
Any itching “down there” is often mis-diagnosed by women and even their doctors as a yeast infection. But other infections, eczema, psoriasis, contact dermatitis, allergies, Lichen Sclerosis, Lichen Simplex, Lichen Planus, and many other general skin conditions including cancer can feel like itching, burning, or pain. It is important to get a correct diagnosis to decide the best treatment plan. Low gluten and good vitamin D intake is important.
A very frequent cause of discomfort, especially in women on a low dose birth control pill, breastfeeding, or those over 40 is having too little estrogen in the vaginal area. Luckily, most women, even those with breast cancer, can use a tiny amount of a low dose topical estrogen cream or other soothing salve to heal those dry tissues. I recommend natural herbal salves or vitamin E oil. Many women need a lubricant with sexual relations; silicone products without chemicals (such as parabens or polyethylene glycol) or natural food oils such as coconut also work very well.