Suggest Treatment For Severe Itching In The Pubic Area
Vulval LSCh; Topical steroids and Oral antihistamines together
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have note doen your concern.
From your description this seems like a condition known as Vulval Lichen Simplex Chronicus (Vulval LSCh).
Lichen Simplex Chronicus presents as thickening (visible to the naked eye as prominent skin markings) and darkening of skin at affected sites.
This thickened, darkened skin of LSCh is dry and it itches. The degree of itch varies from mild to severe.
The more one itches, greater is the desire to scratch, so that it becomes a cycle i.e itch-scratch-itch cycle.
LSCh may either start on its own Or it may be preceded by an inflammtaory skin condition e.g tinea/ fungal infection which may have long been resolved with appropriate treatment, however it may have lead to LSCh, which is self perpetuating.
Treatment is based on breaking this cycle. Oral antihistamines e.g cetrizine Or hydroxyzine cuts off the desire to scratch and is an important part of treatment of LSCh.
In addition topical moderately potent steroid e.g mometasone furoate 0.1% cream Or potent steroids e.g clobetasol propionate 0.05% cream is also beneficial in LSCh but reducing the desire to scratch and reducing thickness and pigmentation of affected skin. Treatment may take weeks or months.
Most common cause for LSCh to return is incomplete resolution Or stopping therapy mid way.
I suggest that you use a moderately potent topical steroid e.g mometasone furoate 0.1% cream, twice daily, along with Oral cetrizine tablet, once Or twice daily.
Fungal infection first needs to be ruled out by a KOH scraping test which looks for fungal elements (i.e hyphae) under the microscope and if detected, needs to be treated appropriately.
Regards