Does topical steroid treatment help with vulval skin changes?

A vulval change can involve redness, swelling, scaling, thickened skin, lighter patches, cracks or soreness. These features can arise from inflammation, dermatitis, infection, hormonal changes or another skin condition. A steroid ointment works on inflammation; it does not treat every infection or explain why the skin changed.

The strength, amount and length of treatment depend on the appearance and diagnosis. Ointment is often less irritating than a cream on delicate skin, but any prescribed product should be used exactly as directed. Using a steroid on an undiagnosed infection can alter its appearance or allow it to worsen.

Arrange an assessment if the change is new, persistent, painful or returning. Until then, wash gently with lukewarm water, avoid fragranced products and do not scrub or scratch. Loose cotton underwear and a plain, unperfumed emollient may reduce friction if the skin is dry.

If a clinician prescribes a steroid, ask where to apply it, how much to use, when to stop, and whether follow-up is needed. Keep the product away from the vagina unless specifically instructed.

Seek prompt medical care for an open sore, blistering, bleeding, pus, marked swelling, fever, severe pain or difficulty passing urine. A persistent patch, lump, ulcer or change in texture also needs examination, even if it is not very uncomfortable, because visual assessment helps distinguish common skin problems from conditions needing different care.

What could be causing this change, and does it need an examination or a swab? Which steroid strength is appropriate? How should I apply it and what side effects should I watch for? When should the skin start to feel better, and when should I return if it does not?