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Atopic dermatitis is the most common type of eczema, a skin condition that makes you itch and leaves red blotches, usually on your face, arms, and legs. While it happens most often in children, it can also affect adults. The rashes tend to flare and go away, but then come back again.

Contact dermatitis is a red, itchy rash caused by direct contact with a substance or an allergic reaction to it. The rash isn’t contagious or life-threatening, but it can be very uncomfortable.

Dyshidrotic eczema causes small, intensely itchy blisters on the palms of hands, soles of feet and edges of the fingers and toes. While the actual cause of dyshidrotic eczema isn’t known, it is more common in people who have another form of eczema and tends to run in families, suggesting a genetic component.

This common form of foot-and-hand eczema is found more frequently in women than in men.

Dyshidrotic eczema is most common in younger adults, typically between the ages of 20 and 40. People can have a single flare-up of dyshidrotic eczema, but it’s more common for it to come and go over long periods of time.

Discoid eczema, also known as nummular or discoid dermatitis, is a long-term (chronic) skin condition that causes skin to become itchy, swollen and cracked in circular or oval patches.

Seborrheic dermatitis is a common skin condition that mainly affects your scalp. It causes scaly patches, red skin and stubborn dandruff. Seborrheic dermatitis can also affect oily areas of the body, such as the face, sides of the nose, eyebrows, ears, eyelids and chest.

Seborrheic dermatitis is also called dandruff, seborrheic eczema and seborrheic psoriasis. For infants, the condition is known as cradle cap and causes crusty, scaly patches on the scalp.

Stasis dermatitis, also called gravitational dermatitis, venous eczema, and venous stasis dermatitis, happens when there is venous insufficiency, or poor circulation in the lower legs.

Venous insufficiency happens when the valves in leg veins that help push blood back to the heart weaken and leak fluid. This allows water and blood cells to pool in the lower legs.

Venous insufficiency can be caused by aging, but it can also signal a serious underlying medical condition, such as heart or kidney disease.

Vulva refers to the external female genital area, labia majora is the outer folds of skin and the labia minora is the inner folds of skin.

Most women experience a slight vulval itch now and again. However, “pruritus vulvae” means the itch is persistent and causes distress. The itch may be particularly bad at night and may disturb your sleep. Proper diagnosis and treatment are vital to get relief from your symptoms.

About 1 woman in 10 sees a doctor about a persistently itchy vulva at some stage in her life. Vulval itch can affect any woman, at any age. It can lead to scratching and rubbing which can break the skin and can lead to soreness, bleeding and skin infections.

What causes an itchy vulva?

An itchy vulva is a symptom, not a condition in itself. It can be caused by many different conditions. Therefore, if you have a persistently itchy vulva, you should see your doctor to find out the cause.

Common causes of vulva itch are:

  1. Yeast infections

The most common signs and symptoms are irritation and soreness of the vulva, vulval itching, pain while urinating, pain while having sex, and a red and swollen vagina. You may also have a thick, white vaginal discharge.

  1. Sensitive vulval skin, such as contact dermatitis

Many things can cause an allergic reaction or irritate your vulvar skin. Some of the common allergens/irritants are:

  • Nylon underwear, chemically treated clothing
  • Vaginal secretions, sweat, and urine
  • Douches
  • Fragrances
  • Wet wipes
  • Panty liners
  1. Bacterial vaginosis

This results from an overgrowth of bacteria naturally found in your vagina. Usually, “good” bacteria (lactobacilli) outnumber “bad” bacteria (anaerobes) – But if there are too many anaerobic bacteria, they upset the natural balance of microorganisms in your vagina and cause bacterial vaginosis. Douching (rinsing out your vagina with water or soap) upsets the natural balance of your vagina, causing bacterial vaginosis. Since the vagina is self-cleaning, douching isn’t necessary.

  1. Menopause

A drop in estrogen levels a few years leading up to menopause, and after menopause, causes your vagina lining to become drier and thinner. This is known as ‘atrophic vaginitis’ and may be the cause of your vulval itch. Other symptoms include vaginal dryness, burning and discharge.

  1. Skin conditions that affect the vulval skin, such as eczema and lichen planus

Accurate diagnosis by your doctor and treatment will be able to relieve your symptoms.

Other causes of vulval itch includes cancer of the vulval skin and systemic conditions causing generalised body itch e.g. uncontrolled diabetes.

Do I need to be examined for an itchy vulva?

Most of the time, your doctor will be able to find the cause of your vulva itch after talking to you and examining you.

Examination will involve your doctor looking at the skin of your vulva and may also involve an internal (vaginal) examination. They may need to take some swabs from your vulva and/or vagina to look for infection.Itchy vulva treatment

This involves treating the cause if possible.

Treatments for itchy vulva (pruritus vulvae) vary, depending on the cause. For example:

  • Identifying and stopping the use of anything that may be sensitising the vulval skin.
  • Using antifungal cream for thrush.
  • Using antibiotic medicines for certain infections,
  • Using steroid cream for various skin conditions.
  • Using hormone cream or hormone replacement therapy (HRT) if the itch is related to the menopause.

Led by Dr Lynette Lee, who trained in the Obstetrics and Gynecology Department in Singapore General Hospital in 2014 and has been working in the Dermatology Department in KK Women’s and Children’s Hospital since 2015, The Skincare Clinic consists of an all-female team, for discreet diagnosis and accurate treatment of your skin issues.

Eczema Treatment

A hydrating spa for your skin!

Wet Wrap Therapy involves covering the inflamed areas with wet dressings, such as gauze, to hydrate your skin and prevent scratching.

Wet Wrap Therapy has many benefits, including a decrease in staph bacteria (Staphylococcus aureus) found on your skin, and reducing redness and inflammation.

Wet wrapping also can help rehydrate dry skin, reduce itching and promote restful sleep. It enhances the effects of creams applied on your skin, reducing your reliance on steroid creams.

Dr Lynette Lee recommends Wet Wrap Therapy frequently for eczema. It is one of the most powerful treatments available to combat very dry skin and extensive eczema flares. It is useful for both widespread eczema and also for more localized flares, including over the face.

However, for parents, Wet Wrap Therapy can be time-consuming and frustrating. Oftentimes, patients with extensive eczema flares have to be admitted to hospital just for wet wraps.

The Skincare Clinic is pleased to be the first medical clinic in Singapore that provides outpatient Wet Wrap Therapy services, to cater to babies, children and even adults, who require more intensive care for their dry skin.

Benefits of Wet Wrap Therapy

Wet wrap therapy can help eczema in many ways.

  • Cool your skin
  • Help topical medications/treatments work better
  • Help you sleep better
  • Hydrate your skin
  • Reduce inflammation and redness
  • Reduce staph bacteria on your skin
  • Relieve itching and reduces scratching

Before starting Wet Wrap Therapy, it is best to see a doctor who is trained in Wet Wrap Therapy to assess your suitability. They can teach you the correct technique, tell you how often to do it, and advise you on which type of topical products to use.

If you suspect that you have an allergy, it can be confirmed through a simple allergy test.

An allergen is any substance that elicits an allergic reaction. During allergy skin tests, your skin is exposed to suspected allergens and observed for signs of an allergic reaction.

Information from allergy tests may help your doctor develop an allergy treatment plan that includes allergen avoidance medications.

Allergy skin tests are widely used to help diagnose allergic conditions, including:

  • Atopic dermatitis (Eczema)
  • Allergic rhinitis (Hay Fever)
  • Allergic asthma
  • Food allergies

Skin tests are generally safe for adults and children of all ages, including infants.

Skin prick test

A skin prick test, also called a scratch test, checks for immediate allergic reactions to many different substances at once. This test is usually done to identify allergies to pet dander, dust mites and foods. In adults, the test is usually done on the forearm. Children may be tested on the upper back.

This type of test uses small needles that barely penetrate the skin’s surface. You won’t bleed or feel more than mild prick. It is not painful at all. The test is done within half an hour and the results will be out out during the same visit.

After cleaning the test site with alcohol, a drop of allergen extract is applied to your skin via a gentle prick. About 15 minutes after the skin pricks, the nurse observes your skin for signs of allergic reactions. If you are allergic to one of the substances tested, you’ll develop a raised, red, itchy bump (wheal) that may look like a mosquito bite. The nurse will measure the size of the wheal and record the results. The doctor will see you and explain the results to you.