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Causes of redness/fissures of vulvar skin

Hi there,

I have had symptoms since last June (07) that I have had all infectious conditions ruled out. I am now looking at biopsy of the vulvar skin to uncover some answers, so I wanted to post here to see if any other women have gone to a dermatologist and had results. I have posted on the women's health forums here, but since i have ruled out std's, fungus, bacteris, yeast, hormone levels, strep-B, etc etc, this is clearly a skin issue.
What happens is that I get occassional redness and mild itching of the vulva. My Dr. has observed that my cervix is also reddened at these times. I get a recurring fissure that is located in a natural skin fold next to my clitoris, and one that appears sometimes on my perineum. I have also had what feels like a fissure on my anal area, it will burn and bleed a little when I wipe.  My gyn prescribed a zpak when I also (in october) began having a thick discharge with elevated white cells. ALL tests were done, no answers. Meds do not affect it.
My reproductive endocrinologist tested my hormones, cortisol, tsh, etc etc- all normal. I do have anti-thyroid antibodies as well as antiphospholipid antibody syndrome, which are both auto-immune diseases. I am asymptomatic for both.
WHAT on earth could be causing my symptoms above??? I am not looking forward to a biopsy, but I am wondering if it is Lichen Sclerosis? The redness and fissures do respond to Clobetasol treatment. In fact i went for 6 weeks without a "flare" from mid-november 07 to January 08.
Anyone have ideas?
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Avatar universal
https://infodiseases.com/different-treatment-for-male-and-female-with-lichen-sclerosus-ls-causes-and-symptoms.html
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Avatar universal
I am 43 and was just diagnosed with LS - which is what brought me to this website. I have an underactive thyroid and am reading how it is almost always associated with Hashimoto's Disease - which is an autoimmune disorder. As is LS. I'm so confused - I don't think any of these doctors know what they're doing anymore. I have always had delicate/sensitive skin and now am wondering if maybe the gentle soap would help. Please don't get a biopsy - save yours the pain. My gynecologist did one on me a few days ago and I am so sorry I let her do it - it was extruciating - I almost cried afterwards. I kept telling her I didn't want to do it but they kept shoving a clipboard in my face to get me to sign the consent form. It was very traumatizing and hurt for 2 days. I totally regret it. Rule out everything else first before you let them do anything that invasive. Good luck.
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1 Comments
Im glad I found this site. Your answers have been very informative. I just want to add to the comments. I have ulcerative colitis and I take an immunosuppressant. I am told by the dermatologist and gynecologist that because of the immunosuppressant. They have a tendency to make your skin thin and sensitive which is why I continue to get vaginal and anal fissures. Both are painful and I don't wish on anyone. I 've used cetaphil but it irritated my skin. I will try the other recommendations given to see if it will get rid of the fissures. I was diagnose d with Hidradenitis Suppurative a skin disorder caused from the ulcerative colitis.
11201698 tn?1416161577
For those with itching and fissures (or just plain itching), please talk to your doctor about Lichen Sclerosus.   It's a skin condition that happens to affect the genital/anal skin.  It can cause burning, itching, redness, white patches, tears (aka fissures) in the front and back as well as loss of labia, skin fusing and an increase chance (I believe it's 40% increase) of vulvar cancer.  You can have ALL, or SOME of the symptoms.  Most women have itching only.  Some have no symptoms and only find out when their gyno notices labial fusing!   It's best to get a biospy done to rule it out.  

I have it and had no symptoms.  I just noticed a white area next to my anus one day and asked my doctor about it.  A biopsy proved positive to LS.   However since then, my fourchette tears easily and I get fissures between my inner/outer labia in the crease, anal fissures, fissures in my butt crack and once, on the top of my butt crack (where it starts).   I now have more burning symptoms as I have  hit menopause.   I was told to only use the steroid ointment on the white areas but now I think I need to use it all over from front to back.  My gyno doesn't think the fissures are LS because the area looks totally normal and I have no itching but the more I read, the more I realize, it's most likely LS related.  

Doctors are not as up to date on LS as they should be.  They only go by what the textbooks say but more and more women (men and children as well) are having other symptoms that have ended up being LS without the textbook itching/white patches.  

The increase in cancer percentage is the main reason to have this checked out.   You can control LS (no cure) and proper treatment reduces the cancer risk.  
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Avatar universal
I really hope that some of you ladies are finding relief. I was suffering from similar issues, which have been especially bad for the last 10 months or so. I was diagnosed with Lichen Schlerosus about 5 years ago and seemed to respond to topical corticosteroids initially, but then had a few glorious years without any real symptoms.  My obgyn didn’t think it looked like lichen schlerosus but couldn’t offer any help. I went to my dermatologist, who kind of blew me off at first. But then I went back to the dermatologist during a flare up and demand to be tested for a possible allergy to toilet paper. I couldn’t think of anything else that might be causing it because I stopped putting anything down there in the hope that my body might resolve the issue. So my dermatologist recently referred me for an allergy patch test (I got the T.R.U.E. patch test) and learned that I am EXTREMELY allergic to gold! I know, gold. Ugh. I've been wearing my white gold wedding band and ring for the past 10 years and was given a gold necklace last fall - this would account for all of my recent problems. But I admit, I was skeptical (to say the least) that a necklace would be responsible for all the hell I had been experiencing. I did some research and learned that although the areas that where jewelry is worn are sometimes unaffected, people can have reactions elsewhere on their body-including-DING DING DING- their vulvar and anal areas!!!!  And I did have flare ups in the vulvar and anal regions and extreme discomfort. But ever since I stopped wearing any jewelry (just to be sure!) I have been symptom free!!!! It’s been about 6 weeks and let me tell you, it’s been like heaven. I’m don’t even have to treat the area with any ointments!  I share this news in the hopes that some of you will have similar responses. I was suffering from swollen, inflamed, itchy, painful, and eventually had fissures in my vulvar skin. As you know, not fun. During a flare-up (which was at least weekly and would last for days) it affected just about every area of my life. I’m now not convinced that I even have Lichen Schlerosus – I think it was the gold allergy all along.
To find out more about this, look at the Allergic contact dermatitis section of the below link (page 4). And please ask your doctor, obgyn, or dermatologist to refer you for an Allergy Patch test. It’s not the most fun test to go through, BUT the possibility of change and HEALTHY skin is totally worth it. For you it might not be gold, but there may just be some other almost unbelievable explanation for this unfortunate pain. Best wishes on your journeys ladies!
http://ir.uiowa.edu/cgi/viewcontent.cgi?article=1255&context=pog

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Avatar universal
I have had this since Dec 2006 when I got my first split in the perineum. 2007 was the worst year of my life with pain and horrible swelling. But the worst was the medical circus that ensued. Not one physician believed me. Even a specislist we went to halfway across the country. improvemrnt csme when I asked to have my hormone levels checked. Estrogren, progesterone, testosterone , etc.  all extremrly low. HRT enmass improved everything. A month ago all of these HRTs were either eliminated or lowered drastically because of other health issues. And here I am looking on the internet for answers to the same problems!  And finding this forum is SO validating!  Thank all of you for sharing and pray for a miracle for all of us. CL
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Avatar universal
I have had this since Dec 2006 when I got my first split in the perineum. 2007 was the worst year of my life with pain and horrible swelling. But the worst was the medical circus that ensued. Not one physician believed me. Even a specislist we went to halfway across the country. improvemrnt csme when I asked to have my hormone levels checked. Estrogren, progesterone, testosterone , etc.  all extremrly low. HRT enmass improved everything. A month ago all of these HRTs were either eliminated or lowered drastically because of other health issues. And here I am looking on the internet for answers to the same problems!  And finding this forum is SO validating!  Thank all of you for sharing and pray for a miracle for all of us. CL
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Avatar universal
haven't been on any hormonal birth control in about 12 years and my symptoms started about 2 months ago. They come and go, negative to STD's. one fissure heals and another one appears ... very frustrating. Currently trying probiotics for women  ( from a natural medicine/ health store). Also started supplementing with silicea tabs ( supposed to help with skin conditions) and a natural remedy for yeast infections... So far a week into it, not much has changed and it is worse since my period started.
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Avatar universal
I have had the splitting problem for several years now.  Burns like heck when I go to the bathroom.....heals in a day or two but splits every time I have sex.  I have gone long periods of time with no sex because the burning splits hurt that bad.  Fortunately husband is supportive.  He has seen the split and is understanding, thank God.  But still, it's no way to live.  I have found that Organic Coconut oil works wonders.  It is a great lubricant for sexual activity.  I apply it every time I go to the bathroom.....all day long.....too.  No soap used for washing.  I use the Cetaphil moisturizing wash only.  no rough wash cloths or towel drying.  Hope this helps others.....
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Avatar universal
I have had similar problems as a lot of you. It started out as redness and slight itching. There was a small thin red line right in the middle of the skin above the clitoral hood. When I touched it, it stung like a paper cut but the skin wasn't broken. I put vaseline on it, thinking maybe it was an irritation from dryness and from intercourse. The vaseline helped but I didn't want to have to keep putting vaseline on every day, so I thought I would try a cream from the drug store for vaginal itching. MADE IT WORSE! After about a week of using the cream, the skin actually split open. No bleeding, but it still stings and I don't want it to get worse. I have an appointment to see my gyno in a couple of weeks, but am not too hopeful after hearing the rest of you say you haven't received much help in that direction. I do have something called endometriosis, but I've had it under control for a few years. It can cause a hormonal imbalance though, especially for women like me who treat it by taking birth control consistently without stopping for a period (doctor recommended).  When the skin actually split open, I put vaseline on it again to moisturize and protect it, and the next morning it looked so much better. This is leading me to believe that it is possibly a dermatologic skin problem. Maybe a dryness issue which gets further irritated when it rubs against underwear and clothing... so the vaseline in that case would help protect the area and keep it from becoming irritated. I will keep using the vaseline for now if that is what's going to help, but I'd love to find a better solution that doesn't require me to carry a thing of vaseline with me everywhere. I already am good about taking daily vitamins, but maybe I'll add in some extra Vitamin C and see if that helps. I'm interested in trying the Cetaphil solution some of you have found as well. I was worried it was something worse, like Herpes, but I've only been with one partner and the symptoms showed up long after we started dating, so I don't think that's the problem. Plus, I have no other symptoms. Just the fissure and occasional redness and itching. No weird or foul smelling discharge. I'm hoping my gyno will have an answer, but if not. I'm just going to keep using the vaseline until I see results from some other method.
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1 Comments
Did you ever find an answer? Suffering from the exact same thing.
Avatar universal
Hi
I would agree that it is not possible to Diagnose a herpes infection without a test that confirms it. That said I am positive for the herpes virus and have over 20 years experience with this condition. I am in the past few years experiencing the same issue as you describe with fissures/splits in my labial folds. The two conditions are separate and distinct! Herpes produces lesions or small blisters not cracks and the sensations are quite different.
I encourage you to keep looking for an answer to your problem.
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Avatar universal
check your vitamin B2.. do you have dry lips too?  you may have a lack of riboflavin  I am checking mine now  I have the same symptomes.
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Avatar universal
For about six years I have had the symptoms many describe on here - the regular tears and discomfort during sex /using a tampon being the most prominent, with problems both external and internal.

Four or so years ago my GP suggested using anti depressants which both me and my husband were unhappy about doing. I was referred to a gynae who on examination said he couldn't see anything and advised again anti depressants to help me relax before sex. I was also given a plastic tube to, well, practice sex with.

My general history is of thrush perhaps four or five times in my adult life, and sadly a bad bout of BV, chlamydia and urine infection from unprotected sex, before I met my husband; which could make my vagina generally vulnerable.

However, I've been with my husband for 10 years and so for the first four our sex life and my vagina were absolutely fine!

I happened to have a facial operation scheduled at the beginning of 2009 and with that going on and a house build, I put my problems aside but sadly the sex life dwindled to just a handful of times a year. I'm lucky to have a very understanding husband!

In Britain we have a programme called Embarrasing Bodies which features candid examinations of ailments and conditions and just at the end of last year they featured a woman with similar symptoms. They happened to film her visiting a clinic fairly local to me but before I visited them, I have done further research and found many mentions of applying evening primrose oil inside the vagina (that's always been my main problem, with 'external' vulval problems coming and going.

So far, I feel like sex has become a little less painful. However, it's still uncomfortable to sit on chairs, ride a bike etc., so I will persevere for now. I also took it orally before my last period and it really helped.

On the plus side I have not had fissures for about five months now. I use a natural cleaning brand in the shower, and try my best not to irritate the vagine with excessive wiping after using the toilet. I was intrigued about the comment about whether surgery food plays any part; I will certainly monitor my intake to see if there's a pattern. The fissures I could never understand as I could never remember 'tearing' the skin.

Anyway, it's been heartening to know I'm not alone and I hope we lull find a solution xx

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Avatar universal
I am so glad I found this thread. While I wouldn't wish this itch, the cuts and uncomfortableness on anyone, it is good to know I am not alone.  I am having a vulva biopsy done next month and hopefully will get some answers.  

Today is a bad day and I am I am at my wits end.  I have two different prescription drug salves but no relief so far, it just keeps coming back.  The frustrating part is my ob/gyn said the skin was not looking inflammed etc.  But to me it seems so raw.  She has been treating it as Lichen Sclerosis.  
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Avatar universal
Hi

Re vulval vulvar fissures

I may be a bit late in entering this thread but I had to comment. I've been fissure free for two years now after suffering from them all the way through my relationship and then marriage to my now ex husband - 17 years in total. I'm 45 years old

I suffered from long paper cuts all along the outside of my clitoris where the middle bit joins the outer large lips - ie in the fold of skin there

I remember that I started getting them just after we started dating and sleeping together as my doctor (who didn't remain my doctor for long afterwards) asked me if my new boyfriend had long fingernails!!!

Not a day went by without one as far as I recollect although I'm probably imagining that - pretty much seems like that though on reflection.

I tried all sorts of things and went for all sorts of investigations but it's only now that the revelation has hit me. I only had them when i was sexually active with one person ie my Husband and had none before him and now after him I don't have one!

I had read somewhere several years ago that you can be allergic to your partner's semen and I kind of poo pooed it at the time. It seemed ridiculous....

Now I can take that as the only answer as I didn't have them before him and don't have them now, after hime. NOT AT ALL. NOT ONE.

I have had a few sexual partners since my split two years ago and haven't suffered at all. NOT EVER.

This won't be much comfort to anyone in a loving relationship where the idea of leaving your partner or refraining from sex is simply not an option but I thought I'd just put it out there.

I hope you find a solution to the horrible affliction and I wish you well
xxx
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Avatar universal
Hi

I may be a bit late in entering this thread but I had to comment. I've been fissure free for two years now after suffering from them all the way through my relationship and then marriage to my now ex husband - 17 years in total. I'm 45 years old

I remember that I started getting them just after we started dating and sleeping together as my doctor (who didn't remain my doctor for long afterwards) asked me if my new boyfriend had long fingernails!!!

Not a day went by without one as far as I recollect although I'm probably imagining that - pretty much seems like that though on reflection.

I tried all sorts of things and went for all sorts of investigations but it's only now that the revelation has hit me. I only had them when i was sexually active with one person ie my Husband and had none before him and now after him I don't have one!

I had read somewhere several years ago that you can be allergic to your partner's semen and I kind of poo pooed it at the time. It seemed ridiculous....

Now I can take that as the only answer as I didn't have them before him and don't have them now, after hime. NOT AT ALL. NOT ONE.

I have had a few sexual partners since my split two years ago and haven't suffered at all. NOT EVER.

This won't be much comfort to anyone in a loving relationship where the idea of leaving your partner or refraining from sex is simply not an option but I thought I'd just put it out there.

I hope you find a solution to the horrible affliction and I wish you well
xxx
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Avatar universal
Hello, I jus wanted to respond.  I am 48 years old, and have those exact symptons.  I first noticed it 5 years ago.  I actually went to my gyno when I had a fissure exposed.  Looks like small cracks that bleed in the folds of the labia.  Some redness and itching too in the anal region.  Well she ruled out herpes...Did a culture on the actual fissure and did not know why I had it.  I get it occassionally.  Maybe once a year or so.  I do not take any medications or supplements of any kind.  I eat a well balanced diet and am not over weight.  I feel I may be in the beginning of the pre-menopause stages, do not experience any vaginal dryness and menstruate every 28 days.  I keep a very close watch of my body and I have found that I mostly expereince this when I have more stress in my life at the time.  I know this may not make much sense, but as a avid health conscious person, I do believe stress is the culprit of many of our physical ailments.  Hope this helps.
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Avatar universal
Oh my god I thought I was the only person in the world with this problem!! So glad ive found this website, But so sorry to u all who are suffering like me :(. A couple of weeks ago I started getting horrible symtoms e.g pain during sex, sore swollen vagina, smelly discharge. AND THEN these weird cuts either side of my clitoris which are soooo painful I can hardly wash down there let alone touch it! I kept putting off going to the doctors untill these cuts but this was the last straw i was in soo much pain.so last week I went to the docs and had a swab done (which killed me!) the results came back that I had bv (bacterial vaginosis) im on anti biotics now, does anyone know if these cuts are because of my infection?? and will they go away after my course of tablets ? I hope so :(. Louise x
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Avatar universal
I am so glad I found this website! I have been having the fissures/small cut(s) at the top of my vagina, right above the clitoral hood, and the pain and itching for about 8 months. They first appeared when I was pregnant with my 2nd child. When the symptoms first happened, I was told by my doctor that I had a really bad yeast infection and after taking antibiotics, it got better but only for about 2 weeks. When it returned, I went back to the doctor who then did a culture for Herpes which came back negative. He prescribed a cream called Premarin or something like that, it is an estrogen cream, which was expensive and in my opinion did not help at all! So I called the doctor to make another appointment but was told I had to talk to the nurse manager first who, instead of making me an appt, told me the doctor was just going to call in another prescription for me. By this time, I was completely FED UP because I felt like he wasn't listening to me at all. I went to see a new doctor today who DID NOT do a culture but she said based on her experience, she thinks it is genital herpes and keep in my mind, this is WITHOUT a blood test and WITHOUT  a culture. I am truly shocked that a doctor will tell someone they have genital herpes without even doing one test!!! Has anyone else experied this? So now I have absolutely no idea what to think. I am completely terrified that I have herpes. Tomorrow I am going to see my old OBGYN who I saw during my first pregnancy and I am hoping that she can give me some answers. When I was on the phone with the nurse at my old OBGYN's office, she told me it was insane for a doctor to diagnose herpes without doing any actual testing so I am still hoping and praying that it is not herpes. But I guess if it is, I will at the very least finally have an answer and hopefully be able to get it under control!

Thanks for all the posts!
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Avatar universal
I have been dealing with this issue for five years now after the birth of my first of three children.  

One thing that helped me is the application of raw untreated honey to the area.  I leave it on for five minutes and then wash it off in the shower.  It must be RAW (or unheated / untreated) honey as this maintains it's antibiotic properties.  Immediate relief, and it seems to clear up the skin fissure really fast.  The skin seems a lot better as well, not so sensitive.

I do not use soap on the area anymore, and now only use a water based dermatologically tested lubricant.  

Hope that this helps.
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Avatar universal
I'm so relieved to find that I'm not alone with this. I've been experiencing this problem for most of my adult life and lived in dread for a long time that is was Herpes. Come to find out that it's not Herpes, nor is it a bacterial or other viral infection. I get just one small fissure, in a natural crease, between the inner and outer lips of the vulva. It's colorless, blends in with the rest of the skin, and is almost invisible unless you know exactly where to look. It almost looks like a small paper cut. For something so small, it packs a BIG punch, for at times the intense itching and pain from it can be all-consuming.

I have found that using DESITIN ointment relieves the pain/itching almost immediately. After a couple of days the fissure is healed. Just wanted to suggest it to anyone who may not have health coverage and cannot afford expensive meds.

Good luck!
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Avatar universal
I am posting this same e-mail on all of my "watched posts," Because my problem is solved and I want to "pay it forward" one last time before I remove my name from this forum.

There seems to be more than one thing happening. I am writing to those women who: have a reoccurring rip-type fissures on the inside of the labia, between the labia and clitoris, along the natural fold. (Mine was always in the same spot. -Note my earlier posts.) You probably have sensitive skin, you are probably high-stress, you may be more "moist" than you think is "typical." You are in relatively good health-maybe you workout. You have at times thought it was everything from soap to rough sex to a "big" boyfriend. You have ruled out everything, one at a time including Herpies and other VD's with a test from Dr. It may be worse with hormonal changes, (monthly) or cyclically reoccurring or just always there to some degree. I had this same condition. "Chronic Whatever-itis" What ever they call it, it means your skin is inflamed. They are naming the symptoms, not the cause/problem.

I went to a Dr. He prescribed a topical steroid and a antibiotic. I also had a infection, which is common when things are out of balance down there. (yeast infections also can be commonly be present). I took the meds, it got better for a week, then came right back and I didn't return to Dr. for another year-just lived with it. This was the second Dr. I went to over the years for it. I had it 2001-2003, then all of 2008-2010. (You can wait and wait and live frustrated, (like I did), or go back as soon as the symptoms return and get your life back! Be assertive! I asked a lot of questions, gave him a ton of data on all that had "ruled out", that I was a serial monogamist that always used protection with my faithful boyfriends... (Frankly, I think he was bored with all of the talk, b/c they are trained to treat the symptoms with the mildest they think will work.) When I returned, He apologized that he didn't treat it more aggressively, the first time. By then I was crying and defeated thinking I would just have it forever. As he explained paired with my research and my first-hand account, this is what happened: At some time there was a trauma to the area, a scratch, rough touch, or yeast infection that went haywire. The body’s defenses are jumping on that area because it had an issue with that area already. My vaginal balance was way off. When the ph changes, and allows more bacteria/yeast to grow, (naturally through the month), that change/moisture irritated the area, increased discharge or sweat from working out or sitting too long, (little oven) irritated the area, my changing soaps and detergents 1,000 different times trying to solve the issue paired with extra wiping, washing and attention to the area irritated it and, it just never got to totally heal. All of the junk I put on it may have made it worse and the worrying didn't help a bit. He prescribed a "Z-pack" Which is Zithromax 250MG/Generic=Azithromycin=4 pills. He prescribed Flagyl 500MG=Metronidazole=14 pills. He prescribed Clobetasol .05% cream=a topical steroid, which I was going to use if I needed it after the antibiotics, but I didn't (maybe I used it for 2-3 days) - I was worried about the steroid, b/c of the fact that it thins the skin and it seemed counter - production intuitively to me). Anyhow the Antibiotics worked great! My body was able to heal itself after the Antibiotic Napalm Bomb. I have discolored skin from the years of trying to healing, but that too is lightening up and I have ZERO pain. It made me think of the "hard reset" on my computer. You know it's not great to do, but sometimes it must be done when nothing else is working. Also, separately and unsolicited -after seeing what I was prescribed, the Pharmacist volunteered that he had only seen this prescribed this way a couple of other time, but that it was quite effective for aggressively solving issues. By the way, he also said, "Do NOT drink alcohol with the one! Like no ‘wine sauce’ at dinner, no 'just a sip of wine.' No mouthwash- It contains alcohol- unless you want to be violently sick.

I wish you all luck in getting your issue taken care of.

Thank to everyone for all of your posts!
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Avatar universal
Wow, I feel so relieved, just to read some of your stories and how you cope has given me a sense of relief. I've never known anyone suffering with this, so I thought it must only be me. This only started with me a couple of months ago, I thought it was a stress escma as I have been under a huge amount of stress for some while now, not being able to afford to go to the Dr. tried all kinds of creams and potions, but the only thing I found that worked was Balmex for babies, admittedly, it does only clear it up for a while, then comes back. I too did use Dove, although I haven't used any soap for some while now just warm water and my own wash cloth and my own small towel.

I'm going to try some of the things you've suggested and see if I can get this gone, it's more than a nuisance, I want to get on with my life.

I love that you've shared your stories and that people like me can feel not so alone - Thank You       'backatcha'
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Avatar universal
BRILLIANT! This just saved me a whole lot of trouble, time and pain. I tried some cleansing wipes yesterday and today. Things are improving and I can't wait for it to just go away completely :) thankyouthankyouthankyou!
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Avatar universal
I've shared your troubles - ten years of misdiagnosis and being told I'm a hypochondriac who should stop wasting people's time. I will say however that despite how bleak it may seem, a loving partner can help you have sex, even on an irregular basis when the flare-ups have died down some. Good luck.
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