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  • Q&A with Australian Health Practitioners

    Why do I have such "skin" discomfort in my genital and anal area?

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    Dermatology Women's Health
    I was diagnosed with Lichen Sclerosus many years ago. Have always been questioned about this diagnosis. I suffer terribly with irritated , painful, split skin , prescribed various lotions Etc, which give some temporary relief. It seems that I cannot get any definitive answer or confirmation that I do have this condition. Consequently, I nearly always feel uncomfortable and toileting can be excruciating. I'm 64, have had Hysterectomy, STAMP procedure, and currently coping with an Enterocele. Have been using Ovestin Cream since Hysterectomy but have been advised to discontinue as there is very strong family history of Breast Cancer. Where do I go for help - Dermatologist or Gyneacologist???
    • 2 answers
    • Dr Joseph Jabbour
    • Glenda Leonarduzzi
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    Dr Joseph Jabbour

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    Dr Joseph Jabbour is a specialist Obstetrician & Gynaecologist and Fertility Specialist with Monash IVF situated in Sunnybank (Brisbane Southside). Dr Jabbour has had the … View Profile

    Lichen Sclerosus (LS) is a diagnosis based on symptoms, appearance of the vulva, and confirmed with a vulval biopsy. Firstly, did you have a proper examination by a gynaecologist and did you have a biopsy to confirm the diagnosis?

    My recommendation would be to see a gynaecologist urgently who will do a proper examination and obtain biopsies to confirm the diagnosis. The treatment for LS is a potent topical corticosteroid cream such as Diprosone (Betamethasone). This is to be applied for a 12 week period; nightly for 4 weeks, every other night for 4 weeks, then twice weekly for 4 weeks. This should treat the condition. 

    In regards to the ovestin cream, its oestrogen content is low and the absorption rate into your system is very low. It is not the same as taking a tablet and having a patch on. Therefore I still prescribe it to patients suffering from a dry vagina. There is enough evidence in the literature now that proves its safety in women with a strong family history of breast cancer. You can also discuss this with a gynaecologist. 

    So to answer your question, go see a gynaecologist for help.

    I hope it works out for you.

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  • Glenda Leonarduzzi

    HealthShare Member

    Thank you so much for taking the time to answer my query. Fortunately, I have been able to finally avail myself of help from a well informed Gyneacologist who specializes in this problem!! We now have a plan of action, and things are settling down beautifully. The situation regarding Ovestin etc, has been sorted and I now have the appropriate medication. I was diagnosed by a Gyneacologist years ago, but no follow up or explanation given. I have had a biopsy performed - indicative but not conclusive - it's been a long, lonely road, but finally I'm getting there.

    Once again a big Thank You for your time and expertise, it's very reassuring.

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