Topical Steroid Withdrawal and eczema of the genitals

Eczema or TSW of the genitals is a delicate subject that affects more people going through topical steroid withdrawal, eczema and sensitive skin than you may realise. It is particularly a problem for women due to the anatomical make up and delicate balance inside the vagina, but can also affect men’s genitals too.

What on earth do you do when you get eczema, oozing, excessing flaking and itching skin ‘down there’!

What is vulvar dermatitis?

Eczema of the soft folds of the vulvar is far more common than you might realise because there is still a lot of taboo about discussing our genitals. I don’t know why, all women have them! It can be very painful, forming tiny thin cracks, be very itchy and cause vaginal weeping and a crusting formation. Please do not use topical steroids to try to heal any eczema here. The skin is so soft and sensitive and could become very damaged. Instead look at removing all fragrances and soap and just wash gently with warm water. The tips below may also help.

Tips for alleviating eczema and TSW of the genitals

It’s a dark, humid warm place so if the skin gets irritated it can become a real problem so here are my tips for coping and the things I found helped me. They are also cheap and available in your home so shouldn’t cost the earth.

1. Apple Cider vinegar baths – add a cupful of apple cider vinegar to a warm bath and submerge your lower half below the water level. Rinse off with warm water after soaking for 20 minutes.
2. Tea tree oil – add 5-10 drops of tea tree oil to your bath as this also can help to avoid any infection.
3. Bicarbonate of Soda bath – Add about 5 tablespoons of bicarbonate of soda to a warm bath and soak for 10- 20 minutes max. It will help to soothe and reduce irritation. When the condition is really sore, you could do this twice a day but once cleared you can just have one periodically to keep the skin healthy and avoid further occurrences.
4. Colloidal oat compress or bath – oats can also be so soothing for eczema skin and can work great in the bath. How I’ve used them is to buy some muslin and string, make a little pouch or bundle, put in a few tablespoons of oats (you can use any oats, but colloidal oats will work even better. You can get them from your local chemists). Tie up the muslin pouch and drop it into your bath water. For added healing, hold the wet muslin pouch over the affected area to soothe.
5. Jug of warm water with apple cider vinegar – I have a jug that I fill with water and add a table spoon of apple cider vinegar and mix. After using the toilet, and whilst still seated on the toilet, pour this jug full down over your perineum and practise tipping your body so that the water trickles into the vulva and washes out into the toilet. Using toilet paper, gently wipe and dry from front to back. Pat dry with a towel. If you are out and using public toilets this might not be possible. If you can, grab a wad of paper towels used for drying hands, or if not available, some loo roll and dampen it. Take this into the loo with you and use to gently wipe over the area, front to back, after you’ve emptied your bladder and bowels. Be careful not to block the loos though. This can also really help if you are experiencing a lot of pain when you pee and the urine gets into cuts and sores. Pour the warm water down between your legs as you pee and it should avoid a lot of discomfort and pain.
6. Only wash with water – no soap! Just use a soft flannel and warm water.
7. Bamboo flannels – I use super soft bamboo flannels and wash at a basin, from front to back. I have quite a few of these and put them in the wash after one use. They are a great eco alternative to using disposable wipes which could also irritate the skin. A healthy vagina is self cleaning and does not need soap anywhere inside the labia. I use Eczemaland bamboo flannels. You can get 15% off using code Ruth15 at https://eczemaland.co.uk/
8. No fragranced products – avoid any perfumed or fragranced products, bubble baths, bath bombs, moisturisers, toilet roll, sanitary products and soaps when cleaning female genitalia, especially if you have sensitive skin.
9. Air it! – At night, don’t wear any panties. Let the area get as much air as possible to avoid it getting warm and itchy. Choose 100% cotton underwear or bamboo or merino knickers to ensure the skin can breathe and not get over heated.
10. Pat dry – Try to be really gentle when wiping. If can remember to dab gently and pat dry it will help to not open up those tiny little cracks in the skin and aid healing.
11. Vitamin E oil and tea tree tampons – If the skin inside your vagina becomes badly affected, soak some tampons in a simple oil such as vitamin E oil or grapeseed oil, mix in a few drops of tea tree oil and insert into the vagina for a few hours, them remove, throw away and insert a freshly soaked on. Do this a few times once a week and this should help and aid healing.
12. Avoid tight clothing – whilst the skin is affected, and all the time if you can, avoid tight clothing that rubs or chafes the groin. Choose loose natural materials and wear cotton tights if you can instead of nylon.
13. Plain unbleached toiler roll – Don’t buy fragranced loo roll. It’s completely unnecessary and is not good for the delicate flora of our genital areas. You might find, Allergic to toilet roll – fragrance allergy interesting. Choose instead just basic, white, uncoloured and unbleached toilet paper.
14. Avoid sex – it goes without saying that sexual intercourse will only make this worse. If you can abstain until you’ve healed the skin you will avoid a lot of extra discomfort.
15. Natural lubes of you do have sex – If you do find yourself caught up the moment, make sure you have some natural lubricants to hand. Even if you don’t think you need it, it will avoid chaffing and irritation of any sensitive bits. Think coconut oil, vitamin E oil, aloe vera, evening primrose oil. Experiment to find something that works for you and patch test first on a small area before going the whole hog! Check out this article from Women’s Health magazine – 15 best natural lubes for a happy vagina according to gynos.
16. Ice – wrap an ice pack in a tea towel or scarf and gently hold it between your legs for relief when it feels hot and itchy.
17. Try not to itch or rub too hard – It can make things much much worse but I know how impossible it is sometimes to ignore that bone deep itch. Try to do it as gently as you can. I find the ice tip above helps a lot with the itch.
18. Moisturise sparingly – I would recommend trying to avoid moisturising inside the vagina if you can. It should be able to self lubricate. But if you really feel dry and sore it can be really soothing to apply something. Stick to unperfumed non fragranced products. I found a little Epaderm soothing when it was really sore. Lyonsleaf marshmallow balm also helped. Visit my discounts page for promo codes for Balmonds and Lyonsleaf balms, both safe to use on genitals.
19. Don’t shave down there – if you can avoid it, any serious hair removal in the lady garden will probably be very irritating. By all means trim and edge as the less hair there can also mean less hot and sweaty, but be gentle with her. She’s fragile and I’m pretty sure you’ll regret it!
20. Crotchless tights – a godsend in winter. I can go for walks in a thick winter skirt and these special tights and get lots of cold air up there to freeze the beejeezus out of my nether regions. Brought some relief that can otherwise be caused by the rubbing of trousers and other clothing. I had mine from years ago when I kept getting thrush and can’t remember where I got them now. I think BHS or one of the old department stores. Nothing saucy, just bog standard nylon tights with the gusset removed. Really hard to get on – like a mensa challenge sometimes but for sore minges they’re a win. You could of course modify some old tights. Or get some stockings and suspenders.

I hope you can find some help and comfort from some of the above. I really feel for you all, I’ve been there and it’s nasty! You feel like you can’t even go out in case you need to itch your crotch – not really acceptable behaviour is it?

NB: I AM NOT A DOCTOR – If you have any worrying vaginal discharge that is painful, stings or smells nasty you should seek advice from your doctor or local STI clinic who can test to ensure you do not have anything that requires antibiotics or further treatment. Left untreated infections or STIs can cause long lasting damage and spread to your sexual partners so please be responsible and get checked out. I am not a doctor so the advice above is just things I’ve found that have helped me. Please get checked with your doctor if symptoms persist. You can also get checked out at your local STC clinic or from the comfort of your own home at http://www.letsgetchecked.co.uk

You may find this link from the Eczema Society useful, but please ignore advice to put any topical steroids on your genitals. That way pure destruction lies! Read Female Genital Eczema.

For some truly fantastic insights into the experiences of both men and women going through TSW who have experienced problems with the skin around their genitals, read: Let’s Talk about TSW and the genitals from my amazing friend Cara’s blog.

Photo by Rosana Solis from Pexels

Further reading

• Pruritis ani, itchy bum or labial eczema
• Perfumed sanitary products cause to sensitive skin
• Wireless comfy bras for sensitive skin