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Old 07-16-2007, 03:06 PM   #1
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use of hydrocortisone creams on vulva

Hi,

Does anyone know of how often a 2.5% hydrocortisone cream can be used on the vulva without concern of thinning or other side effects?

Also, can hydrocortisone be used inside the vagina as opposed to just the vulva?

Any other over the counter creams that others have tried to help with intense itching and burning?

I am seeing a dr but no results can be found for my intense itching and burning as yet. Specialist in a month but I will most likely be insane by then if I can't get some relief from the itching. Like others here, this has turned into a chronic and very debillitating problem. I had a tumor in my spinal cord for a year and the pain and suffering wasn't anywhere near as bad as this is.

Thanks
Jean

 
Old 07-16-2007, 10:51 PM   #2
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Re: use of hydrocortisone creams on vulva

Since you have already been to one Dr, I am assuming they did a culture for yeast and it turned up negative. (They generally go and look at it under a microscope right then and can tell you right away if it is yeast or not.) If this wasnt done, then yeast should definately be ruled out.

If yeast has already been ruled out, then has a Gyno ruled out STDs? Not to scare you, but many STDs can also cause the symptoms you describe.

If it isnt either of the above, then Vulvadynia is a real possibility. It is a condition that causes extreme itching, feeling raw and sometimes swollen. It can come on out of nowhere, but it can also disappear just as suddenly as it came. It is not an STD. You cant give it to someone else or catch it from someone else. Some women (but not all) report feeling small tears that feel like tiny paper cuts. Some report feeling tenderness, pain, and painful sex. Some also report burning during urination. Symptoms differ from patient to patient. In some women, the vagina looks red and swollen, while others with the exact same symptoms show no visible signs on examination.

The bad news is that there is no cure for Vulvadynia, but the good news is there are lots of meds and treatments you can try. Lots of women experiance complete symptom relief from them, while others only experiance partial relief. Some women go into weeks, months or even years long remissions, while others never get a break from it. A good Gyno can be your best friend dealing with it, if this is in fact what you have. Most women report that it is at it's worst right before their periods and/or during ovulation.

Though no one knows the exact cause of it, there are many theories floating around. Some belive there is a hormonal componant to it. But, so far, nothing has been proven.

For most Vulvadynia patients, a muti-faceted approach works best in treating it. Many patients begin by starting the Low Oxalate Diet. You can do a web search to find out about it. This is something you can start now, even before you get in to see your Dr. Some women report immediate relief from this step alone, though most also require meds.

The usual meds for this are Elavil or Cymbalta (antidepressants that also help with neuropathic pain.) Also, neuropathic meds such as Neurontin, Keppra, Lyrica, or Topamax, have proven helpful to many. Hydrocortisone cream is a no-no, so put that stuff down! There are r/x creams and gels that can help. Most Gynos will r/x a med like Premarin cream. It is a hormone cream, but it is r/xed in a very low dose. It helps to thicken the thin vaginal tissues and sort of "toughen them up". Also, most will r/x Lidocaine 2% jelly, a topical numbing gel. Some Drs. also r/x an antihistimine, since many chemicals are so irritating to Vulvadynia patients and cause the mast cells to engage, setting off an inflammatory reaction. You can try OTC antihistimines, as many patients find this helps the itching alot! (Many patients (but not all) report having multiple chemical sensitivites.) Whether you do or not, the antihistimines could certainly help with the itching!

You will also be advised to manage yeast infections immediately, as these can exacerbate Vulvadynia. There are now OTC Yeast infection test kits. If you suspect a yeast infection, it is imperitive that you get it d/xed and treated immediately or else it can set off a Vulvadynia flare. Most Vulvadynia patients find it helpful to eat some yogurt daily with live cultures or to take a probiotic, in order to prevent yeast infections.

You will also be advised to wear only white, cotton undies since synthetic materials and dyes can aggrevate this conditon. You will also be told to avoid bubble baths, scented soaps and bath products. If you DO use these, it is best to use them in the shower instead of the bath, so you wont be sitting in the product. The fragrances and chemicals can be very irritating.
Also, use only unscented tampons and maxipads. (Using the cup would be preferable.) When you wash, try to use only water on your vagina, and when you HAVE to use something else, use only mild unscented products like baby soap. Also, use unscented laundry detergent to wash your undies and no fabric softener.

Sometimes cold compresses or ice packs can help stop and itching cycle. It is worth a try!

That's all I can think of right now! Hopefully, you dont have Vulvadynia. But, if you do, it CAN be managed. Right now your best bet is to find a good Gyno and get d/xed. As soon as you are d/xed, you can start treating and managing your condition.

I hope I havent scared you and that you get to feeeling better soon!

Hugs,
Amy

 
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Old 07-17-2007, 04:46 AM   #3
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Re: use of hydrocortisone creams on vulva

Quote:
Originally Posted by jean3333 View Post
Hi,

Does anyone know of how often a 2.5% hydrocortisone cream can be used on the vulva without concern of thinning or other side effects?

Also, can hydrocortisone be used inside the vagina as opposed to just the vulva?

Any other over the counter creams that others have tried to help with intense itching and burning?
I don't believe the cortisone creams are for internal use. The tube I have says "external use only" so I really wouldn't try that. Have you tried Vagisil?

 
Old 07-17-2007, 06:41 AM   #4
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Re: use of hydrocortisone creams on vulva

Jean,
I understand about the itching. I have a problem with recurring yeast. My skin was both itchy and really red and irritated. My doctor prescriped an anti fungal ointment, i use it in the morning and at night and it really helps. And my skin doesn't look as irritated.
I wouldn't advise cortisol for internal use. There are also anti itch creams in the section of the store where they have vagasil and stuff like that.

 
Old 07-17-2007, 08:56 AM   #5
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jean3333 HB User
Re: use of hydrocortisone creams on vulva

If it isnt either of the above, then Vulvadynia is a real possibility. It is a condition that causes extreme itching, feeling raw and sometimes swollen. It can come on out of nowhere, but it can also disappear just as suddenly as it came. It is not an STD.


Amy,

Thank you so much for taking the time to write all this, it is extremely helpful. You lay it all out so well, many of the symtoms you describe are exactly what I have experienced.

Yes, I've been through about every test for every dang thing from pinworms to HIV. Sometimes it is yeast, sometimes it is an UTI, sometimes nothing.

At one point my gyn told me not to treat my next flare up at all with anything until she could see me. It took a week to get in and by that time I had bloody sores covering my vulva and a diagnosis of a cutaneous yeast infection (in the skin). That sort of freaked her out, why a healthy person would have this, and so lots of tests for autoimmune disease and HIV and etc. But luckily I am healthy.

I went through this for two full years and then, like you say can happen, one day it all just miraculously stopped, completely symptom free. And now 15 months later I am back to this again. Errgghh! I am afraid that you might be right on the vulvodynia.

I am sure this latest episode started with a yeast infection, unfortunately my doctor would not give me a refill on the diflucan because when she looked down there every thing looked fine to her. Well, two weeks later I ended up at a walk in clinic on a Sunday morning and the doc there gave me three diflucan. After three days I am starting to feel slightly better.

One of the hardest and most frustrating parts of this is getting immediate and sympathetic medical care. The gyn takes awhile to get into and the primary care doc discounts my symptoms and lectures me about this not being life threatening. Actually, it is debillitating. And writing this, I have decided to dump my doctor, I don't need lectures.

I live in Seattle and just found out there is a University of Washington special Vaginitis Clinic with MDs who specialize in this. Why my dr and gyn have never referred me before I don't know. I have an appointment in a couple months.

I have some lidocaine gel and will use that and leave off the hydrocortisone cream.

Hey, thanks for listening.

Ann

Last edited by jean3333; 07-17-2007 at 08:59 AM.

 
Old 07-17-2007, 01:59 PM   #6
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Re: use of hydrocortisone creams on vulva

You are very welcome. As you can probobly tell, I have Vulvadynia, that is why I know alot about it. You are right, it definately can be debilitating and very nerve racking! (The worst is when you are itching in public and cant even scratch!)

I think you are right on track going to that place. It sounds like they will definately be able to d/x you there and get you some help. I hope that this isnt what you have and that instead you have something that can be cleared up with a few pills. But, it sure sounds like Vulvadynia.

I wish you the best. I hope you get d/xed and start treatments soon. I am sorry you have been treated so poorly by your past Drs. I hope that will all be just a bad memory from now on and that this new place will suprise you with the compassionate care they give.

Hugs,
Amy

 
Old 07-17-2007, 04:20 PM   #7
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Re: use of hydrocortisone creams on vulva

Thanks again, Amy,

I read up on the low oxalate diet and interestingly my latest flair up was after a few days of eating almost nothing but high oxalate foods.

And the symptoms are almost always much worse in the evening and better in the morning which would make sense if food is contributing to all this.
So, easy to make this change. Thanks for the idea.

Ann

 
Old 07-19-2007, 11:04 AM   #8
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Re: use of hydrocortisone creams on vulva

I have Vulvodynia also, but don't have problems with itching. So, you can still have Vulvodynia without itching. A female disease that causes itching is Lichen Sclerosis. It also causes burning. A Dermatologist who treats vulvar dermatoses will be able to diagnose that or other skin diseases. Do a ****** search and you'll find lots of info. Good luck.

 
Old 07-20-2007, 06:00 PM   #9
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Re: use of hydrocortisone creams on vulva

Thanks for the idea. Yes, itching seems to be the worst symptom. I read up on this and it seems the treatment is hydrocortisone cream which is what I was wondering about using to begin with.

 
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