severe itch

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by Guest Posts on Mon May 10, 2021 10:05 am

severe itch

I am a 70 year old diabetic who was diagnosed with lichen sclerosis 5 years ago. I have suffered from vulva / vagina itch for years, thinking it was yeast infections and treating myself. I have been using Clobetasol only when I had severe itching and sparingly because I was told by my male gynaecologist that it was a steroid and could cause thinning in my skin making it too fragile. I have a new gynaecologist now and she informed me that I had to use the Clobetasol everyday for a month , then 2 x a week for the rest of my life . My problem is the severe itch that keeps me up at night. I have been prescribed hydroxyzine 50 mg to take at bedtime. I know it is supposed to sedate me and relieve the itch. It does neither. Can you suggest anything that will relieve the itch , so I can sleep. Also , this is the worse flare I have had since I have been diagnosed. We now have a hot tub that uses bromine for sanitation ,can hot tubbing prevent the Clobetasol from being as affective as it was in the past ? Also , I am on a new drug for diabetes (Jardiance] I understand that it can cause more yeast infections and UTIs. My last vaginal swabs were negative. Wondering though if the more frequent urination and peeing out the extra glucose is irritating my vulva.
Any advice would be great appreciated as “ The Itch” is hell and debilitating both physically and mentally.
talkhealth team on behalf of a guest visitor

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Dr Karen Gibbon
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by Dr Karen Gibbon on Thu May 13, 2021 1:45 pm

Re: severe itch

I'm so sorry you're struggling with such a severe itch. My thoughts are as follows (not in order of importance):

1. Get your HbA1C level (measure of long-term glucose control) into the normal range with your diabetic medication. Ask your GP to check if your iron levels are in the normal range too.
2. Ask your GP to consider prescribing a weekly thrush agent eg fluconazole 150mg for 6 weeks to see if this helps eradicate any chronic candida on the external skin (providing it doesn't interact with any other medication you're also taking)
3. Are you using the right amount of topical clobetasol and applying it to the right areas - that is not meant to be patronising but using a mirror to check where it's needed can be helpful
4. Are you avoiding pads, panty liners, wet wipes and fragranced products - all are known to be irritant to the vulva.
5. I'm not a fan of hot tubs - the chemicals used to keep them clean can be quite irritant to already thinned vulval skin.
6. If you have any incontinence issues they should be investigated and treated accordingly.
7. Remember to use your emollient cream or ointments regularly - keep a supply of them by your bedside for nigh time use.
8. If despite all of the above your symptoms persist - ask to see a dermatologist. sometimes allergy tests need to be performed to check you're not allergic to the treatments you've been given.

Good luck!
Dr Karen Gibbon
Consultant Dermatologist

http://www.talkhealthpartnership.com/on ... gibbon.php

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