Inflammation

[freeofls24]

Diagnosed with LS and vaginal atrophy June 23.
Using Clobetasol Propionate on vulvar twice weekly and Estriol 1mg internally and on vulva twice a week. Using hydromol and coconut oil for emolient/barrier. Had biopsy 7 weeks ago on posterior forchette and it came back as inflammation with no abnormality. No guidance given as to how to manage inflammation and I don't see NHS gynaecologist until end August. Any tips on managing the soreness/redness/inflammation of posterior forchette and the vagina opening. The Clobetasol and Estriol both seem to make it worse. Does the redness ever go away?

[Dr Rosalind Simpson]

'Inflammation with no abnormality' is quite non-specific as does not state the type of inflammation found. There are different cell types found in inflammation as well as features seen in the structure of the skin cells which can steer towards the cause for the changes. It is important that a biopsy sample is assessed by a histopathology doctor (who looks at samples under the microscope) who is used to looking at biopsies from this area as subtle changes can be challenging to pick up.

It is possible that oestriol being applied to the skin can cause some local irritation.

In this situation, with the cause for soreness being unclear, I usually recommend to keep using the barrier preparation (hydromol), avoid soaps and shower gels, use hydromol instead of soap, and discuss with your doctor whether any further investigation is needed (e.g. swabs to check for infection) and whether a change of topical steroid treatment is required.