Dermatologists or gynaecologists with the necessary expertise will be able to give comprehensive advice for the treatment of individuals, but in general the following management is suitable.

• Manage the underlying dermatological cause.
• Contact dermatitis
• Identify and remove exposure to irritants (for example soaps and deodorants).
• For mild itching, consider prescribing a mild potency topical corticosteroid ointment, such as hydrocortisone 1% for 2–4 weeks, and then review.
• Seek specialist advice if stronger corticosteroids are being considered. Stronger potency corticosteroids (such as betamethasone or clobetasol) may be considered if, symptoms are severe, if the skin is lichenified, or to break the itch-scratch-cycle.
• Consider referral to dermatology for skin patch testing if avoidance of irritants has not helped.
• For more information, see the CKS topic on Dermatitis - contact.
• Seborrhoeic dermatitis
• Ketoconazole shampoo can be used as body wash for seborrhoeic dermatitis.
• For more information, see the CKS topic on Seborrhoeic dermatitis.
• Psoriasis
• For management information, see the section on Treatment in the CKS topic on Psoriasis.
• Lichen simplex
• Consider prescribing a potent topical corticosteroid ointment (such as betamethasone), for 1–2 weeks to break the itch-scratch cycle and bring the condition under control.
• Lichen sclerosus and lichen planus
• Refer to secondary care for confirmation the diagnosis.
• Once the diagnosis is confirmed in secondary care, very potent corticosteroids are usually initiated by a specialist, repeated intermittent courses of topical steroids may be required for longer term management.
• For more information on prescribing:
• Topical corticosteroids: see the CKS topic on Corticosteroids - topical (skin), nose, and eyes.
• Emollients: see the section on Emollients in the CKS topic on Eczema - atopic.