Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Pruritus vulvae - Management
Basis for recommendation

CKS identified no trial evidence to support these recommendations. They are based on guidelines published by the British Association for Sexual Health and HIV [BASHH, 2007] and published expert opinion [Salim and Wojnarowska, 2005; RCOG, 2010].

Lichen simplex

  • The recommendation to use potent topical corticosteroids in women with lichen simplex (for a short period) to bring the condition under control in the early stages is based on published expert opinion [Salim and Wojnarowska, 2005]. It is thought that weaker-potency topical corticosteroids are not effective for breaking the itch-scratch-cycle in women with lichen simplex.

Lichen sclerosus and lichen planus

  • Referral is recommended to confirm the diagnosis because women with lichen sclerosus and lichen planus have a small risk (3–5%) of developing cancer.

Skin patch testing

  • The recommendation to refer a woman with dermatitis to dermatology for skin patch testing is based on published expert opinion from the Royal College of Obstetricians and Gynaecologists (RCOG) [RCOG, 2010].
    • The RCOG state that specific allergic reactions are often identified in women with pruritus vulvae and that most studies suggest that 26–80% of women referred with vulval symptoms have at least one positive result on patch testing. The most common allergens identified have been cosmetics, medicaments. and preservatives. Other allergens identified include fragrances, preservatives in topical treatments, rubber, and textile dyes.

© NHS Institute for Innovation and Improvement