Vulvar fissures are small tears or cracks in the delicate skin of the vulva. These can be quite painful. While concerning, these skin breaks are typically treatable. This article provides guidance on managing and preventing vulvar fissures for relief and long-term vulvar skin health.
Understanding Vulvar Fissures
Vulvar fissures cause pain, burning, and itching. These sensations often intensify during urination, wiping, or sexual intercourse. The pain can be sharp and stinging, particularly when urine or semen contacts the fissure.
Various factors contribute to vulvar fissures. Common causes include dryness, friction, and irritation from soaps or personal care products. Underlying skin conditions like eczema, lichen sclerosus, or contact dermatitis can make skin prone to cracking. Infections (yeast or bacterial) and trauma can also lead to fissure formation. Hormonal changes, such as those during menopause or breastfeeding, can cause thinning and dryness, increasing susceptibility.
Initial Home Care and Lifestyle Changes
Managing vulvar fissures begins with home care to promote healing and reduce irritation. Gentle hygiene practices are fundamental. Use only warm water for cleansing, or a mild, unperfumed, hypoallergenic cleanser if necessary, avoiding direct soap application. After washing, gently pat the area dry instead of rubbing.
Avoiding irritants is crucial. Avoid scented products like perfumed soaps, bubble baths, douches, and feminine hygiene sprays. Tight clothing and synthetic underwear increase friction and moisture; opt for loose-fitting, breathable cotton. Using hypoallergenic laundry detergent can also prevent irritation.
Applying emollients or moisturizers helps protect the skin and maintain hydration, which supports healing. Options like petroleum jelly, vegetable oil, coconut oil, or specialized healing balms create a protective barrier. Apply after cleansing and before bed for overnight healing. Reduce friction, especially during sexual activity; use generous water-based lubricant to prevent new tears.
Medical Interventions
If home care is insufficient or fissures persist, consult a healthcare provider for diagnosis and medical intervention. A professional can identify underlying conditions, testing for infections or evaluating skin disorders.
Topical medications treat vulvar fissures, depending on the cause. Corticosteroid creams reduce inflammation and promote healing, especially for fissures linked to inflammatory conditions like lichen sclerosus or dermatitis. Apply these creams directly, often daily, tapering as symptoms improve.
For fissures linked to hormonal changes (menopause or breastfeeding), estrogen creams restore tissue thickness and elasticity. If infection is present, antifungal or antibiotic creams will be prescribed. If conservative treatments fail, minor surgical procedures may remove persistent fissured tissue and promote healing.
Preventing Recurrence
Preventing recurrence involves ongoing attention to lifestyle and consistent skin care after healing. Maintaining gentle hygiene is crucial; use mild cleansers or just water, and avoid harsh scrubbing. Regularly moisturize vulvar skin with bland emollients to keep it supple and less prone to cracking.
Consistently avoid known irritants like scented products, tight clothing, and certain detergents for long-term prevention. Manage any underlying medical conditions to prevent recurrence. For instance, those with chronic skin conditions like lichen sclerosus should adhere to prescribed treatment plans, often involving regular topical corticosteroids, to maintain skin health and reduce fragility. Address hormonal imbalances, if identified, to prevent future fissures. Regular check-ups with a healthcare provider monitor vulvar health and adjust preventive strategies as needed.