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Initial management relies on the avoidance of contact with irritants (see: “ Strategies to reduce vulvovaginal irritation ”) and the use of emollients. 7 Low-potency topical corticosteroids, . 1% hydrocortisone, can be trialled to reduce inflammation. In women with severe itch, an oral sedating antihistamine or tricyclic antidepressant may be required at night. 7 Vaginal swabs are appropriate if there is abnormal discharge or malodour, as there may be co-existing infections or symptomatic bacterial vaginosis that should be treated appropriately. The use of topical oestrogen can increase the incidence of Candida albicans vaginitis, which is otherwise uncommon in post-menopausal women.

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Propionate lump

propionate lump

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