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I had a bacterial infection (just regular vaginal bacteria) 6 mo.

ago,/ which took two courses of treatment to clear up and then a

yeast infection. It was then that my skin flared up. It was

purple,widespread and felt damp and prickly. Doctors prescribed

nistatin/triamacinolone,hydrocortisone and several other topical

treatments. The discoloration got some better and the areas affected

smaller, but the prickly pain, feeling of dampness and raw skin areas

conintue. My general doctor prescribed Lyrica and that has helped.

I went to a vulvar specialist who injected the areas with

triamacinilone. That has helped somewhat, but I am still left with

raw skin and pain. I have not worked or gone about my life for 8

weeks. I sit with loose clothing on trying to let the skin heal.

The specialist thinks it is a dermatitis. If I don't get more relief

he wants to do a biopsy. He gave me triamacinolone to use 7 days per

month and said I could use hydrocortisone daily. I tried the

hydrocortisone for two days and the area flared up again so I didn't

use it again. I don't even want to try the topical triamacinolone

mixture he prescribed now. I was hoping someone might have some ideas

on where to go for help. I feel like the longer this goes on the

worse it could become. I feel like I don't know where to go for

help. Any advise on what or where I might try?

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Hi, you didn’t mention what area you lived in. Maybe someone

could suggest a doctor if we had an idea of where you lived.

nne

From: VulvarDisorders

[mailto:VulvarDisorders ] On Behalf Of jselbridge

Sent: Thursday, April 24, 2008 5:54 PM

To: VulvarDisorders

Subject: new to this problem

I had a bacterial infection (just regular

vaginal bacteria) 6 mo.

ago,/ which took two courses of treatment to clear up and then a

yeast infection. It was then that my skin flared up. It was

purple,widespread and felt damp and prickly. Doctors prescribed

nistatin/triamacinolone,hydrocortisone and several other topical

treatments. The discoloration got some better and the areas affected

smaller, but the prickly pain, feeling of dampness and raw skin areas

conintue. My general doctor prescribed Lyrica and that has helped.

I went to a vulvar specialist who injected the areas with

triamacinilone. That has helped somewhat, but I am still left with

raw skin and pain. I have not worked or gone about my life for 8

weeks. I sit with loose clothing on trying to let the skin heal.

The specialist thinks it is a dermatitis. If I don't get more relief

he wants to do a biopsy. He gave me triamacinolone to use 7 days per

month and said I could use hydrocortisone daily. I tried the

hydrocortisone for two days and the area flared up again so I didn't

use it again. I don't even want to try the topical triamacinolone

mixture he prescribed now. I was hoping someone might have some ideas

on where to go for help. I feel like the longer this goes on the

worse it could become. I feel like I don't know where to go for

help. Any advise on what or where I might try?

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Guest guest

>

> Hi, you didn't mention what area you lived in. Maybe someone could

suggest a

> doctor if we had an idea of where you lived.

>

> nne

>

>

>

>

>

>

>

> From: VulvarDisorders

> [mailto:VulvarDisorders ] On Behalf Of jselbridge

> Sent: Thursday, April 24, 2008 5:54 PM

> To: VulvarDisorders

> Subject: new to this problem

>

>

>

> I had a bacterial infection (just regular vaginal bacteria) 6 mo.

> ago,/ which took two courses of treatment to clear up and then a

> yeast infection. It was then that my skin flared up. It was

> purple,widespread and felt damp and prickly. Doctors prescribed

> nistatin/triamacinolone,hydrocortisone and several other topical

> treatments. The discoloration got some better and the areas

affected

> smaller, but the prickly pain, feeling of dampness and raw skin

areas

> conintue. My general doctor prescribed Lyrica and that has helped.

> I went to a vulvar specialist who injected the areas with

> triamacinilone. That has helped somewhat, but I am still left with

> raw skin and pain. I have not worked or gone about my life for 8

> weeks. I sit with loose clothing on trying to let the skin heal.

> The specialist thinks it is a dermatitis. If I don't get more

relief

> he wants to do a biopsy. He gave me triamacinolone to use 7 days

per

> month and said I could use hydrocortisone daily. I tried the

> hydrocortisone for two days and the area flared up again so I

didn't

> use it again. I don't even want to try the topical triamacinolone

> mixture he prescribed now. I was hoping someone might have some

ideas

> on where to go for help. I feel like the longer this goes on the

> worse it could become. I feel like I don't know where to go for

> help. Any advise on what or where I might try?

>

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Guest guest

> I live in Central New York near Syracuse. I guess I am just afraid

and tired. After months and months of going to several doctors and

trying multiple creams and one set of injections is that a doctor

might not be able to help.

I guess I am in the process of trying to get use to the idea that

this might be something that I have to live with. However, there

must be something that I can use to improve the skin enough to be

able to walk around the mall, or go back to work and sit forward in

chair etc.

Has anyone tried or heard of the trimictalone injections? I read on

one website that in rare cases these injections are used. That made

me hope that I hadn't done something that is only used as a last

resort and might really make things worse.

> Hi, you didn't mention what area you lived in. Maybe someone could

suggest a

> doctor if we had an idea of where you lived.

>

> nne

>

>

>

>

>

>

>

> From: VulvarDisorders

> [mailto:VulvarDisorders ] On Behalf Of jselbridge

> Sent: Thursday, April 24, 2008 5:54 PM

> To: VulvarDisorders

> Subject: new to this problem

>

>

>

> I had a bacterial infection (just regular vaginal bacteria) 6 mo.

> ago,/ which took two courses of treatment to clear up and then a

> yeast infection. It was then that my skin flared up. It was

> purple,widespread and felt damp and prickly. Doctors prescribed

> nistatin/triamacinolone,hydrocortisone and several other topical

> treatments. The discoloration got some better and the areas

affected

> smaller, but the prickly pain, feeling of dampness and raw skin

areas

> conintue. My general doctor prescribed Lyrica and that has helped.

> I went to a vulvar specialist who injected the areas with

> triamacinilone. That has helped somewhat, but I am still left with

> raw skin and pain. I have not worked or gone about my life for 8

> weeks. I sit with loose clothing on trying to let the skin heal.

> The specialist thinks it is a dermatitis. If I don't get more

relief

> he wants to do a biopsy. He gave me triamacinolone to use 7 days

per

> month and said I could use hydrocortisone daily. I tried the

> hydrocortisone for two days and the area flared up again so I

didn't

> use it again. I don't even want to try the topical triamacinolone

> mixture he prescribed now. I was hoping someone might have some

ideas

> on where to go for help. I feel like the longer this goes on the

> worse it could become. I feel like I don't know where to go for

> help. Any advise on what or where I might try?

>

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Guest guest

Don't give up. This isn't something that you 'are going to have to

live with', there is help out there. If you haven't already, I really

strongly suggest you start to search for a physical therapist that

works with pelvic pain patients. The symptoms you describe can be

the direct result of tight pelvic muscles, especially after guarding

sensitive tissues from any form of pain.

>

>

> > I live in Central New York near Syracuse. I guess I am just afraid

> and tired. After months and months of going to several doctors and

> trying multiple creams and one set of injections is that a doctor

> might not be able to help.

>

> I guess I am in the process of trying to get use to the idea that

> this might be something that I have to live with. However, there

> must be something that I can use to improve the skin enough to be

> able to walk around the mall, or go back to work and sit forward in

> chair etc.

>

> Has anyone tried or heard of the trimictalone injections? I read on

> one website that in rare cases these injections are used. That made

> me hope that I hadn't done something that is only used as a last

> resort and might really make things worse.

>

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Guest guest

> >

> >

> > > I live in Central New York near Syracuse. I guess I am just

afraid

> > and tired. After months and months of going to several doctors

and

> > trying multiple creams and one set of injections is that a doctor

> > might not be able to help.

> >

> > I guess I am in the process of trying to get use to the idea that

> > this might be something that I have to live with. However, there

> > must be something that I can use to improve the skin enough to be

> > able to walk around the mall, or go back to work and sit forward

in

> > chair etc.

> >

> > Has anyone tried or heard of the trimictalone injections? I read

on

> > one website that in rare cases these injections are used. That

made

> > me hope that I hadn't done something that is only used as a last

> > resort and might really make things worse.

> >

>

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Guest guest

You need to take care of the raw skin first, then PT would probably

help with the underlying issues - that's what happened to me. Had to

get the skin under control with topicals first. Obviously in your

condition you probably couldn't tolerate direct PT, although you could

have skin rolling on your thighs and abdomen which would start

releasing some of the nerves and muscles to that area.

Melinda

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Guest guest

My exact thoughts too , is getting that skin healthy as a first objective... and that's where the topical E and maybe (hopefully) the T.... can really benefit... it's what that skin thrives on and needs then go from there.. ;)

Hugs

Dee

Re: new to this problem

You need to take care of the raw skin first, then PT would probably help with the underlying issues - that's what happened to me. Had to get the skin under control with topicals first. Obviously in your condition you probably couldn't tolerate direct PT, although you could have skin rolling on your thighs and abdomen which would start releasing some of the nerves and muscles to that area. Melinda

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Guest guest

>Were there specific treatments that worked to clear your skin? I

used the hydrocortisone when this first started and it seemed to

work, but when I used it again and it burned and made things worse.

How are you now? Do you have to periods of time when you don't have

symptoms or do you have to work on this all the time?

> You need to take care of the raw skin first, then PT would probably

> help with the underlying issues - that's what happened to me. Had

to

> get the skin under control with topicals first. Obviously in your

> condition you probably couldn't tolerate direct PT, although you

could

> have skin rolling on your thighs and abdomen which would start

> releasing some of the nerves and muscles to that area.

> Melinda

>

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Is topical E just vitamin E capsules that you break open and put on

the skin? What is T and where do you get it? Do you put these two

things on together and how many times per day? Is there any chance

either of these can be irritating? Thanks.

>

> My exact thoughts too , is getting that skin healthy as a

first objective... and that's where the topical E and maybe

(hopefully) the T.... can really benefit... it's what that skin

thrives on and needs then go from there.. ;)

>

> Hugs?>

> Re: new to this problem

>

>

> You need to take care of the raw skin first, then PT would probably

> help with the underlying issues - that's what happened to me. Had

to

> get the skin under control with topicals first. Obviously in your

> condition you probably couldn't tolerate direct PT, although you

could

> have skin rolling on your thighs and abdomen which would start

> releasing some of the nerves and muscles to that area.

> Melinda

>

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Guest guest

Hi there, ;) We abbreviate the hormones with letters instead of spelling them out each time. For example: E. = Estrogen T. = Testosterone P. = Progesterone Some of us have found applying topical Estrogen to our skin really helps with the inflammation you are describing. Several of us use either Estrace (brand name for a cream form of bio-identical estrogen, which is exactly what our ovaries make). I would personally stay away from Premarin (synthetic horse urine estrogen *ugh*). Some have to have Estradiol (main ingredient in Estrace - compounded for a more soothing effect). Compounding takes out any inert ingredients in the Rx (prescription) that may irritate some. Some may not need PT if they indeed ONLY have a condition limited to the skin. Others may have more than one thing going on

(like - Interstitial Cystitis, Pelvic Floor Dysfunction, Bowel problems, along with Vulvar pain, etc.) and will probably NEED PT. Tight pelvic floor muscles can refer pain to the vaginal opening, as well as other places. Others may have skin conditions of the vulva, like: Lichen Planus or Lichen Sclerosis as two examples. It just seems to be trial and error for us all - until we dial in the treatment plan that will work for us. Hang in there and be determined not to give up! ;) ~Chelle

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Yes. That is exactly what can happen. The nerves for your genital

area run all through the muscles in your pelvis. If these muscles stay

tight and contracted, this irritates the nerves which in some women

cause the 24/7 burn with the red inflammed skin.

And I will say, for me, 100%, if it wasn't for myofascial release

through my wonderful PT, I would not be were i am today. I've dealt

with this for close to 4yrs now. The past year and a half were the

worst. I am now, close to 95%. PT is worth the effort.

Unfortunately, this is a trial and error kind of thing. And yes,

sometimes the topical treatments the docs hand out will indeed cause a

flare. You need to find out what works in calming down a flare for

you. Warm baking soda baths, or just sitting in a warm bath. Use a

bag of frozen peas or I used to use a full cold beer bottle. When the

bottle warmed up, I knew it was time to stop. You don't want to cause

yourself freezer burn on top of everything else.

No soap, dye free detergent, no 'feminine' products. I also use pure

coconut oil when I have my period. It really helps with tampons and

keeps the irritating blood off of tender tissues. I couldn't tolerate

pads, also stay away from Always brands. They are known to irritate.

I do use a lidocaine ointment 5% to help ease the pain. It stings a

little when I first put it on if I'm flaring but the relief it brings

is worth it to me.

This whole thing is overwhelming, but if you keep searching you will

find the doc who can help you. You may even have to bring the

information to a doc who doesn't know much about this but is willing

to listen and learn.

Don't give up. WE DO get better.

dawn

>

> > I don't understand. Tight pelvic muscles can cause raw skin? I

> mean I have skin that is visablly red and looks irritated. Can

> physical therapy really help this? Do you still keep looking for a

> doctor that can help or keep trying different topical treatments? As

> I read these messages it sounds like trial and error and sounds like

> often you have to tolerate flare ups when something doesn't work. It

> is just overwhelming. Thank you for your respsonse though.

>

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jselbridge wrote:>>>>>>> I used the hydrocortisone when this first started and it seemed to work, but when I used it again and it burned and made things worse. Steriods can be helpful with some of the vulvar skin conditions, but you have to be very careful with them. They can 'thin' the skin if overused. Some have pain all the time and suffer from generalized vulvodynia. Others may only have pain upon contact, i.e. - inserting tampons, tight clothing, sitting, sex, etc. Unfortunately, some have both kinds. *sigh* Have you found a doc or someone to help you at all? ~Chelle

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As you will learn, everyone is very different. I am mostly symptom free

if I keep up maintenance meds and go to PT every few weeks, but I have

flare ups occasionally.

Anything can be potentially irritating, including estrace (E) and

testosterone (T). I have mine compounded in emu oil, which doesn't

irritate me like the regular prescriptions. You just have to do trial

and error to figure out what works for you.

Melinda

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>Thank you. What are your maintenance meds if I can ask. Just trying

to write down all the info I can get to start figuring it all out.

> As you will learn, everyone is very different. I am mostly symptom

free

> if I keep up maintenance meds and go to PT every few weeks, but I

have

> flare ups occasionally.

> Anything can be potentially irritating, including estrace (E) and

> testosterone (T). I have mine compounded in emu oil, which doesn't

> irritate me like the regular prescriptions. You just have to do trial

> and error to figure out what works for you.

> Melinda

>

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Guest guest

>

> >>>>>>> I used the hydrocortisone when this first started and it

seemed to

> work, but when I used it again and it burned and made things worse.

>

>

> Steriods can be helpful with some of the vulvar skin conditions,

but you have to be very careful with them. They can 'thin' the skin

if overused. Some have pain all the time and suffer from generalized

vulvodynia. Others may only have pain upon contact, i.e. - inserting

tampons, tight clothing, sitting, sex, etc. Unfortunately, some have

both kinds. *sigh*

>

> Have you found a doc or someone to help you at all? ~Chelle

>

My general practitioner prescribed the Lyrica for the nerve pain and

an antidepressant. I still use both of these meds and have since

seen the vulvar specialist who injected the area with

triamicinalone. I think that has helped, but I had to go through a

very swollen and bruised few weeks. The bruising still isn't gone.

He then gave me the Lidocane, but it was VERY irritaing for me and

caused the whole area to be red and inflamed. This happened again

with the Hydrocortisone he said to use, and I haven't even tried the

topical Triamcinalone out of fear. So I am using nothing right now

except the oral meds. The next step the specialist has advised is a

biopsy. Anyone had one of those? What are the general thoughts on

that? Maybe I should try a second opinion. I could go to New York

City,Albany,or Buffalo if anyone had a recommendation for doctors in

these areas.

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>Thank you for your informative brief! Even my husband got a kick

out of my vitamin E reference. This really helped.

I called my doctor today to see if I could get the Estridol (since my

skin seems to react to all the recent topicals), but she said she

didn't want anything on my skin right now. Water only to wash and

that's all. I wish there was more for pain. That is part of my

fatigue I think (the rest emotional even with the antidepressants!)

Thank you.

> Hi there, ;)

>

> We abbreviate the hormones with letters instead of spelling them

out each time. For example:

>

> E. = Estrogen

> T. = Testosterone

> P. = Progesterone

>

> Some of us have found applying topical Estrogen to our skin

really helps with the inflammation you are describing. Several of us

use either Estrace (brand name for a cream form of bio-identical

estrogen, which is exactly what our ovaries make). I would

personally stay away from Premarin (synthetic horse urine estrogen

*ugh*). Some have to have Estradiol (main ingredient in Estrace -

compounded for a more soothing effect). Compounding takes out any

inert ingredients in the Rx (prescription) that may irritate some.

>

> Some may not need PT if they indeed ONLY have a condition limited

to the skin. Others may have more than one thing going on (like -

Interstitial Cystitis, Pelvic Floor Dysfunction, Bowel problems,

along with Vulvar pain, etc.) and will probably NEED PT. Tight

pelvic floor muscles can refer pain to the vaginal opening, as well

as other places.

>

> Others may have skin conditions of the vulva, like: Lichen Planus

or Lichen Sclerosis as two examples. It just seems to be trial and

error for us all - until we dial in the treatment plan that will work

for us.

>

> Hang in there and be determined not to give up! ;) ~Chelle

>

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I don't use a lot of maintenance meds. I use emu oil for comfort or

coconut oil, a dab of estradiol daily at bedtime - before I got

pregnant, I was trying testosterone as well but didn't get far enough

to see if it worked and will try again after baby comes. Also, my

doctor wants me to try a steroid for the clitoral area (my problem area

at this point) after baby - probably betamethasone or triamcinolone. I

also do regular PT, eat a gluten-free and mostly whole foods diet, see

a chiropractor regularly - for me, it's about having a whole healthy

lifestyle to be better, not just what meds I put on. That's only one

piece of it. I tried alot of other meds that didn't work. That is the

hardest part for me, the trial and error of it all.

Melinda

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If you can get to New York City, you could have an evaluation at Beyond

Basics PT - they are some of the best and would be able to tell you if

PT would benefit you or not. There must be a good dr. there too - have

you searched the database? Isn't one of the more famous docs in New

York?

Melinda

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