Vulvitis in women. Vulvitis - symptoms and treatment in women, drugs Effective treatment of vulvitis according to the scheme

Vulvitis is an inflammatory process that affects the vulva (external female genitalia). This disease is widespread and can affect not only adult women, but also young girls, as well as elderly patients. In all cases, the symptoms of the disease are the same. With vulvitis, the large and small labia, the vestibule of the vagina, the clitoris and the hymen (in girls who are not sexually active) become inflamed. Also, the disease is characterized by the appearance of itching and burning in the area of the external genitalia, swelling and redness of the labia, the occurrence of pain and copious discharge.

The reasons

The cause of the development of vulvitis is opportunistic bacteria that do not cause negative symptoms against the background of high immunity. In addition, inflammation of the vulva is provoked by sexual infections and, extremely rarely, by Mycobacterium tuberculosis.

In order for the inflammatory process to develop, predisposing factors are necessary - a decrease in immunity and damage to the mucous membrane of the external genitalia.

Quite often, the appearance of vulvitis in women occurs against the background of vaginitis or colpitis. Also, the pathological process is the result of endocrine disorders, non-compliance with intimate hygiene, trauma to the vulva, genital and extragenital ailments.

Provoke the disease can:

urinary tract infections;
hepatitis, jaundice;
urinary incontinence;
helminthiases;
childhood infectious diseases;
frequent sore throats, acute respiratory infections;
intestinal dysbacteriosis;
various skin pathologies;
psoriasis.

In girls, vulvitis develops as a result of mechanical, chemical and thermal factors, as well as when foreign objects enter the vagina. In older women, the disease is often the result of diabetes or cystitis.

Another cause of inflammation of the vulva is seborrheic dermatitis of the external genitalia. This is a rare ailment of unclear etiology, during the development of which inflammatory foci appear on the mucous membrane and skin, having different staining intensity and covered with thin crusts.

Purulent hydradenitis can provoke vulvitis. This is an infectious skin disease with a long course. Patients develop an unpleasant-smelling discharge that corrodes the mucous membrane and skin, leading to the formation of painful scars.

Forms and types

It is customary to distinguish between primary and secondary vulvitis.

In adult women, the primary form of the disease is extremely rare, because the mucous membrane, due to the predominance of an acidic pH environment, sour-milk microflora and normal hormonal levels, is more resistant to various infections.

Primary vulvitis is diagnosed most often in girls and elderly patients and is associated with the anatomical and physiological characteristics of the vulvar mucosa and changes that occur in the body due to the low content of female sex hormones.

In older women during postmenopause, the amount of vaginal discharge is significantly reduced, and the mucous membranes become thin and dry. As a result, they are easily injured and become vulnerable to infection.

In childhood, the mucous membrane and skin of the vulva are quite thin and easily damaged. The microflora of the vagina in a small child is mainly coccal, pH is alkaline, and local immunity has not yet been fully formed.

In addition, vulvitis in girls often develops due to the presence of pinworms, which cause severe itching. Due to scratching, the mucous membrane is injured, and the infection easily penetrates inside.

The secondary form of vulvitis is much more common. It occurs as a result of irritation of the vulva with infected urine in diseases of the urinary tract or infected discharge from the cervical canal and vagina.

There are the following types of vulvitis:

candida- the disease is caused by yeast-like fungi of the genus Candida. This type of vulvitis affects the labia majora, labia minora, vaginal vestibule, and clitoris. Severe burning and itching develops. Outwardly, the vulva looks edematous and reddened, a rash appears on it in the form of small bubbles, and a white curdled film forms on the area between the labia minora.
Bacterial- it is provoked by opportunistic microflora or sexual infections (chlamydia, Trichomonas, gonococci). During pregnancy, this type of disease develops due to reduced immunity as a result of the activation of staphylococcal microflora.
ulcerative- in this case, a plaque forms on the injured mucous membrane of the vulva, after the removal of which ulcers remain. When they heal, deformation of the genitals is quite often observed.
atrophic- this type of pathological process is characterized by thinning of the mucous membrane of the vulva, which often occurs in women during menopause.
sticky is a disease of unknown etiology that occurs in girls under 5 years of age. It is characterized by adhesion of the labia minora.

Symptoms

Clinical signs of the disease depend on the nature of its course:

acute;
chronic.

Acute vulvitis is characterized by a strong burning sensation in the vulva, which is aggravated by walking and urinating. There is redness and swelling of the mucosa, painful itching occurs, and purulent-fibrinous plaque appears. In the inguinal region, the lymph nodes increase, pain is felt in the lower abdomen and lumbosacral region.

If the infection has affected the urethra, then urethritis and cystitis occur. Girls with an acute form suffer from insomnia, they show signs of nervous excitability.

Chronic vulvitis occurs against the background of subsiding pain and itching. The inflammatory process at this stage passes to the internal genitalia, resulting in meager discharge, which is accompanied by a burning sensation. In some parts of the mucous membrane of the vulva, painful hyperemic foci appear.

Treatment

Treatment of vulvitis is carried out in a complex, includes general and local therapy. At the same time, not only eliminate the inflammatory process, but also get rid of the causes that caused it.

Treatment necessarily includes the use of antibiotics, fungicides, suppositories, ointments and antiseptic solutions. The doctor prescribes medicines to normalize the microflora of the vagina and strengthen the immune system.

Candles, ointments and solutions

For the treatment of vulvitis in women at home, it is recommended to use the suppositories described in the table:

Candles	purpose
	Used in the treatment of candidal vulvitis
	The drug has an anti-inflammatory effect and effectively eliminates swelling, itching and redness of the labia
	Candles contain povidone-iodine, which has an antimicrobial effect against gram-negative and gram-positive fungal and bacterial flora
	Suppositories are used for inflammation, which is caused by pathogens of sexually transmitted diseases (ureaplasma, chlamydia, gonococci, Trichomonas)
	The drug contains miconazole and metronidazole. Used for candidiasis and trichomoniasis
	The composition of suppositories, in addition to metronidazole, includes chlorquinaldol, which is used against resistant strains of staphylococci

Suppositories are used 1-2 times a day, the duration of treatment is determined by the doctor. When the suppositories dissolve, the active ingredient begins to spread evenly throughout the mucous membrane of the vagina and vulva. In addition, drugs are used to prevent vaginitis.

Treatment of vulvitis is also carried out with ointments, creams, gels. They are recommended to be applied to the affected areas of the perineum with a thin layer.

In addition to the antimicrobial effect, such drugs have a softening and moisturizing effect, so they are prescribed for the treatment of the atrophic form of the disease:

A drug	purpose
	Antibiotic cream with a wide spectrum of action. Used against gonococci and non-specific microflora
	Contains methyluracil to help tissues recover faster
	The composition of the ointment includes the antibiotic gentamicin, the fungicidal agent clotrimazole and the anti-inflammatory component betamethasone. Thanks to this combination, the drug eliminates swelling, itching and other symptoms of inflammation, destroys the fungal and bacterial flora.
	This vaginal gel is prescribed in parallel with the main treatment. It helps to restore the disturbed microflora of the mucous membrane of the external genitalia and vagina
	The cream helps destroy fungal cells. Active against molds and yeasts, gram-positive and gram-negative bacteria

Treatment of vulvitis with ointments, creams and gels contributes to the rapid onset of the effect. The drugs are applied directly to the pathological area, which minimizes the occurrence of systemic side effects.

For washing and rubbing, doctors prescribe Miramistin solution. This drug is used for the treatment and prevention of sexually transmitted diseases, with exacerbation of chronic vulvitis caused by gram-positive and gram-negative flora.

Antibacterial and symptomatic therapy

Antibiotics for vulvitis are used if the inflammatory process occurs in an acute form and there is a risk of the disease spreading to the vagina. They are also used for venereal infections.

To cure non-specific forms of the disease, the doctor prescribes Amoxiclav three times a day. It contains amoxicillin and clavulanic acid, which increase the effectiveness of the drug.

With trichomoniasis, Trichopolum is indicated. These tablets are used simultaneously with other antibiotics during the treatment of vulvitis. With gonorrhea and ureaplasma, Azithromycin (Sumamed) is effective. Erythromycin is used against chlamydia.

Symptoms of vulvitis, such as pain and itching, often cause irritability and insomnia. That is why the intake of magnesium (Magnesium-B6) and vitamins of group B is indicated. To strengthen the immune system, preparations with echinacea, such as Immunal, are used.

Folk ways

It is necessary to treat vulvitis with folk remedies after consulting a doctor. This is explained by the fact that medicinal plants are not able to cope with a bacterial infection, and their use without the use of antibiotics can lead to the development of a chronic form of the disease.

There are the following effective recipes for the treatment of vulvitis with folk remedies:

1 st. l. round-leaved wintergreen is poured with a glass of boiling water and insisted for several hours. After that, the solution is filtered and lotions are made 2-3 times a day.
A cool decoction of chamomile is prepared: 20 g of dried flowers are poured into a glass of boiling water and filtered. Add it to the solution for sitz baths.
2 tbsp. l. St. John's wort pour 0.5 liters of boiling water and leave for 2-3 hours. When the infusion has cooled, it is filtered and used for washing.

In the treatment of vulvitis, nutrition should be adjusted. To reduce itching, you need to give up salty and spicy foods. Sweets and alcohol must be excluded from the diet.

It is necessary to observe the rules of hygiene and refrain from sexual intimacy until recovery.

Features of vulvitis in children

The main causes of vulvitis in infants and young children are poor hygiene and diaper dermatitis. Inflammation can develop due to wearing uncomfortable synthetic underwear.

Most often, girls are affected by nonspecific vulvitis. Infection with Trichomonas, gonococci and other similar flora occurs when using shared underwear or during childbirth.

Treatment of the disease in infants and young children is carried out as follows:

sitz baths with a weak solution of potassium permanganate or a decoction of chamomile;
washing with a solution of Tsiteal;
treatment of the mucous membrane of the vulva with 1% ointment with hydrocortisone, Bepanten, Levomekol;
lotions with zinc oxide or oak bark;
treatment of the perineum with sea buckthorn, peach oil or Vitaon Baby.

If the symptoms of the disease do not disappear after a week, treatment is carried out with antibiotics. The doctor prescribes Metronidazole, Erythromycin, Augmentin. The duration of treatment is 5-10 days.

Vulvitis during pregnancy and lactation

During pregnancy and during breastfeeding, the disease occurs for the following reasons:

Hormonal imbalance. Due to changes in the hormonal background, a decrease in immunity occurs, the microflora of the vagina is disturbed, provoking the growth of pathogenic bacteria.
Exacerbation of chronic diseases due to a weakened immune system.
Non-compliance with the rules of personal hygiene. Excess or lack of care for the genitals leads to the development of vulvitis.
Wearing too tight clothing or underwear made from synthetic materials.
Avitaminosis.

If vulvitis is suspected during pregnancy, treatment should be started immediately, since the pathology can provoke a miscarriage or cause intrauterine infection of the fetus.

Therapy is carried out with antiseptic solutions intended for washing: Furacilin, Chlorhexidine, Miramistin. If a woman is breastfeeding, the doctor prescribes the most benign drugs to avoid negative effects on the baby through milk. It can also be Miramistin, Chlorhexidine solutions. It is recommended to make warm baths with medicinal herbs, compresses, lotions.

Prevention of vulvitis is to observe intimate hygiene and use protection against sexually transmitted infections.

The purity of the intravaginal flora directly depends on the state of the hormonal background of the female body. If the production of estrogens is reduced, then the secretion will not protect the mucous surface from infections and pathogens. As a result, a woman may develop vulvitis, characterized by the presence of an inflammatory process, which involves the external genitalia.

Most often, the disease occurs in girls and postmenopausal women, when the concentration of estrogen is low due to natural causes. Much less often, vulvitis occurs in women of childbearing age. At risk, as a rule, are those patients who, according to the results of a blood test, have a lack of estradiol.

Causes of vulvitis

Deficiency of female sex hormones is the main factor, the presence of which causes the appearance of other causes of the development of vulvitis:

General weakening of the immunity of a woman or girl, which is noted over a long period of time (more than 2-3 months).
Avitaminosis
Careless attitude to the observance of the rules of daily intimate hygiene. Most often, this circumstance is the cause of vulvitis in girls.
Frequent microtraumas of the mucous membranes of the vagina, which remained without treatment.
Synthetic underwear.
Allergic reaction to intimate area care products.
Allergic reaction to drugs taken orally. These include, in particular, anticancer drugs that cancer patients have to take for a long time.
Frequent use of alcohol.

In general, all causes of the disease can be divided into two types: primary and secondary. In one case, the inflammatory process begins due to factors that directly led to the injury of the mucous membrane. In the second case, the causes of vulvitis are other diseases of a woman that do not concern the genital area.

Forms of the disease and their symptoms

According to the nature of the course of the disease, gynecologists distinguish its acute and chronic forms. Accordingly, the symptoms will be different. If the acute form is characterized by vivid manifestations, then with chronic vulvitis the clinical picture is often blurred and the patient may not see a doctor for a long time, believing that nothing dangerous is happening to her body.

Signs of an acute form of the disease:

An increase in temperature to 38 degrees, which is not accompanied by signs of SARS.
Violent burning in the vulva. Unpleasant sensations become stronger during movement and with prolonged sitting.
Swelling of the mucous membrane of the labia, a feeling of pulsation, swelling.
Redness of the skin.
Isolation of pus from microcracks on the labia or from the vagina (if the treatment is not started on time).
The appearance of genital warts in the intimate area and in the anus.

All symptoms will increase rapidly if you do not urgently consult a doctor and begin to stop the spreading inflammatory process. Acute vulvitis will not be fatal for the patient, but if therapy is not started in a timely manner, then the subsequent healing of the mucous membrane of the labia will be very long.

Signs of a chronic form of the disease:

Hyperplasia of the sebaceous glands located on the mucous membranes of the labia. Outwardly, they resemble nodular neoplasms of a yellowish color. If you run your finger over such a surface, it will seem rough.
Moderate itching, often without a burning sensation. Itching subsides for a while immediately after hygiene procedures and gradually becomes more noticeable as the mucosa becomes contaminated.
The presence of microcracks, formed due to the fragility of tissues, weakened by a sluggish infection.
The skin is edematous, have a reddish color. In some cases, there may be no swelling, and only redness indicates the presence of an infection.
Itching that occurs on the external genitalia immediately after sexual contact.

Without medical intervention, it is difficult to determine what chronic vulvitis looks like in women - its external manifestations may be similar to signs of other gynecological diseases that require other treatment regimens.

To make an accurate diagnosis, a single examination on the chair is not enough. Therefore, the doctor must take a smear on the flora to determine the presence of pathogenic coccal bacteria. Cervical mucus is collected from the external labia, the vestibule of the vagina and from the surface of the external pharynx of the cervix. To determine the type of antibiotic that needs to be prescribed to the patient, a sensitivity test to certain types of antibacterial drugs is carried out. In some cases, the doctor will order a urine test if there is a suspicion that the infection has entered the vagina from the urethra.

Treatment of vulvitis - antibiotics, herbs, etc.

With inflammation of the mucous membranes, an effective therapy is a combination of oral administration of drugs and the use of local treatment (baths, douches, suppositories).

Use of drugs

Antibacterial therapy - drugs are prescribed according to the results of an antibiotic susceptibility test. Amoxiclav, Ceftriaxone, Tinidazole, Trichopolum can be used. In the treatment of vulvitis in women, the duration of antibiotics is at least 10 days. If, according to the results of the analysis, there is no improvement, then the doctor changes the drug.

Anti-inflammatory therapy - is prescribed simultaneously with antibacterial. Helps reduce swelling of the mucous membranes, relieve discomfort and temperature in case of an acute form of the disease. Usually a doctor can prescribe Ibuklin, Ibuprofen, Diclofenac.

Antifungal therapy - prescribed in cases where the inflammatory process caused by coccal bacteria is aggravated by the presence of candidiasis. In this case, Nystatin, Flucostat are prescribed.

Use of topical medicines

When a woman has symptoms of vulvitis, an additional treatment that can be arranged at home is herbal tinctures, antibacterial suppositories, as well as ointments and gels that eliminate burning and swelling of tissues. It is important to remember that it will not be possible to cope with the disease if only topical agents are used.

The coccal bacteria will not disappear without serious antibiotic therapy, which a doctor can prescribe. Therefore, self-medication with herbal remedies can lead to the fact that the acute form of vulvitis develops into a chronic one, which will be much more problematic to cure.

Herbal infusions

Three tablespoons of dry herb St. John's wort pour two cups of boiling water and leave for 2 hours, then strain and refrigerate. The resulting infusion is used for washing 2 times a day for a week.
Mix two tablespoons of dried inflorescences with 1 teaspoon of St. John's wort, 1 teaspoon of oak bark and 1 teaspoon. Pour two mills of cold water and bring to a boil over low heat. Do not boil, immediately turn off the gas and cover with a lid. Infuse for 5 - 6 hours, and then use for douching and wiping the mucous membranes of the external genital organs with a cotton swab dipped in this decoction.
Four bags of dried chamomile brew three cups of boiling water, leave to cool completely. Use as a douche 3 times a day.
Mix five tablespoons of sage with the same amount of chamomile. Pour in three liters of boiling water. Wait until it cools down and use the infusion for a sitz bath.

The use of ointments, solutions

Candide - is used in cases where the inflammatory process is associated with an exacerbation of candidiasis. Most often this happens in young patients, therefore, for the treatment of such vulvitis in girls, ointments are used, the names of which indicate that they are intended to regulate the amount of Candida fungi in the intravaginal flora.
Levomekol - has a strong anti-inflammatory effect, heals small cracks on the mucous membrane of the large and small labia.
Miramistin is an antibacterial solution that is prescribed when, for one reason or another, the patient cannot take high doses of the antibiotic. With frequent treatment (1 time in 2 hours), vulvitis can be dealt with in a few days.

Using Candles

Terzhinan - plates intended for insertion into the vagina. They contain an antibiotic and in cases where it is contraindicated for the patient to use oral antibacterial drugs, they can be prescribed as the main treatment for vulvitis.
Hexicon - used for various inflammatory diseases of the female genital area. However, with coccal bacteria, they cannot be the main type of therapy and serve only as an addition to antibiotics.

A complication of vulvitis can be severe damage to the mucous membranes. In cases where the disease is neglected, areas of necrosis are formed, a putrid odor appears, microbes penetrate the urethra, and infection of the kidneys occurs. Therefore, if there are signs of vulvitis, you need to consult a doctor, without self-medication, choosing medicines at random.

Unfortunately, many girls and women have to deal with the problem of vulvitis. The disease occurs with poor hygiene of the genital organs, due to hormonal disorders or mechanical influences (for example, riding a horse, cycling, active sexual intercourse). These factors lead to the development of inflammation of the vulva - vulvitis. Drugs that treat the disease can be easily found in a pharmacy, so getting rid of the disease is quite simple. Only the right approach to therapy and the choice of suitable drugs for vulvitis are important.

First of all, you need to go to the hospital, where the doctor will prescribe an examination plan. Unfortunately, many women do not rush to the doctor, despite the enormous discomfort, pain and itching that the disease causes. This is wrong, since vulvitis can be secondary, that is, develop against the background of inflammation (often specific) of the internal genital organs. In this case, you must first get rid of the primary pathology, and only then apply drugs to treat vulvitis. After all, without eliminating the cause, it is useless to fight the symptoms.

The most common causes of inflammation of the external genital organs:

vaginal dysbacteriosis due to prolonged antibiotic or radiation therapy;
various neurological or endocrine disorders (diabetes mellitus, ovarian dysfunction, etc.);
the presence of an infectious process of the internal genital organs (often it is caused by chlamydia, mycoplasmas, gonococci, ureaplasmas or other microorganisms that cause STDs);
allergic reactions, lack of vitamins, etc.

Before starting therapy, it is imperative to exclude all serious diseases that could lead to vulvitis. Drugs for treatment should be selected taking into account the etiology and the presence of concomitant pathology. It is very important to consider which microorganisms caused the disease. Antibiotics are indicated for a bacterial infection, antiviral and immunomodulatory agents are indicated for a viral infection, a fungal infection should be treated with agents like Fluconazole. However, the cure for vulvitis in women does not end there. Lotions, baths with solutions of chlorhexidine or decamethoxin help well. The external genitals are washed with betadine, miramistin - this also helps to get rid of the infection. Some ointments and creams for vulvitis are widely known. It is advisable to prescribe vitamin therapy or means to strengthen the immune system - they will increase the body's resistance and prevent the recurrence of the disease or its transition to a chronic form.

What antibiotics are used for vulvitis?

The disease can have a different nature. Depending on the pathogen, the following types of vulvitis are distinguished:

atopic(to put it simply, allergic) - occurs due to the increased sensitivity of the body to allergens;
Viral- as a result of a viral infection of the genital organs (for example, with genital herpes);
Bacterial vulvitis. It is treated with antibiotics, since only they are able to destroy bacteria;
candida- caused by opportunistic fungi of the genus Candida;
atrophic- develops, as a rule, in women in menopause due to hormonal changes in the body.

There is also acute, subacute and chronic vulvitis. Antibiotics are only used if the infection is caused by bacteria. This must always be remembered, because antibiotics for vulvitis of a fungal or viral etiology will not only not help, but will even harm. They will aggravate dysbacteriosis, which will make it much more difficult to recover.

The doctor should select antibacterial drugs, taking into account the etiology of the disease. For diagnosis, you need to pass a smear on the flora.

The most commonly used antibiotics in tablets for vulvitis:

Ceftriaxone or other cephalosporins - effective when detected in a smear of gonococci (this indicates the presence of gonorrhea);
Tinidazole, Ornidazole, Metronidazole for vulvitis are prescribed if it is caused by Trichomonas;
Chlamydia, ureaplasma, mycoplasma and many other vulvitis are treated with broad-spectrum antibiotics or their combinations.

Metronidazole is often prescribed as part of the drug Trichopolum for vulvitis. In addition to trichomoniasis, this remedy is effective for bacterial vaginosis, ureaplasmosis, gonorrhea, chlamydia. Trichopol also affects a large number of bacteroids. However, the drug is ineffective against viruses and fungi.

Widely known combination drug Terzhinan. It contains ternidazole, neomycin sulfate, nystatin and prednisolone sodium metasulfobenzoate. The remedy is effective for non-specific, bacterial, fungal and mixed vulvitis. Terzhinan is quite often used in gynecology, since it has practically no such effects and contraindications (with the exception of individual intolerance to the components).

Antibacterial drugs of systemic action can be taken only with the permission of a doctor. This will not only help you recover faster, but also protect you from chronic illness. In addition, improper antibiotic therapy can cause the development of microbial resistance, and then it will become even more difficult to cure.

Treatment of vulvitis with drugs

In addition to pills for vulvitis, there are many other effective methods of therapy. These include antibacterial suppositories:

McMiror;
Terzhinan (the drug is available both in tablets and in the form of suppositories);
Neo-penotran.
Hexicon.

They should be inserted into the vagina after thorough washing, best at night. The duration of treatment depends on the severity of the symptoms and is 7-10 days.

Antiseptic solutions have proven themselves well. These drugs for vulvitis in women help to quickly relieve itching, swelling and discomfort. They also have a weak antibacterial effect, which greatly helps in the treatment and protects against the addition of a secondary infection. The most famous of them:

Miramistin;
Betadine;
Iodine Povidone;
Chlorhexidine;
Hexicon

As alternative methods of treatment, you can use baths, douches and lotions using decoctions and infusions of oak bark or some herbs (chamomile, calendula, sage).

With allergic vulvitis, as well as to relieve itching in its other forms, antihistamines are sometimes used:

Claritin;
Tavegil;
Loratadine;
Suprastin.

It should be noted that the treatment of vulvitis with tablets is justified only if the inflammation of the external genital organs was caused by a serious systemic cause. If the disease is caused by non-compliance with hygiene standards or wearing tight clothing, the tablets are categorically contraindicated. You can only use topical products. Therefore, if it is possible to avoid taking pills - do it. Topical treatment is just as effective and has far fewer side effects.

Boosting immunity also plays a role in the treatment of vulvitis. Vitamins, immunomodulators (Viferon, Genferon, Cycloferon) are great for this purpose. By increasing the nonspecific resistance of the organism, they help it to overcome the infection and resist it in the future. The most commonly used vitamins A and E for vulvitis. The instruction is as follows: a cotton swab is moistened with an oil solution and the external genital organs are treated several times a day. This is great for relieving itching and discomfort. Vitamins are also taken orally. Immunomodulators are used in the form of rectal suppositories. The most famous means:

Genferon;
Viferon;
Derinat;
Cycloferon.

They cause a minimal amount of side effects in women, so they are prescribed most often. For vaginal administration, interferons are used as part of Giaferon or Kipferon preparations.

Drug treatment of vulvitis with creams, ointments, gels

In most cases, local remedies are enough to get rid of the disease. Bed rest, hypoallergenic diet, ointment or cream - and you will be healthy in a couple of days.

The advantages of topical preparations are that they act locally, directly on the source of infection, without affecting other organs and systems. If systemic antibiotics cause intestinal dysbacteriosis and many other complications, then these drugs do not have such effects at all.

What ointments for vulvitis are most often used?

Their list is quite large, but you need to choose, again, depending on the etiology. These products should be used after thorough washing of the external genitalia. For this purpose, you can use a solution of chlorhexidine or miramistin. Wipe the perineum with a soft towel, gently so as not to irritate the skin and prevent additional damage. Then you need to insert a tampon with ointment applied to it into the vagina. With vulvitis in women, the method received reviews just wonderful, because it quickly and effectively eliminates unpleasant symptoms. And after a few days, the disease completely disappears. Some of these ointments are also prescribed for vulvitis in girls.

Antifungal ointments are used for a disease caused by the reproduction of opportunistic fungi of the genus Candida:

Pimafucin.
Nystatin.
Candide.
Doctors prescribe antiviral agents in case of viral inflammation.
Myrtoplex.

Antiseptic ointments for vulvitis in women are used not only for bacterial infections, but also for many others. They have a disinfecting effect and serve to prevent the addition of a secondary infection.

Iodine Povidone.
Hexicon.
Betadine.

It should be said that Betadine is one of the most universal among all the above-mentioned ointments for vulvitis. The active substance of the ointment is povidone-iodine, which has a fairly wide spectrum of action. Being an antiseptic, it acts on fungi, viruses and bacteria, therefore it is effective in the treatment of non-specific inflammation (bacterial vaginosis), candidiasis, including those caused by Candida albicans, trichomoniasis, genital herpes, infections caused by protozoa, etc.

Another widely used vulvitis ointment for women and children is Hexicon. The tool is based on chlorhexidine bigluconate, therefore it is also an antiseptic. Affects many microorganisms, with the exception of viruses, fungi and acid-fast bacteria. It is also used in complex treatment and for the prevention of syphilis, gonorrhea, ureaplasmosis, chlamydia, trichomoniasis.

Vulvit - gels and creams for local use

These agents have a similar mechanism of action. Contacting with the inflamed mucous membrane, they relieve itching, swelling and eliminate redness, contribute to a quick recovery. Like ointments, creams and gels are classified according to which microorganisms they target.

Gels and creams with antimycotic activity:

Lomeksin.
Ifenek.
Ginofort.
Candide.
Pimafucin.
Dafnedgin.

Antibacterial drugs for vulvitis:

Clindamycin.
Clindamycin.
Dalacin.

Antiviral creams and gels:

Zovirax;
Viru-Merz Serol.

Note that most of the above funds are also available in the form of vaginal suppositories or tablets. Therefore, you can choose the most convenient method of application for yourself.

Vulvit - drug treatment in children

Unfortunately, this disease occurs in girls no less often than in adult women. Most often, it is due to non-compliance with hygiene standards, contamination of the external genital area with feces or transplacental infection (we are talking about intrauterine infections). The etiological factor can be both specific and nonspecific microflora. All this leads to vulvitis in girls. Ointments to fight the disease are most often used in this case, since almost all systemic antibiotics are contraindicated for children, especially newborns. However, in some cases (specific infections) they are still prescribed.

In girls, sitz herbal baths are often used to treat pathology (calendula, chamomile or St. John's wort are suitable). The genitals are washed with antiseptic solutions (furatsilin or potassium permanganate). To combat discomfort and itching, ointments are used for vulvitis in children. Anesthetics and antihistamines are also indicated to reduce pain. Immunomodulators, multivitamins and eubiotics have a general strengthening effect, thus helping to fight infection.

Only complex treatment will help to get rid of the problem once and for all and avoid its reappearance in the future.

A purulent-inflammatory disease that affects the external genital organs of women below the vulvar ring is called vulvitis. This disease rarely occurs without involvement in the inflammatory process of the genital organs located in the pelvic area, while the vagina is also affected.

Therefore, more often you have to deal with vulvovaginitis.

Causes and symptoms of vulvitis

Vulvites are classified depending on the causes that provoked the inflammatory process.

Specific - or infectious. It provokes the introduction of known pathogenic microorganisms.

Nonspecific - it is impossible to find out the exact cause of the onset of the inflammatory process; rather, several coinciding factors led to the development of the disease.

Specific vulvitis of the external genitalia is caused by:

gandarella;
Candida;
streptococci;
staphylococci,
trichomonas;
coli.

As already noted, isolated treatment of vulvitis in women is rarely performed, symptoms of the disease occur against the background of other inflammatory processes:

vaginitis - inflammation of the vagina;
cervivitis - cervical inflammation;
adnexitis - inflammation of the appendages;
metritis - inflammation of the uterus.

Nonspecific vulvitis is caused by hypothermia, poor hygiene, frequent change of sexual partners, wearing tight synthetic underwear, using perfumed hygiene products and perfumes.

With vaginal dysbacteriosis, which is almost always a companion of vulvitis, laboratory tests rarely reveal any one pathogen. The inflammatory process appears when several pathogenic or opportunistic cultures are activated.

Clinical manifestations of the disease cause significant inconvenience to the woman.

Symptoms of the disease:

the appearance of abundant secretions from the genital tract - more often purulent, with an unpleasant odor;
there is itching of the genital organs;
the vulva swells, turns red;
there are sharp pains in the perineum, aggravated by movement and urination;
when secretions get on the inner surface of the thighs, irritations occur on them.

The disease in girls and women during menopause often has a non-specific etiology. In girls, vulvitis appears when the rules of hygiene are violated, in women - due to a violation of the hormonal background during colpitis.

Strengthen the severity of the course of the disease, the tendency to allergic reactions, mechanical damage to the mucous membrane of the external genital organs, endocrine disorders, diseases of the gastrointestinal tract.

Diagnosis of vulvitis

For the treatment of vulvitis, it is necessary to accurately establish the etiology of the disease and identify the causes that caused it:

To do this, a gynecological examination is mandatory, during which tests are taken - swabs from the vagina, cervical canal and urethra.
A study is being carried out on genital infections - PCR diagnostics.
Bacteriological examination - sowing, which reveals the sensitivity of the flora to antibacterial drugs prescribed for the treatment of vulvitis in women.
In acute vulvitis, occurring against a background of high temperature, it is necessary to take general urine and blood tests.
Outside the clinic of the disease and the severity of the condition, blood is donated for HIV diagnosis and RW examination.

With a specific vulvitis, a parallel examination of the sexual partner may be necessary, and in the future, his treatment.

Treatment of the disease

To eliminate the disease, drugs of directed action are used. Vulvitis caused by candidiasis and trichomonas are eliminated by various drugs, so the therapeutic regimen is individual for each woman.

Comprehensive therapeutic measures are carried out in the following areas:

anti-inflammatory treatment that stops the acute process and progression of the disease;
antibacterial therapy that destroys pathogenic microorganisms or stops the activity of opportunistic flora;
desensitization - to exclude allergic reactions to drugs, reduce swelling of the external genital organs, reduce the risk of lowering the immune status;
adjustment of the immune system - increasing the body's defenses.

After treatment, the vaginal flora is restored and acidity is normalized.

Systemic antibacterial or antifungal therapy is carried out with the help of drugs of general action.

The external genitalia are treated with antiseptic solutions - baths and washings are carried out. More recently, douching was actively used, but at present, many doctors believe that during home douching, beneficial flora is washed out of the vagina, and this increases the inflammatory process.

Chlorhexedine, a solution of manganese, hydrogen peroxide, lactic and boric acids, and a solution of furacilin are used as antiseptics.

At this stage, traditional medicine is connected. Healing infusions are brewed with herbs that have anti-inflammatory and antiseptic properties. These plants include: calendula, sage, oak bark, chamomile, tricolor violet.

Vaginal tablets with antibacterial and anti-inflammatory components are used, as an active ingredient, hydrocortisone may be included in their composition.

Vaginal suppositories and tablets:

"Polygynax";
"Terzhinan";
"Ginezol";
"Ginalgin";
"Viferon" and others.

Means of local action are represented by a wide range, and the doctor should deal with the selection of the drug. Each drug is designed to act on certain microorganisms. Their components may be metronidazole, clindamycin and antibiotics of various groups.

To restore the integrity of the mucosa, eliminate irritation and swelling, treatment with ointments for vulvitis in women is carried out. In addition to ointments of a specific action - for example, nystatin or "Metrogyl-gel" - means are used that have several components in their composition.

Quickly relieves hyperthermia of the vulvar mucosa with specific vulvitis "Triderm" - an ointment that includes antibiotics and hydrocortisone. With a non-specific form of the disease, it is advisable to use Celestoderm - the agent contains an antihistamine component.

Helium-neon laser treatment has received great popularity at the present time to exclude recurrence of infection. Irradiation of the external genitalia destroys the pathogenic flora, prevents the disease from becoming chronic, and promotes rapid healing of the mucosa.

Nuances in the treatment of vulvitis

In the treatment of young girls, antibiotic therapy is rarely used. Elimination of inflammation of the mucosa is carried out with the help of topical agents - ointments and creams.

Vulvitis is an inflammation of the external genitalia in women or girls. These include the labia majora and labia minora, the vestibule of the vagina, the external opening of the urethra, the hymen, the Bartholin glands, the clitoris, the pubis, and the perineum. This pathology is diagnosed in adults and children. Girls aged 1–9 years are most susceptible to vulvitis. Inflammation of the genitals with improper treatment can lead to dangerous consequences, including damage to the uterus, appendages and infertility.

Reasons for the development of vulvitis

In more than half of the cases, the skin and mucous membranes become inflamed due to infection and changes in the normal microflora. The causative agents of the disease are:

Fungi.
Escherichia coli.
Streptococci.
Viruses.
Trichomonas.
Chlamydia.
Gonococcus.

An allergic form of the disease can provoke contact with irritating substances. The latter are foods (chocolate, citrus fruits, nuts, protein), medicines, latex, lubricants, synthetic underwear, scented pads and tampons, and intimate hygiene products.

Before puberty in girls, the reaction of the environment in the vagina is neutral or slightly alkaline. This is due to the absence of lactobacilli. Such microflora contributes to a decrease in immunity, which increases the risk of inflammation. The following etiological factors are involved in the development of vulvitis:

Often, infection with specific microbes occurs with frequent changes of sexual partners and commercial sex.

Symptoms

Primary and secondary vulvitis proceed in the same way. The main symptoms of the disease are:

burning;
pain;
soreness of the genitals;
discomfort during sexual intercourse;
increase in body temperature;
irritability;
redness;
puffiness;
tearfulness.

The incubation period is from 2 to 10 days. When the vaginal mucosa is involved in the process, pathological discharges appear. They may be greenish-yellow, frothy, and foul-smelling. With a fungal etiology of the disease, a white coating is detected. The discharge may resemble cottage cheese.

In sick girls with acute vulvitis, appetite and sleep are often disturbed. There may be an increase in lymph nodes in the groin area. With a herpetic etiology of the disease, rashes are found in the genital area. They are represented by small single or grouped vesicles. Their diameter is 2–8 mm. The bubbles burst, leaving behind ulcers.

With secondary vulvitis against the background of vaginitis or inflammation of the cervical canal, pain in the lower abdomen may appear. If syphilis served as the cause of the damage to the genitals, then it occurs. This is a painless erosion or rounded ulcer about 1 cm in size. The allergic form of inflammation is characterized by severe itching, reddening of the genitals and burning. Symptoms subside when taking antihistamine medication.

Vulvitis against the background of papillomavirus infection is characterized by the formation of papillomas (warts) or (painless growths on the leg) on the skin and mucous membranes. They tend to grow and merge. Warts can spread to the perineum and anus. Every gynecologist saw a photo of such patients.

Ways to detect the disease

Therapy of vulvitis begins after the diagnosis is clarified and another pathology is excluded. This will require:

collecting an anamnesis of the disease and life;
gynecological examination on the obstetric chair;
smear analysis for microflora and STI pathogens;
rectal examination;
general blood analysis;
examination of feces for helminth eggs;
scraping from the perianal area for enterobiasis;
Ultrasound of the pelvic organs;
bacteriological culture;
polymerase chain reaction;
linked immunosorbent assay;
blood chemistry;
palpation of the abdomen.

When bacteria are found in a smear of a woman with vulvitis, their sensitivity to antibacterial drugs is determined. This allows the doctor to choose the optimal medicine. Diagnosis necessarily includes an assessment of the obstetric and gynecological history. It allows you to identify previous diseases, sexual activity and risk factors for the development of vulvitis.

How to treat vulvitis

This inflammatory disease requires an integrated approach to treatment.

Medical therapy

The main aspects of therapy are:

temporary abstinence from sexual intercourse;
the use of local medicines;
systemic etiotropic therapy;
elimination of etiological factors;
increased immunity;
physiotherapy;
complete nutrition;
treatment of sexual partners.

Antibiotics are prescribed for specific and nonspecific vulvitis. With a mixed microflora, penicillins or cephalosporins (Amoxiclav, Cefazolin sodium salt, Ceftriaxone Kabi) are indicated. If gonococci are found in the smear, then macrolides, cephalosporins and fluoroquinolones are the drugs of choice.

Medications containing metronidazole may be prescribed. The treatment regimen for gonococcal vulvitis includes vaccination and the use of immunostimulants (Likopida, Immunorma). With inflammation of the trichomonas nature, the following medicines are effective:

Klion;
Metrogyl;
Trichopolum;
Metron;
Bacimex;
Metronidazole Nycomed;
Ornidazole;
Tiberal;
Dazolik;
Gyro;
Klion.

The gynecologist selects the drug taking into account the age of the patients and contraindications. Many medicines are not used during pregnancy. In the case of recurrent trichomonas vulvitis, the Solcotrichovac vaccine may be administered. If there are signs of candidiasis of the external genital organs, then antimycotic drugs are used. These include: Irunin, Levorin, Itrazol, Orungamine, Orungal, Diflucan, Fluconazole, Mikosist and Flucostat. These drugs are available in the form of capsules and tablets.

Treatment of allergic vulvitis involves stopping contact with the irritant (refusal of synthetic underwear, hyperallergenic products, latex, lubricants and fragranced pads), taking H1-histamine receptor blockers and corticosteroids. When a herpes simplex virus is detected in the blood, patients are prescribed an antiviral drug (Acyclovir Akrikhin, Zovirax, Valtrex, Famvir).

If there are papillomas or condylomas in the genital area, then Isoprinosine is prescribed. If necessary, the growths are removed by cryodestruction (freezing), electro- or laser coagulation. Such treatment allows you to eliminate a cosmetic defect. Radical therapy is not mandatory and is carried out at the request of the patient.

The use of local preparations

An important aspect of vulvitis therapy is local treatment. It involves the use of antiseptics, topical antifungal, antibacterial or antiviral drugs in the form of ointments, gels, creams, vaginal tablets or solutions. For inflammation of the genitals, apply:

Miramistin;
Chlorhexidine;
Tantum Rose;
Sanguiritrin;
Lomexin;
Polygynax;
Chlorophyllipt;
Galenophyllipt;
Evkalimin;
Furacillin;
tetracycline and erythromycin ointments.

With vulvitis, infusions and decoctions based on medicinal plants (oak bark, St. John's wort, calendula, eucalyptus, celandine) help. In the chronic form of the disease with frequent relapses, immunostimulants are indicated (Likopid, Eleutherococcus or ginseng tincture, Panavir, Viferon, Immunal).

With a helminthic etiology of the disease, an anthelmintic drug (Vermox, Nemozol or Pirantel) is indicated. Enzymes, sedatives, and interferon inducers are often used in vulvitis. Sometimes hormonal drugs are prescribed. With combined infectious inflammation of the genitals and vagina, eubiotics (Acilact) are indicated.

Be sure to follow the rules of personal hygiene. They include:

washing the genitals and perineum from front to back after each visit to the toilet;
daily change of underwear;
regular washing of linen and its ironing;
cutting nails (important for enterobiasis);
use of a separate towel;
replacing synthetic underwear with cotton;
limiting the use of soap.

With vulvitis, normalization of the general condition is important. For this you need:

to carry out sanitation of foci of chronic infection;
walk more often in the fresh air;
go to bed earlier;
properly organize the working day;
eliminate stressful situations;
eat more fruits and vegetables;
drink vitamins;
give up alcohol.

Most often, treatment is carried out. With the development of complications, hospitalization is required.

Diet

If vulvitis develops, then it is necessary to adhere to proper nutrition. The diet suggests:

It is useful for patients to eat fish and seafood. In the fungal form of the disease, the nature of nutrition is different. It is necessary to limit the consumption of foods rich in simple carbohydrates (sweets and pastries).

Complications

If you do not use ointment, systemic drugs and do not follow the doctor's recommendations, then the following complications are possible:

bonding of the vagina and labia;
the formation of adhesions (unions);
inflammation of the urethra and bladder;
scar formation;
inflammation of the vagina;
inflammation of the uterus and its appendages.

Chronic infectious form of vulvitis can cause female infertility.

Preventive measures

There is no specific prevention of the disease. In order to prevent inflammation of the genitals, it is necessary:

refuse promiscuity;
use a barrier method of contraception;
do not overcool;
do not masturbate;
stop smoking, alcohol and drugs;
observe the rules of personal hygiene;
timely treat enterobiasis;
exclude any injury;
eat more dairy products, vegetables and fruits;
normalize hormonal levels;
regularly visit a gynecologist;
wash and shower daily;
wear underwear made from natural fabrics.

Allergic vulvitis can be prevented by avoiding contact with irritating substances. To do this, you need to abandon lubricants, aromatic gaskets and some products.