Female Genital Dermatology
Female genital dermatology is the diagnosis, treatment and prevention of conditions associated with the vulva, or external female genitalia. Patients can experience discomfort and find the problem impacts their day to day life. It can often be an area untreated as patients find it difficult and embarrassing to talk about. For some women it can be an issue which has been ongoing for quite some time because of misdiagnosis or an unknown allergy to the prescribed treatment.
Patient symptoms can vary from mild to severe & can include:
Pain
Itching
Burning
Ulcers
Changes in vaginal discharge
Lumps
Swelling
Sores
Dyspareunia
Bleeding
Stenosis
Bruising
Why Choose Dr Liz?
Dr Liz is a highly qualified and passionate dermatologist with a special interest in female genital dermatology. She leads the female genital dermatology clinic at Northern Sydney Dermatology & Laser, and regularly lectures in vulval dermatology for the Sexual Health & Family Planning Association and The Skin Hospital. Dr Liz has also provided specialised training for local doctors and medical students in Fiji, sharing her expertise internationally. Her dedication to the field has been recognised with the Meritorious Service Award for service to Dermatology, and she has served on the National Examination Committee.
Dr Liz is committed to providing the highest standard of dermatological care. She creates a welcoming and supportive environment, encourages open discussion of concerns and symptoms, and always tailors her approach to each patient’s unique needs with professionalism and respect.
She is also a proud member of the International Society for the Study of Vulvovaginal Disease (ISSVD), an organisation dedicated to advancing women’s health through education and research. Dr Liz has contributed to patient education by helping design a comprehensive section of patient handouts for the ISSVD website. Click here to explore these valuable resources for women with vulvovaginal conditions.
A Practical Introductory Guide For Medical Practitioners In Women's Health Services
by Dr Elizabeth Dawes-Higgs
This book is based on a lecture series Dr Liz has been presenting as part of the National Certificate in Reproductive & Sexual Health for Doctors since 2014.
FEMALE GENITAL DERMATOLOGY CONDITIONS:
Lichen sclerosus
Lichen Sclerosus is a skin condition affecting the skin, particularly the vulva and anus. It is most common in menopausal women but can occur in young women too. White, thick and crinkled patches on the skin occur which can cause scarring. Lichen Sclerosis is thought to be an auto-immune disease which can lead to a risk of developing cancer in the affected skin. The appropriate treatment and diagnosis is important to reducing symptoms and the risk of developing vulval cancer.
Symptoms associated with Lichen Sclerosus include:
Itching
Burning
White spots
Dyspareunia
Bleeding
Stenosis
Bruising
Blisters
Treatment options:
Topical corticosteroid preparations
Steroid medication
Retinoids or vitamins
Tacrolimus ointment
Ultraviolet light treatments
Chronic Vulvovaginal Candidiasis
Vulvovaginal candidiasis is the most common vulval symptom affecting women. This can be chronic if it occurs multiple times over a brief period. There are a few different pathogens which can cause these symptoms, but they don’t all respond to the same prescribed treatment. Appropriate diagnosis and treatment is fundamental in the treatment of chronic vulvovaginal candidiasis. Allergies to the prescribed treatment may also result in unresolved symptoms or the condition getting worse.
Symptoms include:
Itching
Irritation
Burning
Dyspareunia
Abnormal discharge
Swelling of the vulva
Treatment options:
Anti-fungal topical preparations
Anti-fungal oral medication
Vulval cancer
Vulval cancer commonly occurs between the labia minora, the labia majora and the perineum. Vulval cancer affects 300 Australian women each year, two-thirds of which develop vulval cancer caused by lichen sclerosus.
Symptoms include:
Itching
Skin changes
Bleeding
Pain
Lumps
Ulcers
Lesions
Causes:
Skin conditions
Precancerous conditions
Smoking
Treatments options:
Surgery
Radiotherapy
Chemotherapy
post menopause vulval skin changes
Vulvovaginal Atrophy
Postmenopausal vulvovaginal atrophy (VVA), part of the Genitourinary Syndrome of Menopause (GSM), is a common condition caused by declining oestrogen after menopause. This leads to thinning and dryness of the vulval and vaginal tissues, loss of elasticity, irritation, pain with intercourse, and sometimes urinary symptoms. These changes can be worsened by factors like lack of sexual activity, smoking, or certain medications, and are often underreported due to embarrassment or the belief that nothing can help.
Vulva skin care
The vulval area is unique—its skin and mucosa are more delicate, sensitive to hormones, and easily affected by friction, moisture, and irritants. Disruption of the vulval barrier can lead to irritation, dermatitis, or flare-ups of conditions like lichen sclerosus or eczema.
Essential Principles for Vulva Skin Care
Gentle Cleansing: Use only lukewarm water or a pH-balanced, fragrance-free non-soap cleanser. Avoid soaps, shower gels, bubble baths, and intimate washes, as these can strip natural oils and upset the skin’s balance.
Maintain Moisture: Apply a bland emollient (like soft paraffin, sorbolene, or ceramide-based creams) daily to keep the area hydrated and protect against dryness and irritation. This is especially important after menopause or if you have a history of vulval skin conditions.
Minimise Irritants: Choose 100% cotton underwear, avoid scented products and harsh detergents, and change out of sweaty clothes promptly. Pads, panty liners, and excessive wiping can all contribute to irritation.
Use Moisturisers Wisely: Vulval moisturisers (such as Replens®, Yes®, or pure sorbolene) can be used both externally and internally, depending on your needs. Look for products with a pH around 4–5 to support healthy flora.
Protect Against Friction: If you’re prone to irritation from exercise or heat, cornstarch-based powders or zinc barrier creams (like Sudocrem®) may help. Avoid talc-based powders.