In the majority of cases, a diagnosis is very easily made at the first clinic visit. Often a simple examination is all that is required to make a diagnosis and plan treatment. Sometimes a small skin biopsy can be very useful in establishing a precise diagnosis. When this is necessary it can usually be done easily at the same visit. The procedure involves a small injection of local anaesthetic, removal of a tiny piece of skin (about the size of a rice grain) and one very fine stitch that dissolves itself over two weeks.
If preferred, arrangements can of course be made to take any biopsy on another occasion with general anaesthetic.
Once a diagnosis is made, effective treatment can be started and there is often rapid improvement in symptoms. Treatment is almost always medical with skin creams or ointments and it is most unusual for surgery to be required.
For some women, longer term hospital follow up visits are recommended, perhaps two or three times a year. This is because, although very uncommon, some vulval skin conditions have a small risk of malignant change. Many women are already aware of this risk and are understandably anxious, but are not fully informed of the whole picture. One of the biggest advantages of specialist advice is a careful explanation of the real risk, overall and in relation to a patient’s individual circumstances. In reality, the risk is almost always very small.
