Dr Alice Rudd & Dr Felicity Gould

The vulva, just like any other part of the body, is covered in skin—and that skin is vulnerable to many common conditions such as eczema, dermatitis, and irritation from over-washing or the use of harsh soaps.

At Skindepth Dermatology, our team frequently treats women of all ages with vulval skin concerns, from childhood through to menopause. As a leading skin clinic in Melbourne’s St Kilda East, we provide expert care in diagnosing and treating these sensitive conditions with compassion and discretion.

Puberty and Vulval Skin Changes

As girls enter puberty, hormonal changes can cause an imbalance in the vulval microbiome (known as dysbiosis) and a shift in pH. This makes the vulva more susceptible to thrush, particularly after a course of antibiotics or while taking the contraceptive pill.

While most cases of thrush respond to topical or oral antifungal treatments, recurrent infections may indicate an underlying issue that needs further investigation.

Another common concern during puberty is vulval dermatitis, often triggered by contact with allergens such as:

• Toilet paper

• Lubricants

• Over-the-counter or prescription medications

• Perfumed products

• Antifungal creams and pessaries

• Antiseptics

• Nail polish

• Latex condoms

• Semen

Midlife and Lichen Sclerosus

In the middle years, lichen sclerosus becomes more common. This autoimmune, inflammatory condition affects the vulva, perianal skin, and occasionally other areas. It is intensely itchy and, if left untreated, can cause scarring, disfigurement, and even lead to vulvar intraepithelial neoplasia (VIN)—a pre-cancerous condition.

Any ongoing vulval itch should be assessed by a qualified dermatologist in Melbourne, such as Dr Alice Rudd at Skindepth Dermatology, to ensure a correct diagnosis and early treatment.

Menopause and Genitourinary Syndrome

After menopause, declining oestrogen levels can result in dryness and discomfort in the vulval area. Previously referred to as vaginal atrophy, this condition is now called Genitourinary Syndrome of Menopause (GSM). It is often treated effectively with topical oestrogen, depending on your medical history.

Diagnosis and Treatment at Skindepth Dermatology

While many vulval conditions can be diagnosed through clinical examination, sometimes additional testing or a biopsy may be necessary. A thorough internal exam may also help identify any contributing issues from within the vaginal canal.

We also understand that vulval skin issues often affect intimacy. Symptoms such as dryness, pain during intercourse, or difficulty with arousal can lead to anxiety or vaginal spasm. While lubricants may offer some relief, many patients benefit from support from a pelvic floor physiotherapist to restore comfort and confidence.

Other Vulval Infections

In addition to thrush, infections such as HPV (genital warts) are also common. Staying up to date with your cervical screenings (Pap smears) is essential, as is receiving the HPV vaccine to reduce the risk of cervical and vulval cancers.

When Should You See a Dermatologist or Gynaecologist?

It’s not always clear whether a vulval issue requires a gynaecologist or a dermatologist. That’s why we established the Skindepth Vulva Clinic, offering collaborative care from both specialists.

Many GPs can manage basic vulval conditions, but when symptoms are chronic, overlapping, or difficult to diagnose, a combined approach ensures accurate diagnosis, comprehensive treatment, and better long-term outcomes.

Our clinic is staffed by expert specialists including Dr Alice Rudd, leading dermatologist in St Kilda East Melbourne, and Dr Felicity Gould, gynaecologist with an affiliation at the Royal Women’s Hospital, for women who may require further procedures.

Bookings are limited. To secure your spot at our next clinic at Skindepth Dermatology, please book early. A GP referral is required.

📍 Located in St Kilda East, our clinic serves patients across Melbourne with specialised care in vulval dermatology and women’s skin health.

To book, call (03) 9527 4209 or visit www.skindepth.com.au