Hi doctor, I have a really embarrassing problem. The skin around my vulva and anus is red and it keeps cracking or bleeding. The skin around my anus is also flaky and yellow in some places. It is itchy and is causing me serious embarrassment. It has started affecting me psychologically as it has been an ongoing problem for the past one year or so. I have been tested for all STDs including HIV and I am negative. So, that it has been ruled out. I have tried all sorts of steroid creams and thrush treatment, but it never worked. I really need help with this as it is making me really depressed. I also got an itchy flaky scalp and occasionally get flaky skin on my eyelids. What could this be and how can I get it treated?
Hi. I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern. 1. Itchy and flaky scalp and eyelids indicates seborrheic capitis and dermatitis or dandruff.  2. For that, you can use Ketoconazole based shampoo on your scalp twice a week.  3. You can apply Betamethasone lotion on your scalp over the itchy areas twice daily for one week.  4. Apply Hydrocortisone cream over the eyes once daily for seven days and then stop. Constant unremitting itching over the vulva could be due to lichen sclerosus. 1. The mainstay of treatment will be topical steroids. In addition, you may take Fluconazole 150 mg orally once weekly for two weeks. 2. Use a non-soap cleanser. 3. Take oral antihistamines, for example tablet Hydroxyzine 25 mg at night. 4. Avoid constant itching or rubbing. It will aggravate the symptoms. 5. Apply emollients for relief and to avoid itching. Loose cotton based clothing and inner wear will be helpful. For further information consult a dermatologist online.--->