How to apply Clobetasol or Halobetasol

Posted , 9 users are following.

Hi guys,

I am just curious I've listened to Dr. Goldstein's lecture and found it very informative on how to use Clobetasol (soaking warm bath for 20 minutes before applying Clob). My question is what areas to apply the Clob. My uro gynecologist says to apply in affected areas, labia major, labia minora and above the urethra in soft skin area. My dermatologist tells me to avoid the vaginal opening, don't apply to the area near  the rectum or an mucosal areas. I'm confused. Another question I had a D & C in July due to vaginal opaque discharge. The discharge has returned I've seen the gynecologist twice regarding the discharge. She states it's not a yeast infection. Does this usually occur With LS?  Question number three in my inner labia minora I have two reddish spots they're are not open wounds just like vessels under the skin is this part of the many ways LS shows up? 

2 likes, 13 replies

13 Replies

  • Posted

    Hi Wil--I apply the clob ointment to the inner areas of the vulva--labia minora, clitoris (which is a little sore and trying to fuse on me, I think), around the urethra (I also feel irritation there from the LS), so--all of the mucosal tissues.  I don't have any white or red areas on my perineum or anus at this point, so I don't apply there.  My labia majora is not involved at this point, either--just the inner mucosal areas.  I do apply a little to the area around my vaginal opening (introitus) because I have some narrowing going on there.  I guess anywhere that we have symptoms in that "figure eight" area that LS commonly strikes is appropriate if we are symptomatic there.  

    I don't think that this is a science yet, so our doctors may just be trying to figure it out, like we are.  We have to weigh the costs/benefits of treatment versus no treatment and make our decisions accordingly.  Treating comes with some risks, but not treating comes with a lot of risks, too.  

    I have some slightly reddened areas next to the white areas.  Not sure if that's what you are seeing.  I assume that your doctors are keeping an eye on you for maligancy, which we all run a slight risk of with LS.

    Regarding the discharge, I had similar sounding discharge a few years ago and it turned out to be bacterial vaginosis.  Have you ruled that out with your doctors?  It sometimes can have a very mild fishy odor.  It is very common in women (and sometimes passed back and forth between sexual partners).  The odor is sometimes more pronounced after intercourse and the next day.  Some antibiotics can treat bacterial vaginosis, but I haven't had any recurrances of it since following some research that I read which says that low vitamin D levels can make it more likely (can assess vitamin D levels with a blood test), so I take vitamin D.  I think that the probiotics that I take and fermented foods also helps the vaginal flora to maintain itself in a healthy way, too.  

    I hope that sharing some of my experiences are of some use to you.  These are not easy issues to be dealing with!  --Suzanne

     

  • Posted

    I was given Clobetasol for anal areas and it made my symptoms worse then my gynae said he did not think I had LS so I stopped using it. I soak in bath for 20 mins e45 actually shower cream not bath then I apply e45 intensive lotion (red top type) around the vagina and anus and so far had good results the redness all gone. Am using Vagifem for vaginal atrophy and so far things now going ok.The Clobetasol will thin your skin which is why you can see the vessels under your skin. This happened to me when I was using it, but if there is no alternative because of the symptoms, then I guess you still have to use it. I also guess people get urine infections as the cream could get in the urethra. I am sure the instructions on using the cream as well say do not apply to the areas your gynae told you, and think your dermatologist correct. Sometime common sense has to prevail as there is so much conflicting info between doctors gynae and dermatologists. Hope this helps
  • Posted

    Will, those discolored patches (red or bruised-looking) are just part of LS. I kind of agree with your doctor about not applying clob inside the the vagina. LS is in skin, not mucosal membranes. There's no danger of thinning LS affected skin, because it's actually way too thick with deadeded cells. Like Suzanne, I'm tempted to slip around the edge with the application, where the bridge across the 'fourchette' is slowly tightening. I have used it on the big red area around my anus, but not on the actual sphincter, which is a different type of tissue and that redness really cleared up nicely.

    One of the biggest obstacles to solving LS, as Dr. Goldstein said, is that Dermatologists have more training that gynaecologists on the disorder, but aren't accustomed to examining any areas under our panties.

    It's very clear wherever you read that LS is never inside the vagina. That would more likely be lichen planus or, as Suzanne says, an infection. Then you're really in gynaecolocy's territory.

    I've had a yeast infection this past week (treating it with the slow-working cream, which is gentler on LS than the Bomb – one-night suppositories) and it seeems to be causing an LS flare (white perineum again and a long split). I've suspected that all the years before my diagnosis those many yeast infections (caused by sugar, stress and the friction of sex) were giving the LS repeated boosts. I blame the current outbreak of yeast on a combination of rubbing Premarin cream on for three nights, a stressful day, and an ice cream cone.

  • Posted

    A lot depends on where the LS is! I had it around the rectum quite badly, the typical keyhole shape described in many articles, so I had to use it there. The splitting and fissures I had healed well.  However I have to be really careful not to let dermovate near my ureathra as it makes me very sore.  Nowadays I usually get on fine with daily applications of 1% hydrocortisone, but last week for the first time in two years I had to use dermovate for three days and it felt like I had a UTI. I think experience will be your best guide

     

    • Posted

      Hmmm.  I feel irritation a lot on my urethra and thought it was the LS.  Now wondering if it is the clob ointment.  Thanks for your thoughts!
    • Posted

      Suzanne, I have no idea what everyone else's anatomy looks like, but my urethral meatus looks like a big red glans standing up all by itself in the area in front of my vagina. There is no way I can get any clob on it without trying. And I wouldn't try. I rub it in for a third of my 90 seconds on the still-active crease behind my anus, then for another 90 seconds on the perineum, then for another 90 seconds at the top of the pubes' divide and down over the fused clitoral hood. I don't get close to the urethral meatus.

      I think if you have been getting it on there (it's mucous membrane, not skin) it's not surprising it's sore.

    • Posted

      Hi Morrell--My urethra is right in the middle of the LS action and sounds like it is a lot more inset than in your anatomy.  My white areas are right above the introitus and inside the labia minora in a circular pattern, and now my clitoris is getting in on it--it's irritated and seems to be disappearing some as others have described.  While I've tried, there's just no way for me to avoid getting the clob ointment on my urethra.  Plus, I've been worried that the irritation there might be related to LS due to the Koebner phenomenon following a UTI that I got three or four months ago, and thought maybe I should be treating it also.  This can get confusing!
    • Posted

      I suspect you've hit it with the UTI/Koebner relationship. I would not leave a UTI untreated. It is possible for LS to get into the urethra. Not the vagina – that's lichen planus. I think it's more likely that LS is irritating the urethra than the clob. Just me talking, though.
    • Posted

      Would it be worth trying an experiment for a few days.....first put a little vaseline around the urethra to protect the immediate area and then apply the clob. If the irritation eases off then you'll know if its the clob causing it.

       

    • Posted

      Excellent idea Kate! Like a resist mask on a painting.
    • Posted

      Great idea, Kate.  I'll give it a try.  --Suzanne
  • Posted

    A lot depends on where the LS is! I had it around the rectum quite badly, the typical keyhole shape described in many articles, so I had to use it there. The splitting and fissures I had healed well.  However I have to be really careful not to let dermovate near my ureathra as it makes me very sore.  Nowadays I usually get on fine with daily applications of 1% hydrocortisone, but last week for the first time in two years I had to use dermovate for three days and it felt like I had a UTI. I think experience will be your best guide

     

  • Posted

    the new gyn I saw today told me to apply the clob to the whole vulva area, the white skin, raw skin , thin skin, all of it. but I do not have any problems in the tissue around my urethra, she said it was fine.  I asked about my anus and she said no because she did not see LS there right now, but Im sure it was there in the beginning. Definately not in the vagina, just around the opening of the vagina.

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.