Effectiveness of treating non-specific pruritus vulvae with topical steroids: a randomized controlled trial

To determine the effectiveness of triamcinolone cream in the treatment of non-specific pruritus vulvae.

A total of 50 patients, aged between 8 and 55 years, with non-specific pruritus vulvae were consecutively included in a double-blind randomized controlled trial by their general practitioner in 25 general practices in the Netherlands. Analysis was by "intention to treat". An infectious cause was excluded by a vaginal and cervical swab. After randomization, 27 patients were treated with triamcinolone cream and 23 patients with a placebo cream. The effectiveness was assessed by: change in the severity of itch visual analogue scale (VAS) score; the percentage of patients with complete recovery; and changes in general health according to COOP/WONCA charts.

The mean decrease in severity of itch was 2.08 points in the triamcinolone group compared to 3.26 points in the placebo group. Forty-two per cent of the women in the triamcinolone group completely recovered versus 35% in the placebo group. There was no difference in general health perception between the two groups. After 12 weeks, more than 80% in both groups reported recurrent vulval itch.

No significant differences in effectiveness were found between the two groups, because both treatments were ineffective. We can conclude that triamcinolone cream is therefore not the treatment of first choice for non-specific pruritus vulvae.