From the Research
The treatment plan for desquamative inflammatory vaginitis (DIV) should prioritize topical anti-inflammatory therapy, with clindamycin 2% vaginal cream or 10% hydrocortisone as first-line treatment options, as they have been shown to dramatically relieve symptoms in 86% of patients within 3 weeks 1. The choice between these two options may depend on the patient's specific symptoms and medical history. Some key points to consider in the treatment plan include:
- The use of clindamycin 2% vaginal cream or 10% hydrocortisone as first-line treatment options, with the potential for adding intravaginal hydrocortisone for patients who do not respond adequately to clindamycin alone 1.
- The importance of maintenance therapy to prevent recurrence, as 32% of patients may relapse within 6 weeks of discontinuing treatment 1.
- The potential need for local estrogen therapy in postmenopausal women or those with low estrogen states, to help restore normal vaginal epithelium and pH 2.
- The importance of avoiding potential irritants during treatment, including douches, scented products, and tight synthetic clothing, to help manage symptoms and prevent recurrence. It is also worth noting that DIV is a chronic inflammatory process, and long-term maintenance therapy is often required to manage symptoms and prevent recurrence 1, 3. Overall, the goal of treatment should be to reduce inflammation, restore normal vaginal flora, and improve symptoms, with the ultimate goal of improving quality of life for patients with DIV.