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Jessica

Age at interview: 20
Age at diagnosis: 20
Brief Outline: (Audio or text only clips) Jessica has seen doctors for both acne and vulvar eczema. She found that healthcare professionals were not as knowledgeable about vulvar eczema and that is more difficult to deal with than acne because it is less common.
Background: Jessica is 20 years old and an undergraduate university student. Her ethnic background is Indian British.

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Jessica has seen doctors for both acne and vulvar eczema. Jessica’s initial symptoms of vulvar eczema included an itchy vagina and pain during sex. She describes her route to diagnosis with the GP as a “process of elimination” for all other possibilities including yeast infections, sexually transmitted infections (STIs), and bacterial infections. Tests and treatment for these possibilities took a few months and the itching continued. Out of frustration and with support from her mum, Jessica went to a private doctor who had seen vulvar eczema before and was able to give the diagnosis. In terms of treatment, the private doctor prescribed medicated washes, creams, and ointments. The doctor also suggested bringing this prescription up with a GP so that Jessica could get a repeat prescription on the NHS in case of flare ups. 

Jessica found that switching doctors can be difficult because it often means convincing a new doctor that the diagnosis is correct and that all other health conditions have been ruled out. She found that although doctors were sympathetic, they were generally not knowledgeable enough of vulvar eczema. Her suggestion to healthcare professionals is to clearly communicate all possible diagnoses and treatment options to the patient. Jessica found that although she told some friends about her eczema, they did not understand the chronic nature of the condition. She explains that her mum’s persistence and support made the diagnosis process easier, but she also had to open up to her mom more about her sex life. Jessica’s main sources of information about vulvar eczema was online, where she read through websites and posts about people’s own experiences. Although she found that vulvar eczema affected mostly older people, there were also some people her age posting online. Jessica suggests that “having hope” and accepting that “everyone’s skin is different” may help others get through their experiences with skin conditions. 
 

Jessica saw many GPs and did her own research before being diagnosed with vulval eczema and receiving specialist treatment.

Jessica saw many GPs and did her own research before being diagnosed with vulval eczema and receiving specialist treatment.

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Over like summer, I started having like a really itchy like vagina. So now I sort of have vulvar eczema which is actually quite unusual. And obviously at the beginning with sor-that like—cos it’s, that’s really hard to go through the NHS because it’s quite like a gynaecological/dermatological problem, so no one really knows where to put it. And obviously, at the beginning they thought like, had an infection. Or like an STI and I’ve had like so many tests until Yeah, I was like telling my mum about it and she got quite frustrated, went to like a private doctor who finally diagnosed it as vulvar eczema and has given me like steroid cream and stuff. 

So, like, when you like Google outright ‘itchy vagina’, the o-, first thing that comes up is you probably have an infection… that sort of thing. Yeah, I never really thought I had an STI, that seemed unlikely Yeah, for a while I was just sort of, sort of like, oh, I don’t really know what I have, but like oh they’ll figure it out. I am taking all these tests like, sort of thing. I’m pretty sure it was the Internet that first gave me the idea that I probably have eczema.
 

Jessica saw many GPs and did her own research before being diagnosed with vulval eczema and receiving specialist treatment.

Jessica saw many GPs and did her own research before being diagnosed with vulval eczema and receiving specialist treatment.

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Over like summer, I started having like a really itchy like vagina. So now I sort of have vulvar eczema which is actually quite unusual. And obviously at the beginning with sor-that like—cos it’s, that’s really hard to go through the NHS because it’s quite like a gynaecological/dermatological problem, so no one really knows where to put it. And obviously, at the beginning they thought like, had an infection. Or like an STI and I’ve had like so many tests until…Yeah, I was like telling my mum about it and she got quite frustrated, went to like a private doctor who finally diagnosed it as vulvar eczema and has given me like steroid cream and stuff. 

So, like, when you like Google outright ‘itchy vagina’, the o-, first thing that comes up is you probably have an infection…that sort of thing. Yeah, I never really thought I had an STI, that seemed unlikely Yeah, for a while I was just sort of, sort of like, oh, I don’t really know what I have, but like oh they’ll figure it out. I am taking all these tests like, sort of thing. I’m pretty sure it was the Internet that first gave me the idea that I probably have eczema.
 

Jessica saw many GPs and did her own research before being diagnosed with vulval eczema and receiving specialist treatment.

Jessica saw many GPs and did her own research before being diagnosed with vulval eczema and receiving specialist treatment.

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Over like summer, I started having like a really itchy like vagina. So now I sort of have vulvar eczema which is actually quite unusual. And obviously at the beginning with sor-that like—cos it’s, that’s really hard to go through the NHS because it’s quite like a gynaecological/dermatological problem, so no one really knows where to put it. And obviously, at the beginning they thought like, had an infection.  Or like an STI and I’ve had like so many tests until Yeah, I was like telling my mum about it and she got quite frustrated, went to like a private doctor who finally diagnosed it as vulvar eczema and has given me like steroid cream and stuff. 

So, like, when you like Google outright ‘itchy vagina’, the o-, first thing that comes up is you probably have an infection… that sort of thing.  Yeah, I never really thought I had an STI, that seemed unlikely Yeah, for a while I was just sort of, sort of like, oh, I don’t really know what I have, but like oh they’ll figure it out. I am taking all these tests like, sort of thing.  I’m pretty sure it was the Internet that first gave me the idea that I probably have eczema.
 

Jessica and her dermatologist think her itchiness might now be an allergic reaction to a cream for vulval eczema.

Jessica and her dermatologist think her itchiness might now be an allergic reaction to a cream for vulval eczema.

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So I’ve been back and apparently I might be allergic to some of the like cream that she’s given me. So I’m having like a patch test in a few weeks to check that out, because when she, cos I went twice and the second time she’s like, when she examined me she’s like ‘well looks like your eczema’s actually gone, but you’re still itchy. So you’re probably gon-’ and then she was like ‘oh have you ever been allergic to like’ she gave me a few like things that I might’ve been allergic to and she was like one of them was like, ‘oh have you ever been allergic to like  sort of like cheap jewellery’. And I was like, yeah and she gave me so- some sort of stats about people that are allergic to jewellery normally are quite allergic to some sorts of creams and things. So I’m having like a patch test in a few weeks, we’ll see how that goes. So the vulvar eczema thing is sort of still very much ongoing.
 

Jessica is unsure whether stress is a trigger for her eczema.

Jessica is unsure whether stress is a trigger for her eczema.

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See, I don’t know, just like everyone’s always like ‘oh, is it cos you’re really stressed?’ But I don’t actually notice it that much. And I feel like if no one had ever told me that like it’s quite a common thing, ‘oh, stress is a trigger for acne, stress is a trigger for eczema’. But if no one had said it to me I probably wouldn't have even noticed.  Yeah, I’m pretty sure that the like, it’s self-perpetuating because of, the vulvar eczema thing stresses me out. And then that’s sort of like, is stressful. But like yeah, I can’t think of a specific. I don’t, I don’t think it gets worse near exam time or anything. So I can’t really think of any specific time. 
 

Jessica’s friends know about her vulval eczema but she doesn’t feel she can keep bringing the topic up.

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Jessica’s friends know about her vulval eczema but she doesn’t feel she can keep bringing the topic up.

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I’m really not even a very awkward person at all. But yeah, so like, I think I told like a few of my friends back home, we like, this is fine. But they sort of, you’ll tell them and they’ll just sort of just be like, oh, that’s just some sort of like that can’t be a thing that is long running like, do you know what I mean? Like so, you’ll tell them and they’ll be like, oh, that just means she ha-kinda has to go to the GP and like people don’t really understand that actually this is quite a long term problem.

But, you’re not just gonna just like, cos if you had like, I don't know, if you had some sort of like rash on your arm, you could easily like complain about it for ages. But you aren’t gonna complain about like a group full of people, your friends that you have like an itchy vagina.
 

Jessica heard about vulval eczema online but found her doctors didn’t know much about it.

Jessica heard about vulval eczema online but found her doctors didn’t know much about it.

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like right now I’d say I know more about vulvar eczema than like majority of GPs, which is like, I don't know, the fact that like, I- a Google article can tell me and like they don’t know anything about it sort of thing. 

How long did it take you sort of looking online to find vulval eczema as an explanation?

Like two seconds. 

Yeah.

Like, yeah, like or maybe I’d read an article or, like not every article that you say, that has like itchy, you have an itchy vulva—but like the majority of them would actually even like, the majority of them would reference eczema probably at the end. And so then from then, if and then if you actually Google vulvar eczema then you get lots of stuff. So, yeah.

And like it’s not even a problem like, I’m pro- pretty sure that like even some sort of NHS site has vulvar eczema on it somewhere. 

I don't know understand if like there’s so much information out on the Internet like, I dunno is it not, not somewhere that like or even like can’t the doctor just Google it? Like the fact that, when I went to the GP here and he was like, ‘I’m out of options, I have no idea what you’d have’. Like Google could tell me the, p- possible things that I could have. Why can’t you tell me the possible things that I could have? 

Like I didn't understand that. That was a bit weird. 
 

Jessica has done a lot of research on the internet about vulva eczema.

Jessica has done a lot of research on the internet about vulva eczema.

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I’ve literally feel like I’ve looked through any sort remotely big website. The main thing I think I looked like there, there were two like biggish sort of blogs of people and writing about their experiences. I think it definitely seems to, hit older people more. Or people often who’ve had like children and stuff. There were like quite a few people my age, but like, yeah, I see, I think this is the sort of thing that like if you have it and you go online that like you would write and stuffs. But I think like, oh well I don’t think it’s a very common problem. Yeah, I don’t, I don’t know if it was, it made me feel better or worse I think, that there were so many people that were like oh, we’ve had really shit experiences with like doctors and things and stuff. I think yeah, oh and I think there were like, you know people that had some sort of success were like, I went to a really good like dermatologist who told me to do this and put me on some sort of like treatment. There were some people that were like, had help through like unconventional medicine which was quite surprising. Yeah, but there were a lot of like and I think by the end of my research I could tell there were a lot of like, I could see like, I read things by a lot of frustrated people that like were probably slightly earlier in the process than me. So you kind of like see how frustrated they were. Yeah, so I dunno if that made me feel better or worse, but I did look through it all.
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