Kuyini i-Vulvar Dermatitis? Izimbangela, Izimpawu kanye Nokwelashwa eNingizimu Afrika

Sawubona msizi wami noma wena othandekayo ofunda lesi sihloko namuhla. Ake sicabange kancane:ake uthathe umzuzwana ucabange ngesimo lapho isikhumba sakho esithweni sangasese siqala ukulunywa noma ukusha ngendlela engakhululeki. Kube buhlungu, ungakhululeki, futhi ngezinye izikhathi uthole ukuthi ngisho nokuhamba noma ukugqoka izingubo kuba nzima kakhulu, akunjalo? Phela, lezi yizinto eziningi zabesifazane ababhekana nazo nsuku zonke kodwa abasaba noma abangazi ukuthi bangakhuluma nobani ngazo. Namuhla thina kodokotela bakho silapha ukuthi sixoxe ngale ndaba ngendlela evulekile, efudumele futhi eqondakala kalula, okuyisimo esaziwa ngokuthi i-vulvar dermatitis.

Mhlawumbe wake wazibuza ukuthi kungani le ndawo izwela kangaka, noma ukuthi yini le edala ukuthi isikhumba sibe bomvu futhi silume ngendlela ethusayo. Ngabe kukhona okusha okusebenzisile muva nje? Ingabe kukhona okuthintile okungahambisani nesikhumba sakho? Asihloleni ndawonye konke lokhu, kusukela ezimbangeleni, ezimpawwini, kuze kuyofika ezindleleni esingelapha ngazo emtholampilo wangakini noma ekhaya. Uhlale ukhumbula ukuthi awuwedwa kulolu hambo, futhi kuhlale kukhona usizo oluseduze nawe lapha eNingizimu Afrika.

Kuyini i-Vulvar Dermatitis?

I-vulvar dermatitis iwukuvuvukala kwesikhumba esisesithweni sangasese sangaphandle sowesifazane, okubizwa nge-vulva, okubangelwa ukuchayeka entweni ecasula isikhumba (irritant) noma ebangela ukungezwani (allergen). Asihloleni ngokujulile: lapho sikhuluma nge-vulva, sikhuluma ngazo zonke lezo zingxenye zangaphandle zohlelo lwakho lokuzala, kuhlanganisa amalebe angaphandle nangaphakathi kanye nendawo ezungeze i-clitoris. Lesi sikhumba sithambile kakhulu futhi sinamandla okumunca amakhemikhali ngokushesha okukhulu kunesikhumba esisezindaweni ezinjengasezandleni noma ezinyaweni zethu. Lokho kusho ukuthi noma yini ethintana nayo – kungaba insipho, i-lotion, noma ngisho nendwangu yogqoko lwakho – ingasiza ekudaleni ukucasuka okukhulu kalula nje, akunjalo?

Uma isikhumba sale ndawo sicasukile, siba sengozini yokuba nesimo esibizwa nge-eczema yesitho sangasese, lapho isikhumba siba bomvu, siqhekeke, futhi silume ngokungabekezeleleki. Ezinye iziguli zethu zisitshela ukuthi zizizwa sengathi kunomlilo ovuthayo noma ukudonsa okubuhlungu okungapheliyo ikakhulu ebusuku noma uma ziya ocansini. Kulula ukuqonda ukuthi lokhu kungaphazamisa kanjani impilo yakho yansuku zonke kanye nokuzethemba kwakho. Kodwa ungakhathazeki, ngoba sinazo izindlela zokukusiza ukuba uzizwe ungcono.

Ubani Othinteka Kakhulu Yilesi Simo?

Mhlawumbe uyazibuza: "Ingabe lesi simo sithinta abantu abathile kuphela?" Iqiniso liwukuthi noma ngubani wesifazane anganqunywa yi-vulvar dermatitis kungakhathaliseki ukuthi uneminyaka emingaki. Nokho, kunezimo ezithile ezenza abanye abesifazane babe sengozini enkulu yokuba naso. Labo abanezinkinga ezivele zikhona zesikhumba ezinjenge-atopic eczema (isikhumba esomile nesilumayo), i-asthma, noma ukungezwani nezinto ezithile (allergies) bavame ukuba sengozini enkulu.

Ngaphezu kwalokho, abesifazane abajuluka kakhulu ngenxa yesimo sezulu saseNingizimu Afrika esishisayo nesinomswakama (njengasezindaweni zaseThekwini noma eGauteng ngezikhathi zasehlobo) nabo basengozini enkulu. Uma umswakama uhlala isikhathi eside endaweni yesitho sangasese, ubuthakathaka besikhumba buyanda, futhi lokho kwenza izinto ezinjengezinsipho noma izinto zokuhlanzeka zingene kalula zibangele ukucasuka. Akunjalo? Siyazi kahle ukuthi ukuba sesimweni lapho ujuluka khona bese ugqoka izingubo eziqinile kungenza izinto zibe zimbi nakakhulu.

Ziyini Izimpawu ze-Vulvar Dermatitis?

Ziyini izimpawu ozizwayo uma unalesi simo? Masixoxe ngazo ngokuningiliziwe ukuze ubone ukuthi zihambisana yini nalokho okuzwayo. Izimpawu ezivame kakhulu zihlanganisa:

• Ukulunywa okukhulu (Itching): Lokhu kuvame ukuba kubi kakhulu ebusuku, uma ulale embhedeni, noma ngemva kokuya ocansini noma ngezinsuku zokuya esikhathini lapho isikhumba sithintana noketshezi oluningi.
• Ukuzwa ukusha noma ubuhlungu: Isikhumba sizwakala sengathi siyasha, siyahlaba, noma silimele njengamanxeba amancane.
• Ukuvuvukala nokubomvu: Ezinye izindawo zesikhumba zingase zibonakale zibomvu kakhulu, futhi uma isimo siqhubeka, isikhumba singase sizwakale sijiyile noma sikhulu kunesijwayelekile.
• Ukwakha uqweqwe noma ukukhipha uketshezi: Indawo yesitho sangasese sowesifazane ingase izwakale imanzi noma ikhiphe uketshezi olucacile ngenxa yokuthi isikhumba sonakele (okubizwa ngokuthi isikhumba esekhalayo - weeping skin).
• Ubuhlungu ngesikhathi socansi noma sokuhlolwa: Ubuhlungu obukhulu uma uya ocansini, lapho usebenzisa i-tampon, noma lapho udokotela efaka i-speculum ngesikhathi sokuhlolwa kwe-pelvic emtholampilo.

Yiziphi Izimbangela ze-Vulvar Dermatitis?

Asihloleni ukuthi yini edala lesi simo. Ngokuvamile, i-vulvar dermatitis ihlukaniseka kabili: ukucasuka okuqondile kwesikhumba (irritant contact dermatitis) noma ukungezwani komzimba nomkhiqizo othile (allergic contact dermatitis). Nazi izinto ezivame kakhulu ezibangela lokhu:

• Imikhiqizo yokugeza nokuhlanzeka: Izinsipho ezinamakha, amabhabhu okugeza (bubble baths), ama-shampoo, ama-conditioner, kanye namasipho okuhlanza umzimba anamakha amandla.
• Amakhemikhali wokuhlobisa nokuqeda iphunga: Ama-deodorant endawo yangasese, amaphunga amnandi (fragrances), uketshezi lokuhlanza ngaphakathi (douches), kanye nepuphu ye-talcum powder).
• Izindwangu zezingubo zangaphansi: Izingubo zangaphansi ezenziwe ngezindwangu zokwenziwa ezingaphefumuli kahle ezinjenge-nylon noma i-polyester.
• Izinto zokuwasha izingubo: Insipho yokuwasha izingubo zangaphansi ezinamandla noma amabhola okomisa angashiya amakhemikhali ezindwangwini.
• Imikhiqizo yezinsuku zokuya esikhathini: Ama-sanitary pad (ama-pads) anamakha, ama-panty liner, noma ama-tampon.
• Amanye amakhemikhali nezinto zasendlini: Iphepha lendlu yangasese elinombala nelinamakha, amafutha okugcoba anamakha, noma ngisho nezithako zemvelo ezithile ezinjengamafutha esihlahla setiye (tea tree oil) abanye abantu abangawezwani nawo.

Lesi Simo (i-Vulvar Dermatitis) Sitholakala Kanjani?

Uma uza emtholampilo wangakini noma ku-dokotela womndeni ngezimpawu zokulunywa nokuvela kwamabala, udokotela wakho uzoqala ngokuxoxa nawe ngomlando wakho wepilo nokuthi yimiphi imikhiqizo oyisebenzisayo. Udokotela uzobe esecela ukuthi ahlolisise indawo ethintekile (pelvic examination) ngendlela enakekelayo nehloniphekile ukuze abone ukuthi isikhumba sinjani, ukuthi sinesikhumba esibomvu yini, noma esiqhekekile yini.

Kubalulekile kakhulu ukuba udokotela akwazi ukwehlukanisa i-vulvar dermatitis kwezinye izimo ezingase zibe nezimpawu ezifanayo. Nazi ezinye zezimo esizihluzayo ngesikhathi sokuxilonga:

• I-Lichen Planus kanye ne-Lichen Sclerosus: Izifo zesikhumba ezingelapheki ezibangela ukuba isikhumba sibe mhlophe, sibe mncane futhi sibe buhlungu kakhulu.
• I-Psoriasis: Isifo sesikhumba esingathinta nezinye izindawo zomzimba ezinjengekhanda kodwa futhi esingathinta nendawo yesitho sangasese.
• I-Seborrheic Dermatitis: Ukuvuvukala kwesikhumba esinamafutha amaningi.
• Ukoma kwesitho sangasese (Atrophic Vaginitis): Okujwayelekile kwabesifazane abadala noma abasanda kungena esikhathini sokuya esikhathini sokuyeka (menopause) lapho ama-hormone e-estrogen ehla khona.
• I-Vaginitis noma i-Vulvitis: Ukutheleleka ngezifo ezifana nemvubelo (yeast infection / candidiasis) noma amagciwane.
• Umdlavuza we-Vulvar Cancer): Nakuba ungavamile kakhulu, udokotela wakho uyakuqapha lokhu ukuze aqiniseke ukuthi akukho okubi okufihlekile.

Nazi izici eziqhathanisayo phakathi kwe-vulvar dermatitis nezinye izimo ezifanayo ukuze uqonde kangcono:

Iyini Indlela Yokwelapha Lokhu?

Ukwelashwa kwe-vulvar dermatitis kugxile ekusetshenzisweni kwezinto ezimbili ezinkulu: ukushintsha indlela yokuphila nendlela esiphila ngayo nsuku zonke, kanye nokusebenzisa imithi edambisa ukucasuka. Asixoxeni ngalokho ngakunye.

Izinguquko Zendlela Yokuphila

Ukushintsha imikhuba yakho yansuku zonke yiyona ndlela ebaluleke kakhulu yokuvimbela ukuthi lesi simo sibuye. Nazi izinto ongazenza namuhla:

• Ungagezi ngokweqile: Geza indawo yakho yesitho sangasese kanye kuphela ngosuku. Sebenzisa amanzi afudumele kuphela noma insipho ethambile kakhulu engenamakha (unscented gentle cleanser).
• Sebenzisa izandla zakho: Uma ugeza, sebenzisa isandla sakho neminwe esikhundleni sendwangu yokugeza (washcloth) noma isipha, ngoba indwangu ingaphica isikhumba esibuthakathaka.
• Sula ngendlela efanele: Emva kokuwasha, sula ngendlela yokuphaphezela ngethawula elihlanzekile elithambile, kodwa ungahlikihliki ngamandla. Gcina indawo yomile kahle.
• Gqoka izingubo zikakotini ezingu-100%: Gqoka izingubo zangaphansi zikakotini ezikhululekile esikhundleni sezindwangu zokwenziwa ezivala umoya. Ebusuku, uma kungenzeka, kungcono ukungagqoki nhlobo izingubo zangaphansi ukuze isikhumba siphefumule kahle.
• Qaphela indlela owasha ngayo izingubo: Sebenzisa insipho yokuwasha izingubo engenamakha, futhi uqinisekise ukuthi izingubo ziyagezwa kahle kakhulu amanzi asukile onke ngaphambi kokuba uzigqoke.
• Gwema amakhemikhali: Yekela ukusebenzisa izinto ezifana nama-feminine wipes anamakha, amaphepha asendlini yangasese anamakha, noma izifafazo zokuqeda iphunga.

Imithi Esetshenziswayo

Uma izinguquko zasekhaya zinganele, udokotela wakho angakunika imithi ethile ezosiza ukunciphisa ukulunywa nokuvuvukala:

• Amafutha e-Corticosteroid Creams): Lawa ngamafutha abaluleke kakhulu anciphisa ukuvuvukala nokuluma ngokushesha. Izibonelo zifaka i-hydrocortisone, i-desonide, noma amafutha anamandla amakhulu uma isimo sinzima kakhulu, kodwa kumelwe asetshenziswe ngaphansi kwesiqondiso sikadokotela.
• Ama-Antihistamine: Ngezinye izikhathi udokotela angakunika imithi enjenge-hydroxyzine noma i-doxepin ezokusiza ukuthi ulale ebusuku ngaphandle kokulunywa kakhulu.
• Amafutha athambisayo (Emollients / Barrier Creams): Amafutha angenasici asiza ukugcina isikhumba simanzi futhi avikela isikhumba ezintweni ezingaphandle ezingacasula.

Ingancishiswa Kanjani Ingozi Yalesi Simo?

Ukwazi ukuvikela i-vulvar dermatitis kusho ukuthi uqaphela zonke izinto ezithintana nesikhumba sakho esibuthakathaka. Qiniseka ukuthi uhlola yonke imikhiqizo oyithengayo uyeke leyo enamakha. Uma uqala ukusebenzisa insipho entsha noma i-lotion, yizame kuqala esikhumbeni sengalo yakho izinsuku ezimbalwa ngaphambi kokuyisebenzisa endaweni yesitho sangasese. Futhi, zama ukuzivikela ekujulukeni ngokweqile ngokushintsha izingubo zangaphansi ezimanzi noma ezijulukile ngokushesha okukhulu.

Kuzothatha Isikhathi Esingakanani Ukuthi Lesi Simo Siphole?

Lesi ngesinye sezimpendulo abesifazane abaningi abazibuza zona: "Ngizolunga nini?" Isikhathi esithatha ukuthi i-vulvar dermatitis siphole sincike ekutheni isimo sinjani nokuthi uqalile nini ukusebenzisa imithi nezindlela zokuzivikela. Ezinsukwini zokuqala zokusebenzisa amafutha kadokotela nokugwema izinto ezicasulayo, uzobona ukuthi ukulunywa kuyancipha kancane kancane.

Ngokuvamile, kungathatha phakathi kwesonto elilodwa kuya emavikini amabili ukuthi isikhumba siqale ukubuyela esimweni esijwayelekile. Kodwa uma isimo sibe khona isikhathi eside (saba yisimo esingapheli/chronic), kungathatha izinyanga ezimbalwa ukuba silawulwe ngokuphelele. Into ebalulekile ukuba ube nesineke futhi uqhubeke nemikhuba emihle ngisho noma usuqalile ukuzwa ukukhululeka.

Kufanele Ngimbone Nini Udokotela?

Nakuba ezinye izinkinga ezincane zingasabalala ngokushintsha nje insipho, kunezimpawu ezithile ezidinga ukuthi ubone udokotela wakho ngokushesha. Kufanele ubonane nodokotela noma uvakashele umtholampilo wakwangakini uma:

• Ukulunywa noma ukusha kungathuthuki ngemva kwezinsuku ezimbalwa zokuzama ukushintsha imikhuba yasekhaya.
• Ubona amanxeba, ukuqhekeka kwesikhumba, noma ukuvuvukala okukhulu okungapheliyo.
• Ukhipha uketshezi olunegazi noma olunempunga/olunombala ongaqondakali kanye nephunga elibi.
• Ubuhlungu bukhulu kangangokuthi bukuvimbela ukuthi uhambe noma ulale ngokuthula.

Kubukeka Kanjani Ukuvuvukala kwe-Vulvar?

Uma ubheka isikhumba sakho, ukuvuvukala kwe-vulvar kubonakala ngamabala abomvu noma aphinki angacacile kahle emngceleni wawo. Isikhumba singase sibonakale sithambile kakhulu, some, siqhekekile, futhi ngezinye izikhathi sibe nezindawo ezincane ezinamagazi amancane ngenxa yokuhlikihla noma ukuluma. Kwesinye isikhumba esimnyama, amabala angase abukeke emnyama kancane noma abe muncu kunokujwayelekile. Ukubona lezi zimpawu kusiza kakhulu udokotela ukuba aqonde kahle ukuthi yini edalainkinga.

Ibukeka Kanjani i-Vulvar Eczema?

I-vulvar eczema ihlobene kakhulu ne-vulvar dermatitis. Isikhumba siyoma, sibe namagxolo amancane, futhi sibe namabala abomvu acwebezelayo ngenxa yokuthi manzi. Uma isimo sithatha isikhathi eside, isikhumba singase sibe mancane futhi sibe namagodolo noma sijiyile (okubizwa ngokuthi i-lichenification) ngenxa yokulunywa njalo nokuhlikihlwa ngesikhathi ubuthongo noma phakathi nosuku.

Yimuphi Ukhilimu Ongcono Kakhulu Wokuluma Endaweni Yangasese?

Abantu abaningi bayabuza: "Ngisize, ngithenge muphi ukhilimu esitolo?" Impilo yethu isitshela ukuthi akufanele uzithengele noma yimuphi ukhilimu noma amafutha asendaweni yokudayisa (chemist) ngaphandle kokubuza udokotela. Ezinye izinhlobo zika-khilimu ziqukethe amakha noma izinto ezingase zandise ukucasuka esikhumbeni sakho esibuthakathaka. Udokotela wakho nguyena kuphela ongakukhethela ukhilimu ofaneleka kakhulu, njengamafutha anciphisa ukuvuvukala angaphansi kwesigaba esifanele noma amafutha athambisayo angaxutshwanga namakha.