- 9720 Wilshire BLVD, STE Lower Level
- (424) 479-1770
- info@drkarentoubi.com
Itching, burning, skin changes, pain, recurrent infections — these are real, diagnosable, treatable conditions. A specialist who knows the difference changes everything.
Book a Consultation See What We TreatLichen sclerosus, lichen planus, contact dermatitis, and desquamative inflammatory vaginitis are all commonly misdiagnosed as recurrent yeast infections. The treatments are completely different. And in the case of lichen sclerosus, delayed diagnosis leads to permanent scarring — and a measurably higher risk of vulvar cancer.
Get a Proper EvaluationVulvovaginal disorders sit at the intersection of gynecology and dermatology — a gap that means many women bounce between providers for years without a definitive answer.
Dr. Toubi is an active member of the ISSVD (International Society for the Study of Vulvovaginal Disease), ISSWSH (International Society for the Study of Women's Sexual Health), and The Menopause Society (NAMS) — giving her a comprehensive view across vulvovaginal disease, sexual medicine, and hormonal health that few clinicians possess. She attends international conferences and applies current research directly to patient care. When a tissue diagnosis is needed, she performs biopsies in-office. No referrals. No delays.
Persistent itching, burning, or skin changes? You deserve a real diagnosis — not another prescription for fluconazole.
Book a ConsultationEach of these has distinct features, distinct treatments, and distinct consequences if missed. Getting the diagnosis right is everything.
A chronic, progressive inflammatory skin condition causing intense itching, white or pale skin changes, tearing, and pain. Untreated, it causes architectural scarring — clitoral burial, labial fusion, vaginal narrowing — and significantly increases the risk of vulvar cancer. With proper treatment and consistent monitoring, the disease is well-controlled and complications are greatly reduced. This is the most important vulvovaginal diagnosis to catch early — and one of the most commonly missed. Dr. Toubi sees this condition regularly and manages it with the vigilance it demands.
An autoimmune inflammatory condition that often involves the vaginal canal — causing erosions, scarring, painful sex, and discharge. It requires different treatment from lichen sclerosus, which is exactly why the diagnosis matters. Erosive, papulosquamous, and hypertrophic presentations each have distinct management approaches.
The vulvar skin is exquisitely sensitive. Common culprits: scented soaps, wipes, laundry detergents, fabric softeners, panty liners, topical medications, lubricants. Correctly identifying and eliminating the trigger — combined with barrier restoration — resolves the condition. Many women carry this for years without ever being told what caused it.
Proper management requires culture confirmation of the organism, assessment of contributing factors (hormonal status, vaginal pH, microbiome), and a suppression strategy. Dr. Toubi takes a systematic approach — not rotating through the same treatments indefinitely without answers.
Abnormal vulvar skin changes that require biopsy and careful monitoring. In-office vulvar biopsies are performed here — ensuring precancerous changes are identified and managed promptly.
A chronic vaginal condition causing profuse discharge, burning, and painful sex — distinct from BV and yeast, and frequently misdiagnosed as one of them. Requires specific treatment that differs from standard vaginal infection protocols.
Psoriasis, seborrheic dermatitis, and atopic dermatitis can affect the vulva and require management adapted to the sensitive mucosal environment. Dr. Toubi bridges gynecology and dermatology — so patients stop being passed between the two.
Adhesions between the clitoral hood and glans can cause clitoral pain, decreased sensation, and difficulty with arousal and orgasm. Dr. Toubi performs lysis of clitoral adhesions in-office — often a life-changing procedure for patients who've been suffering without any provider identifying the problem.
Chronic vulvar skin conditions — including lichen sclerosus and lichen planus — can cause progressive architectural changes: labial fusion, clitoral burial, narrowing of the vaginal introitus, and significant scarring that affects both function and quality of life. Dr. Toubi performs functional vulvar reconstruction to restore anatomy and function for women who have experienced these changes. This is not cosmetic surgery — it is reconstructive care aimed at relieving pain, restoring sexual function, and giving patients back a part of their anatomy that was lost to disease. For many women, this procedure represents the end of a very long road.
Estrogen-deprivation causes thinning, inflammation, and loss of elasticity — contributing to dryness, burning, painful sex, urinary urgency, and recurrent infections. Highly treatable with local and systemic options including EmFemme radiofrequency.
Biopsies, lysis of clitoral adhesions, and other in-office vulvovaginal procedures are performed with appropriate local anesthetic and careful technique. For patients with heightened pain sensitivity, pelvic floor tenderness, or anxiety about procedures, nitrous oxide (laughing gas) is available in the office — offering safe, effective relaxation with no recovery time needed. Women with vulvovaginal pain conditions often have difficult examination histories. This office takes that seriously. Your comfort during care is part of your care.
Vulvovaginal diagnosis requires time, a trained eye, and willingness to build a full differential. A proper evaluation here includes:
For atrophic changes, GSM, and tissue changes from hormonal loss, the EmFemme stimulates collagen, elastin, and moisture — restoring the structural and functional integrity of vulvovaginal tissue. In-office, non-invasive, no downtime. Works synergistically with local hormonal therapy.
Emerging research also shows promise for radiofrequency as an adjunct treatment for lichen sclerosus — studies suggest it may improve tissue quality, reduce symptoms, and complement topical steroid therapy. Dr. Toubi incorporates this as part of a comprehensive management approach for appropriate patients.
"Most women leave their first appointment here with a diagnosis they've never had — and a plan they've never been offered. That's the entire goal."
Treatment looks completely different depending on the condition — which is exactly why getting the right diagnosis first is non-negotiable.
High-potency corticosteroids for lichen sclerosus and lichen planus, calcineurin inhibitors, topical estrogen, compounded formulations — matched precisely to the diagnosis.
Local vaginal estrogen, systemic HRT, and testosterone therapy — addressing the hormonal drivers of vulvovaginal tissue atrophy and immune changes underlying many conditions.
Non-invasive collagen and elastin stimulation for atrophic changes and GSM — no downtime, works synergistically with topical estrogen.
Vulvar biopsy, lysis of clitoral adhesions, shockwave therapy — performed in-office with local anesthesia and nitrous oxide available. Functional vulvar reconstruction for scarring from lichen sclerosus and other skin conditions also offered.
Culture-guided therapy, vaginal suppression protocols, microbiome support, and pH restoration for recurrent BV and candidiasis.
Comprehensive guidance on products, hygiene, and barrier restoration — often the highest-impact intervention, and almost never discussed at routine visits.
Active member of ISSVD, ISSWSH, and The Menopause Society — spanning vulvovaginal disease, sexual medicine, and hormonal health. International conference attendee. Applies current research directly to patient care.
When tissue diagnosis is warranted, it's done in this office — same visit. Faster diagnosis, faster treatment, no fragmented referral chain.
Vulvovaginal disorders sit at the intersection of both specialties. Dr. Toubi bridges them — so patients stop being sent in circles.
Procedures performed with local anesthetic and careful technique. Nitrous oxide available for patients with anxiety or heightened pain sensitivity.
Vulvovaginal disorders and sexual function are deeply intertwined. Dual expertise in both means the full experience — pain, pleasure, and everything in between — is addressed.
You'll leave understanding your diagnosis, what drives it, and what to watch for. Educated women make excellent decisions for their own health.
Almost certainly yes. Lichen sclerosus, contact dermatitis, lichen planus, and desquamative inflammatory vaginitis are all commonly misdiagnosed as recurrent yeast. If you've been treated without a culture confirming the organism, a proper evaluation is overdue.
Lichen sclerosus is chronic — it doesn't "go away" — but with appropriate treatment, it can be very well-controlled. Symptoms resolve, skin normalizes, progression is halted. The key is consistent management and regular monitoring. Treated well, most women do extremely well.
Not every case requires a biopsy — but when a lesion is clinically ambiguous, it's the right call. Vulvar biopsies are performed in-office under local anesthetic, and nitrous oxide is available if you're anxious. The procedure is much less intimidating than it sounds — and a tissue diagnosis is often what finally ends years of uncertainty.
Yes — significantly. Vulvovaginal disorders are a major driver of sexual pain, arousal difficulty, and avoidance of intimacy. Treating the underlying condition is often transformative for sexual function, and Dr. Toubi addresses both the dermatologic and sexual medicine dimensions in the same practice.
At least annually — more frequently when the condition is active or being adjusted. This is not a "treat and discharge" diagnosis. Regular surveillance matters for disease control and early detection of any atypical changes that require biopsy.
If you've been dealing with itching, burning, skin changes, pain, or recurrent infections without a clear diagnosis — this is the appointment that changes that. Most patients wish they had come sooner.
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