The vulvar area is the part of the external female genitals which includes the labia, clitoris, vaginal opening, and the opening to the urethra from which urine passes. Vulvar itching, also called vulvar pruritus or vulvitis, is a common occurrence.
If your vulva itches, it is important to see a doctor for a diagnosis. There are many possible causes of vulvar itching, and treatment will depend on the cause.
- Self-treatment is not recommended because without knowing the cause, the self-selected treatment may not help, and it could even make the condition worse. What you might think is a yeast infection that would be treated with an over-the-counter (OTC) antifungal medicine could actually be a bacterial infection or a sexually transmitted disease (STD) which requires prescription antibiotics.
- Also avoid aggressively washing the vulvar area, which can add to irritation. Follow a gentle skin care routine until you receive a diagnosis.
What Are Symptoms of Vulvar Itching?
Other symptoms that can accompany vulvar itching may include:
- Inflammation
- Irritation
- Burning
- Stinging
- Soreness
- Redness
- Rawness
- Unusual vaginal discharge
- Vaginal odor
- Bumps
- Rash
- Pain during sexual intercourse
- Pain or discomfort when urinating
- Thin cracks in the skin, weeping, and crust formation
- Itchy purple bumps that may be streaked with white
- Pale or pink vulvar skin, which may have a white lacy pattern
- Changes in vulvar shape
What Causes Vulvar Itching?
There are many possible causes of vulvar itching, which is why it is important to see a doctor for a diagnosis.
Causes of vulvar itching include:
- Vaginal yeast infection (vulvovaginal candidiasis)
- Bacterial vaginosis (BV)
- Sexually transmitted diseases (STDs)
- Eczema, which can be caused by:
- Allergic reactions
- Products and substances that commonly cause allergic reactions may include:
- Benzocaine, a topical anesthetic
- Chlorhexidine (in K-Y Jelly)
- Fragrances
- Imidazole antifungals such as clotrimazole or miconazole, found in over-the-counter yeast infection treatments
- Latex found in condoms and diaphragms
- Neomycin, a topical antibiotic
- Propylene glycol, a preservative
- Tea tree oil
- Products and substances that commonly cause allergic reactions may include:
- Irritation from certain products
- Products and substances that commonly cause irritation may include:
- Bath products such as soap, bubble baths and salts, shampoo, conditioner
- Laundry detergent
- Spermicides, lubricants
- Perfume, talcum powder, deodorant
- Alcohol
- Astringents
- Adult or baby wipes
- Panty liners and their adhesives
- Nylon underwear
- Chemically treated clothing
- Vaginal secretions
- Sweat
- Urine
- Douches
- Products and substances that commonly cause irritation may include:
- Allergic reactions
- Psoriasis
- Lichen planus
- Lichen sclerosus
How Is Vulvar Itching Diagnosed?
The cause of vulvar itching is diagnosed with a patient history which may include questions about other skin problems elsewhere on the body, bladder or bowel issues, clothing you wear, and how you clean and care for the skin in the vulvar area.
A physical examination of the vulva and a vaginal examination will be performed. Tests may include:
- Blood tests
- Urine tests
- Swabs to collect samples from the vagina
What Is the Treatment for Vulvar Itching?
Treatment for vulvar itching depends on the cause.
Treatment for vulvar itching due to vaginal yeast infection (vulvovaginal candidiasis)
may include:
- Antifungal medicine
- Applied inside the vagina
- A single dose of fluconazole taken orally
- Other medicines applied inside the vagina, such as boric acid, nystatin, or flucytosine
Treatment for vulvar itching due to bacterial vaginosis (BV) may include:
- Antibiotics
Treatment for vulvar itching due to sexually transmitted diseases (STDs) may include:
- Antibiotics
- Antibiotic/antiprotozoal medications
- Antiviral medicines
- Over-the-counter (OTC) pain medicines such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain and inflammation
- Sexual partners may need to be treated at the same time
Treatment for vulvar itching due to eczema may include:
- Gentle skin care
- Cold pack to help relieve itching
- Antihistamine to help with itching
- Topical corticosteroid ointments
Treatment for vulvar itching due to psoriasis may include:
- Topical steroid cream or ointment
Treatment for vulvar itching due to lichen planus may include:
- High-potency topical steroid medication
- Usually requires long-term maintenance treatment
Treatment for vulvar itching due to lichen sclerosus may include:
- High potency corticosteroid ointment for several weeks
- Regular examinations after treatment because the condition can make affected skin more likely to develop skin cancer
Estrogen therapy delivered vaginally via ring, tablet, or cream, or applied directly to the vulva, may help some women by helping prevent atrophy and inflammation.
How Do You Prevent Vulvar Itching?
Gentle care of the vulvar area may help prevent some causes of vulvar itching. Gentle care may involve:
- Use plain water, or unscented, non-alkaline cleanser such as Cetaphil or Basis
- Clean gently with fingers instead of a washcloth
- Soak for five minutes in lukewarm water to remove residue from sweat, lotions, or other products
- Gently pat the vulvar area dry and apply any prescribed medication or a soothing and protective substance such as Vaseline or olive oil as recommended by your doctor
- Wear loose clothing
- Wear cotton underwear
- When at home, allow the vulvar area to air out and don’t wear underwear when possible
- Avoid products with multiple ingredients and those that contain chemicals that could irritate or cause contact dermatitis
- Don’t use moistened wipes
Image source: iStock Images
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081372/
https://www.health.harvard.edu/staying-healthy/managing_common_vulvar_skin_conditions
https://www.cdc.gov/fungal/diseases/candidiasis/genital/index.html
https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm
https://www.cdc.gov/std/default.htm