Vulval itching

Itchiness of the vulva is almost never caused by a sexually transmitted infection, but is usually a result of thrush or a skin condition. The lips of the vulva (the labia) are covered by ordinary skin, so the area can be affected by conditions such as eczema and psoriasis. And sometimes only the vulval skin is affected, so the diagnosis may come as a surprise.

 

The usual mistake with vulval itching is to assume that you have thrush, and keep on applying anti-thrush creams that you have bought from a pharmacy. This may actually worsen the condition, because you can become allergic to some of the ingredients. If an anti-thrush cream does not deal with the problem within a few days, or if the itching comes back, see your doctor. If you have a skin condition, and not thrush, you need the appropriate treatment.

 

This section explains the most common causes of vulval itching and what you can do about them. And you can find more information about thrush and trichomoniasis in the section on genital infections.

 

Thrush is a fungal infection caused by Candida albicans. About 1 woman in 5 has Candida in her vagina without it causing any symptoms. Hormones in the vaginal secretions and the friendly vaginal bacteria keep it at bay. But problems can arise when this natural balance becomes upset, and the Candida multiplies.

 

Thrush does not always cause a discharge – the main symptom is itching or soreness, and this gets worse in the week before a period. If there is a discharge, it is usually only slight, does not smell and looks like cottage cheese.

 

Trichomoniasis. Infection with Trichomonas vaginalis can be itchy.

 

Psoriasis is a skin condition that can be extremely itchy when the genitals are involved. The skin usually becomes bright red, often with painful cracks. The affected area may extend to the groin and to around the back passage (the anus) and between the buttocks. Psoriasis on other parts of the body is scaly (check your scalp, knees and elbows), but in the vulval area it tends to be smooth. You can have psoriasis on the vulva without having it anywhere else on your body.

 

Lichen sclerosus is another extremely itchy skin condition affecting the vulva. The itching is often so bad that it can affect a sufferer's sleep. It is most common around the menopause and in girls just before puberty, though it can occur at any age. Its cause is a mystery. The skin looks thin and pale, and the area around the anus may also be affected. If it is not treated, the lips of the vulva eventually shrink, the vaginal opening narrows and sex becomes painful and can tear the skin.

 

Treatment of this condition is simple, and your doctor can prescribe a special steroid cream.

 

Allergies and sensitivities can cause redness and itching. The vulval area seems to be very sensitive to chemicals, probably because the vulva is moist and warm conditions that favour the absorption of chemicals by the skin. It is possible to develop an allergy to almost any chemical substance that comes into contact with the vulva, such as may be present in:

Excessive washing can irritate the vulval area. Older women who may find it difficult to get into a bath may worry about personal hygiene, with the result that they wash the area too much. There is no need to wash several times a day – once is sufficient.

 

Vulval intraepithelial neoplasia is a condition that usually affects older women, and causes itchiness in only a small area. It occurs because the skin in that area has become abnormal. There is a risk that it could develop into a skin cancer of the vulva, so it is important to see your doctor if you suspect you have this condition. Cancer of the vulva is very rare, and tends to affect mainly older women; itching can be the first sign, or there may be a lump or a sore.

 

Stress or anxiety can cause itching. When you are stressed or anxious, your nervous system is on alert, and small sensations can become amplified into unpleasant itching or even pain. So it is not imaginary, it is real.

 

• Start by trying to eliminate anything that could be causing an allergy or sensitivity – look at the dos and don’ts for vulval problems. Avoid swimming while you have the irritation – the chlorine may make it worse.
• If you have been applying cream from the pharmacy for more than 1 week, and you still have the problem, stop using it. You may have developed a sensitivity to one of the ingredients.
• If the itch is really bad, you may be scratching in your sleep, causing more damage. Keep your fingernails short and wear cotton gloves when you go to bed (you can buy them from a pharmacy).
• If you think thrush is a possibility, look at the information on thrush in the genital infections section.

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Tuesday, March 9th 2010

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Comments on this article

Posted by Optional on 08/03/2010 at 03:14:37 am

I am a 45 year old female. I have been plagued with peristant soreness, itchyness, swelling of the vulva for the past year. After trying various creams and antidepressants, which have had no effect, I have now been prescribed tostestorone. Why have I been prescribed this and how will it be effective in treating me?

Posted by Anonymous on 02/02/2010 at 06:46:00 pm

hi i've had this itching for more than 3 years but i was too embarrsed to go tot he doctor until a year ago. it got so bad that i would scream in pain because i had scratched it so much it began bleeding and was sore. the doctor first thoughgt it was thrush however then realised it was not but still did not know what it was. i use a cream called aveeno which is used for dyr skin and if it gets really bad i use hydrocortisine. none of these however get rid of the problem they just calm it down. i will however try and use aloe vera gel to see how that is. i thought i was weird and alone and anyone i ever spoke to about it never understood, i feel bettet knowing it;s not just me but i wish that one day i can sleep through the night like normal people and not fidget uncontrollablly in socail situations when the urge to itch becomes too much.

Posted by EMW on 10/01/2010 at 04:16:00 pm

I've never had a constant itching, just once in a while it will begin to itch bad. I try not to itch it because the sensation will eventually go away, but with intercourse during this time it is more painful then enjoyable. It's only happened possibly 4 times since I can remember, so I'm not worried bout std's because it happened b4 I ever had sex. I do have sensitive skin everywhere, so I'm thinkin it may juss be some kinda alergic reaction. Any ideas?

Posted by Helen on 29/12/2009 at 06:50:00 pm

Hi. I had sex for the first time two days ago. It hardly hurt at the time, but they day after my vagina was slightly sore. When i walked i was aware that i had had sex the night before. Today it is just itchy. There is not an abnormal amount of discharge. I used contraception. Why is it itchy?

Posted by Rheaum on 04/12/2009 at 10:22:00 pm

Have suffered with severe itching for a long time and have discovered pure Aloe Vera gel which calms the area quickly. Also good for other skin problems.

Posted by Leah on 29/11/2009 at 02:47:00 am

I am thirteen years old, and my vagina began to itch an hour or so ago.Does it meean i am beginnning my first period??

Posted by clare on 22/11/2009 at 11:28:00 pm

i have an outer itch on the outer part of my vagina when i have my period it stops itching. but when its finished it starts again i feel its ruining my sex life with my partner because it gets sore and itch so much i make it bleed. please help with some advise thankyou

Posted by xhxhxhx on 03/11/2009 at 08:09:00 pm

my lady parts are itchy except for when i am on my period. once i start itching i cant stop.then i get a burning sensation. it is not thrush as iv had that many times before. what is it???

Posted by trace on 09/10/2009 at 04:22:00 pm

i have a yellow white discharge n bit itchy any ideas

Posted by cochan on 28/09/2009 at 09:13:00 am

ever since i had my hysterectomy (total( due to fibroid growth in the uterus)over the years the groin area becomes rather itchy esp. in the summer months - i feel like just having a 'good old scratch' but it does feel very embarrassing - really! please help. I do use an ayurvedic concoction of coconut oil from a kerala pharmacy too which really helps. But i would like to know what is the reason for this. Thanks.

Posted by No One in Particular on 16/09/2009 at 05:27:00 am

I have to same problem as everyone, vulva itching. But this itch doesn't happen often- it last almost 1 week right before my cycle. Not all day, just in the evening before bed and right when i wake up. Any suggestions on treatment.

Posted by Anonymous on 09/07/2009 at 09:48:00 pm

I have a case were I have itchiness around the vulva, my hygine is very high in this area, I wash myself everytime I go the toilet. However I'm a vergin so I can't pick it from someone. What should i do?

Posted by Ellie on 28/06/2009 at 04:01:00 am

I haven't started yet but i think im about to. Its so itchy down there and i can't stand it. So i put lotion on it. Its is for chapped skin. Its almond oil from the body shop! I put it on, waited 5 minutes and the itch was gone! You could also try sitting in a lukewarm bath with 1/2 cup of baking soda for 20 minutes. I heard it works well. I NEED to do that!

Posted by jessica on 19/06/2009 at 11:18:00 am

im currently suffering from itching in the inner part of my vaginal lips... i'm worried it is a STD.. what should i do?

Posted by marie on 06/06/2009 at 02:29:00 am

i also suffer from itchness of the virgnal wall.my outer virgnal walls are really dry and itches all the time.the doctor precribed me a enczema cream based soap and it working well.but,i think my body is imune to it.the itching has started again and am losing sleep over it. Help me,please!

Posted by not alone!!! on 27/04/2009 at 10:57:00 pm

It does bring me some comfort that I am not the only one suffering from this, I have again today been to the doctors to show them my bits, I've been suffering, like "desperate for help" severe vicious itching, worse at night, keeps me awake, no discharge though. Docs keep prescribing thrush creams which dont work, one doc said it was in my head, thanks, thats why it wakes me up is it!! It is very depressing, im 6 months pregnant, had this itching for 3 years, how we had sex i will never know!! the problem will not go away, Ive tried no soap, using baby soap, using "simple" soap, changing all my underwear to loose cotton, changing washing powder, nothing is working. Im getting quite depressed, im supposed to be resting at this time in preparation for my babys arrival in the summer but im going to be exhausted when it arrives with my own body breaking up my sleep every night. I hope someone can help me! steroid cream did help for a bit but not allowed it at the moment. Not looking forward to more negative test results in a week, im sure it will come up with nothing.

Posted by desperate for help! on 20/04/2009 at 11:08:00 pm

help - for as long as i can remember i have had a problem mainly at night. Basically i suffer from itching in the inner part of my vulva (i think this is the correct term). Its soo bad i don't know i'm doing it until i wake myself up while im scratching because it takes the itch away. I always felt i was alone and abit of a freak for doing, knowing its not very well known. I have explained to my doctor several times, but just get thrush treatments prescribed, but they don't work. Note it does not affect my vagina inside, just the outer part. What is wrong with me, the discharge is a yellowish creamy texture and usual sets during the night and becomes hardened in my finger nails (disgusting i know!). Does anyone put a reply on in relation to this plea for help?

Posted by curiously paranoid on 18/04/2009 at 04:35:00 am

okay so i thought i had a yeast infection because i did have burning and itching around the vagina and on the vulva. i took the monistat and it went away mostly. i went to the gyn for my annual and told him what happend. he said it looked like a bacterial infection that was clearing up. he took a culture and that came back negative. he aslo did a swab for stds as well as a pap. he said it wasnt neccisary for a blood test unless more symptoms came about. i am a little worried casue ONCE in a while i get a slight irritation just on my vulvar now and not inside the vagina at all. could this be just because im worried, could it be because i am sweating or allergic to something or do u think its an std that only a blood test would catch? im worried... please help! it doesnt disurb my sleep and doesnt happen all day or all the time. maybe once a week or so. any ideas?