Patient education: Vulvar itching (The Basics)

What is vulvar itching? — Vulvar itching is itching in the area around the opening of the vagina (figure 1).

People with vulvar itching sometimes have other symptoms. These can include:

●Burning or stinging

●A "raw" feeling, like the vulva was rubbed by something rough

●Redness

●Vaginal discharge

What causes vulvar itching? — Vulvar itching has many different causes. Some common causes include:

●Skin irritation from soap, lotion, or another product that was on the vulva

●Infections in the vagina or vulva

●A skin disease called "lichen sclerosus" – This disease causes itching and skin changes.

●Pubic lice, also called "crabs" – These are tiny insects that can live in the hair around the vulva.

●Allergies

Should I see a doctor or nurse? — Yes. If you have vulvar itching, see a doctor or nurse so they can figure out the cause. Your doctor or nurse will talk with you and do an exam.

Will I need tests? — Maybe. The doctor or nurse might be able to find the cause of the itching by talking with you and doing an exam. If this happens, you might not need any tests.

If you do need tests, they can include:

●Tests on a sample of fluid from the vagina – These tests can check for infection.

●A "patch test" – For this test, a doctor puts small amounts of different substances on the skin of your back. Then, they check to see if the substances cause rash and itching.

●A "biopsy" – For this test, a doctor takes a small sample of skin from the vulva. Another doctor looks at the sample under a microscope. You might have this test if other tests do not show the cause of your vulvar itching. But most people with vulvar itching do not need this test.

How is vulvar itching treated? — If the itching is caused by another medical condition, such as an infection, treating the condition usually makes the itching stop. Or the doctor might tell you to stop using substances or products that can cause itching.

Treatments include:

●Medicines to treat infection – These can be pills that you take by mouth, gels or creams that you put in your vagina, or shots.

●Medicines to relieve itching – These can be ointments that you put on your vulva or pills that you take by mouth. If your itching is very bad at night, the doctor might give you doxepin (brand name: Silenor) or hydroxyzine (brand name: Vistaril). These medicines can relieve itching and help you sleep. If other treatments to relieve itching do not work, the doctor might give you a shot of medicine in the itchy area. They will put a numbing cream or gel on your vulva before giving the shot.

●Medicines to get rid of pubic lice – These are lotions or creams that you put on your skin.

●"Sitz baths" – Your doctor might tell you to soak your vulva in 2 or 3 inches of warm water. This is called a "sitz bath." You can do this for 5 minutes in the morning and 5 minutes at night. Do not add soap, bubble bath, or anything else to the water.

If your vulvar itching is caused by an infection, your sex partner might need to see a doctor.

Can vulvar itching be prevented? — You can prevent vulvar itching from some causes if you:

●Use only water and unscented non-soap cleanser to wash your vulva.

●Take baths in plain warm water, and do not use scented bath products.

●Pat your vulva dry with a soft towel, instead of rubbing it.

●Wear cotton underwear, and avoid underwear or pants that are too tight.

●Do not use sprays or powders on your vulva.

●Do not douche (putt liquid inside your vagina to rinse it out).

●Do not wipe with baby wipes or scented toilet paper after you use the toilet.

More on this topic

Patient education: Lichen sclerosus (The Basics)
Patient education: Trichomoniasis (The Basics)
Patient education: Vaginal discharge (The Basics)
Patient education: Vulvovaginal yeast infection (The Basics)
Patient education: How to take a sitz bath (The Basics)

Patient education: Vulvar lichen sclerosus (Beyond the Basics)
Patient education: Pubic lice (Beyond the Basics)
Patient education: Vaginal discharge in adult women (Beyond the Basics)
Patient education: Vaginal yeast infection (Beyond the Basics)