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Vulvovaginal Pruritus

Vulvovaginal Pruritus

What is vulvar itching? — Vulvar itching is itching in the area around the opening of the vagina (figure 1).
Women with vulvar itching sometimes have other symptoms. These can include:
Burning or stinging
A "raw" feeling, like the vulva was rubbed by something rough
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.
Should I see a doctor or nurse? — Yes. If you have vulvar itching, see a doctor or nurse so that he or she 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" – In this test, a doctor puts small amounts of different substances on the skin of your back. Then, he or she checks to see if the substances cause itching.
A "biopsy" – In 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 women 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 gets rid of it. 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 you take by mouth, gels or creams you put in the vagina, or shots.
Medicines to relieve itching – These can be ointments you put on the vulva or pills 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. He or she will put a numbing cream or gel on the vulva before giving the shot.
Medicines to get rid of pubic lice – These are lotions or creams you put on the skin.
"Sitz baths" – Your doctor might tell you to soak the 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 by:
Using warm water and unscented non-soap cleanser to wash your vulva
Taking baths in plain warm water, and not using scented bath products
Not using a hair dryer or rubbing the vulva dry – Instead, dry it by patting with a soft towel.
Wearing cotton underwear, and not wearing underwear or pants that are too tight
Not using sprays or powders on your vulva
Not douching (douching is when a woman puts a liquid inside her vagina to rinse it out)
Not wiping with baby wipes or scented toilet paper after you use the toilet
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83970 Version 6.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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