What is an itchy vulva?
'Pruritus vulvae' simply means itching of the vulva. The vulva is the area of skin just outside the vagina. Most women experience a slight vulval itch now and again. However, pruritus vulvae means the itch is persistent and causes distress. The itch may be particularly bad at night and may disturb your sleep. About 1 woman in 10 sees a doctor about a persistent itchy vulva at some stage in her life. Vulval itching can affect any woman, at any age. It can lead to scratching and rubbing which can break the skin and can lead to soreness, bleeding and skin infections.
What causes an itchy vulva?
An itchy vulva (pruritus vulvae) is a symptom, not a condition in itself. It can be caused by many different conditions. Therefore, if you have a persistent itchy vulva, you should see your doctor to find out the cause.
Causes of an itchy vulva tend to differ slightly between adults and children. However, they can include the following:
- Some sexually transmitted infections, such as trichomoniasis and genital warts.
Sensitisation of the vulval skin
Sensitivity of the vulval skin is the most common cause of persistent vulval itch. The vulval skin can become sensitive to anything that comes into contact with it, such as:
- Creams, including treatments for, for example, thrush.
- Excessive sweat.
- Wet wipes.
- Textile dyes - for example, in coloured underwear.
- Fabric conditioners - may cause an itchy vulva or just irritate a vulva that is already itchy.
- Panty liners.
- Sanitary pads and tampons.
Skin conditions that may affect vulval skin
- Atopic eczema.
- Lichen simplex can affect the vulva. It is caused by scratching, usually initially triggered by the itch of eczema.
- Lichen planus affects the vulval skin and the entrance to the vagina.
- Lichen sclerosus affects the vulval skin and the skin around the anus. It may cause the skin to look like it is bruised or, more often, it turns the skin white.
Urinary or faecal incontinence
- This can make the skin of the vulva moist and irritated.
- In little girls a particularly common cause is careless or inadequate washing or drying of the area, and wiping the bottom in the 'wrong' direction (towards the front).
- Scrubbing too vigorously with toilet tissue can also contribute.
- Because of lower oestrogen levels, the vulval skin tends to become thinner and drier during and after the menopause. This can make it prone to itch.
- The low oestrogen levels can also cause vaginal dryness.
- Low oestrogen levels can start before the actual menopause, ie when you are still having periods.
- Local oestrogen can be helpful, either used as a cream, tablet or plastic ring inserted into the vagina, where it will help just these symptoms. Hormone replacement therapy (HRT) is also available as tablets or patches that will help any other symptoms of the menopause too.
- This can cause itch due to swelling of the veins in the vulva (vulval engorgement).
- There is also an increased risk of vaginal discharge and thrush during pregnancy, which may also cause itch.
Can cause itch due to low oestrogen levels.
Generalised body itch
Any cause of generalised body itch may also cause itching of the vulva. For example, a generalised body itch may be a side-effect of some medicines or due to some blood disorders, thyroid problems or kidney or liver disease.
Can cause itch in the vulval area, particularly if the diabetes is not well controlled and sugar levels are tending to run high.
Cancer of the vulval skin
- This is an uncommon cause.
- Usually there is a small lump or warty bit of skin as well as itch.
Stress can cause an itchy vulva. It may also make an itchy vulva which is due to some other cause last long after the original cause has settled.
In some cases, including some severe cases, no cause can be found.
The human vulva of four different, adult women via Wikimedia Commons:
Top left: vulva of a Caucasian woman with slender labia minora
Top right: vulva of a Caucasian woman with natural pubic hair
Bottom left: vulva of a woman with African descent (with clitoral hood piercing)
Bottom right: vulva of a Caucasian woman with protruding, strong developed labia minora and trimmed pubic hair
Did you find this information useful?
- Pruritus vulvae; NICE CKS, May 2016 (UK access only)
- UK National Guideline on the Management of Vulval Conditions; British Association for Sexual Health and HIV (2014)
- European guideline for the management of vulval conditions; International Union against Sexually Transmitted Infections, 2016
- Lee A, Bradford J, Fischer G; Long-term Management of Adult Vulvar Lichen Sclerosus: A Prospective Cohort Study of 507 Women. JAMA Dermatol. 2015 Oct 151(10):1061-7. doi: 10.1001/jamadermatol.2015.0643.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.