How do you treat an itchy vulva?
By treating the cause if possible
Treatments for itchy vulva (pruritus vulvae) vary, depending on the cause. For example:
- Identifying and stopping the use of anything that may be sensitising the vulval skin.
- Using antifungal cream for thrush.
- Using antibiotic medicines for certain infections,
- Using steroid cream for various skin conditions.
- Using hormone cream or hormone replacement therapy (HRT) if the itch is related to the menopause.
- In young girls, learning to wipe gently from front to back, and to wash and rinse well and dry even when showering (when the vulva can be missed or left soapy).
What general treatments are there for an itchy vulva?
These are treatments which are likely to help with an itchy vulva (pruritus vulvae) whatever the cause.
Bland moisturisers (emollients) such as emulsifying ointment can help to ease the itch. You can use emulsifying ointment in addition to most other treatments. Use it very liberally. Emollients can also be used as a soap substitute. Some of the creamier emollients can be stored in the refrigerator to keep them cool. If you are feeling particular itchy, applying some cool emollient from the refrigerator on to the skin may be soothing.
You can buy emollients at pharmacies, or obtain them on prescription. However, there is a slight word of caution. Occasionally, some people become sensitised to various ingredients that are in some emollients. This can make itch worse. Aqueous cream is a commonly available unbranded emollient but the ingredients can vary between manufacturers, including the addition of perfume, so it is best used simply as a soap substitute and not as a moisturiser. Sensitivity to emollients is unusual, however; bland moisturisers without added perfumes do help symptoms in most cases.
Vaginal moisturisers and lubricants can also be very helpful, especially if the itch is on the inside as well as the outside.
Try to avoid the itch-scratch cycle
The itch-scratch cycle occurs when scratching causes more itching - which causes more scratching - which causes more itching - etc. So, if you scratch, it may make the itch worse. Excessive scratching can also cause thickening of the skin - which then becomes even itchier. Therefore, apart from any other treatment, try not to scratch if at all possible. Keep your nails cut short and don't wear nail varnish. Consider wearing cotton gloves at night to stop scratching in your sleep. Scratching may also damage the vulval skin and increase the risk of the skin becoming infected with germs (bacteria).
What else might help?
General vulval skin care and other advice
The following may also help ease an itchy vulva (pruritus vulvae), whatever the cause.
- Wear loose 100% cotton underwear. Avoid nylon or synthetic underwear material which tends to block fresh air and causes you to sweat more.
- Change your underwear daily.
- Avoid wearing tight-fitting clothes such as cycling shorts or leggings. Skirts and dresses are probably better than trousers. Stockings are probably better than tights. The aim is to allow some air to get to the vulva, and not to allow it to become too sweaty.
- Consider wearing no underwear - for example, when you are at home, and at night.
- Wash your vulva gently, once a day. Do not scrub or wash vigorously and avoid using a sponge or flannel to wash with. Over-cleaning may make symptoms worse. Use a bland, unscented moisturiser as a soap substitute. (Using water alone may dry out the skin and make symptoms worse.)
- Taking a shower is generally better than having a bath, as it's easier to wash the vulva - but take care to wash off any soap.
- Don't put on your underwear until your vulva is fully dry. Dry the skin gently by dabbing it with a soft towel. A hairdryer may be useful to dry properly. Make sure it is on cool and held well away from the skin.
- Try to avoid getting shampoo (which runs down your body in a shower) on to the vulva, where it may irritate.
Other general advice
- Sometimes soaps, perfumes, bubble baths, deodorants, scented creams, the dye in toilet tissue, etc, can irritate (sensitise) the delicate vulval skin. Don't use any of these on your vulva or in your bath water or shower. Use plain, non-coloured toilet tissue. Use non-perfumed sanitary towels and panty liners and try to avoid using them on a regular basis. Consider avoiding plasticised 'one-way' top sheets which can cause sweating and reduce air circulation.
- Avoid antiseptics or special vaginal washes.
- Some people develop a skin sensitivity to a washing powder or fabric conditioner. This is uncommon but it may be worth considering changing to a different brand of washing powder and not using any fabric conditioner for underwear.
- Avoid condoms that are lubricated with spermicide, as they can be sensitising. Similarly, avoid perfumed lubricants.
- Do not shave pubic hair.
Is there anything that can help me sleep?
An antihistamine medicine at bedtime may help if sleep is affected. Antihistamines do not have a great effect on the itch but some cause drowsiness (for example, hydroxyzine). This may help you to sleep. A doctor or pharmacist can advise on which antihistamines are sedating.
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.