Itching of the area around the opening of the vagina is a common problem for many women. It can be persistent and severe and make life completely miserable. The uncontrollable urge to scratch or rub the skin may cause an embarrassment and constant scratching may lead to further skin injury and thickening.
Itching is usually around the vaginal opening (also called the introitus), on the lips of the vulva and also towards the opening of the anal canal. The condition is known in medical terms as.
Causes of vaginal itching:
Many infections are associated with vaginal discharge and itching:
- Thrush: A very common infective cause is the yeast called candida. Candida is a normal organism on the skin and in the bowels of many people and only cause problems if there is an overgrowth of the yeast. The excess growth can be caused by recent use of antibiotics (which removes “healthy” bacteria which protects against the yeast), high sugar levels in diabetics, suppressed immunity and the use of antiseptic lotions or soaps with a high Ph. Treatment for candida can be bought over the counter at a pharmacy and is in the form of creams or vaginal suppositories. If the problem is persistent you need to see a doctor who will do a simple test to confirm the diagnosis and prescribe medication. The doctor may do tests for underlying illness that can cause the thrush. Pills taken by mouth are sometimes more effective, because it lowers the amount of candida in the bowel and rest of the skin. (see section on vaginal discharge)
- Trichomonas and gardnerella are two infections that are easily diagnosed by your doctor and are treated with antibiotics. Your sexual partner also needs treatment in the majority of cases
- Herpes is a painful blistering infection in the acute phase. Sometimes the skin may have a tingly or itchy feeling after the initial infection which can be very bothersome.
- Lichen sclerosis is a condition that affects older women, but can also be found in young girls before puberty. The main symptom is itching and it is associated with de-pigmentation of the skin. The most affected area is around the clitoris and in the midline towards the anal opening. The cause is largely unknown and it is sometimes very difficult to treat effectively. Creams containing cortisone are often prescribed, but the condition is chronic. Your doctor will often do a small skin biopsy to confirm the diagnosis, in rare cases the de-pigmented skin is an indication of the pre-cursors of cancer.
- Psoriasis is usually a generalised skin condition, but it can also affect the area around the vagina.
- Allergic reactions to chemicals (contact dermatitis). The cause of the allergy can be extremely difficult to find and may include: laundry detergents, tampons or sanitary towels, condoms, soap or bubble bath, powders, toilet paper and synthetic materials.
- Certain areas of the skin can thicken and change in colour with a condition called VIN (vulva-intra-epithelial neoplasia). VIN is confirmed with a small skin biopsy and the treatment is usually to remove the whole affected area surgically.
- Warts of the vulva and vagina may be itchy; particularly when there is an additional bacterial infection. Warts are treated by freezing or other forms of removal.
- Cancer of the skin around the vagina is rare, but may cause itching as the main symptom. There is often a raised area of skin or a sore that does not heal. The colour of the skin may be darker or lighter. (It is often easier to use a small hand mirror to inspect the skin). If the problem continues for more that two weeks - see your doctor. Ask the doctor to look at your skin.
- Avoid soap, shampoo and other chemicals on the vulva (do dot wash hair in bath to avoid vulva skin contact with shampoo)
- Do not shave pubic hair
- Wear loose, cotton underwear and change daily.
- Wash skin carefully with water. Do not scrub or rub vigorously.
No cause found
Sometimes women experience itching of the vulva/vagina and it is associated with painful intercourse. The pain is at the entrance of the vaginal canal. This condition is called vulvar vestibulitis. It is a complex condition and needs careful assessment by a gynaecologist.
If a solution is not found ask for an opinion from another health professional. A combined assessment by a gynaecologist and a dermatologist can be arranged.