Why Is My Vulva Itchy?Common Causes and What to Do

It’s 2 a.m., and you’re lying completely still, trying to will away an itch you can’t scratch in public and can barely stand in private. You’ve already googled it twice. You’ve already decided it’s something terrible.

Irritation

Cleveland Clinic¹ says skin irritation from sweating or tight clothing and from products like soaps and detergents commonly triggers itching. Its guide to vulvar disorders describes contact dermatitis: mild to severe itching, redness and skin thickening from irritants such as laundry detergent, soaps or feminine products.

What helps, per Cleveland Clinic², is removing irritants one by one to find the culprit, and a short, lukewarm bath of 10 or 15 minutes, with or without four or five tablespoons of baking soda, two or three times a day. Steroid creams may help in severe cases.

The NHS³ gives a short list for the washing side: use water and an emollient instead of soap, dry thoroughly, wear cotton underwear, avoid tight clothing, and skip douches and deodorants on the genital area.

Infection

Yeast. Cleveland Clinic² lists vulvar swelling and redness, severe itching, burning, painful urination, painful sex and a thick, white discharge. Our article on repeat yeast infections goes through diagnosis and treatment.

Bacterial vaginosis. Listed by Cleveland Clinic¹. See what BV is.

Sexually transmitted infections. Cleveland Clinic¹ says several can cause itching: trichomoniasis, genital herpes, genital warts, chlamydia and gonorrhea. Its vulvar disorders guide describes herpes as painful ulcers on the vulva that crust over, and trichomoniasis as a foamy discharge with a foul odor, treated with a single dose of antibiotics for you and your partner.

Skin conditions

Eczema and psoriasis. Cleveland Clinic¹ says treatment for eczema can include topical steroids.

Lichen sclerosus. The NHS⁴ describes itchy, white patches of skin that look smooth or crinkled and are easily damaged, so they may bleed or hurt if rubbed or scratched. Cleveland Clinic² describes shiny, smooth spots on the vulva that can tear, causing bruising, itching and bleeding. The NHS says the cause isn’t known, it isn’t caused by an infection, and it’s not contagious. It can’t be cured, but a strong prescription steroid ointment usually helps. The NHS also says it increases the risk of cancer of the vulva, though it describes that risk as low. That’s one more reason to have a new white patch examined.

Hormonal changes. Cleveland Clinic¹ says menopause and its genitourinary symptoms can cause itching. If that fits, vaginal dryness is worth reading.

What to avoid

Cleveland Clinic¹ says, “Try not to scratch!” It explains that in some cases the more you scratch, the itchier your skin gets. It also advises avoiding irritating products and wearing loose, natural-fiber clothing.

The play

Try this: remove one irritant at a time

List everything that touches the area: soap, wash, wipes, pads, liners, laundry detergent, fabric softener, tight leggings, lubricant.

Remove one item for a week. If the itching eases, you found a suspect. If not, put it back and test the next.

Write down what you changed and when, so your clinician can see it.

When to get checked

Don’t wait if

1. Emergency

   At 2 a.m. the itch feels like an emergency. By Monday it can be a short, specific appointment with a likely answer.

Cleveland Clinic¹ says to see a provider if itching lasts a long time or keeps coming back, or if it comes with abnormal discharge, burning or visible lumps, and that it’s always important to have your physician examine you if you have symptoms and can’t get relief. The NHS⁴ says to see a GP for an itchy white patch on your genitals, if prescribed treatment isn’t working, or if you have pain when going to the toilet or having sex.

Book an appointment if any of these fit:

• The itch has lasted more than a week or two, or keeps returning
• You see white, shiny or thin patches, tears or bleeding
• You have abnormal discharge, burning, sores or lumps
• You’ve had a new partner and may have been exposed to an STI
• Sex or going to the toilet is painful
• Treatments you tried haven’t worked