When vaginal itch occurs, you may assume that you have a yeast infection. But think twice before you dash to the store for an over-the-counter (OTC) antifungal remedy. If you try to treat the condition poorly, you may do more harm than good.

Occasional vaginal itching is common and often resolves on its own. Persistent itching may be a sign of something more serious. Here are five possible reasons for vaginal itching other than a yeast infection.

If you’ve recently changed a product in your routine and your vaginal area is itching, contact dermatitis may be to blame. Contact dermatitis causes an itchy rash.

It may be caused by an allergic reaction to an irritating substance, such as an ingredient in:

Prolonged friction from activities such as riding a bike, wearing tight pants or underwear, and horseback riding may also cause contact dermatitis and vaginal itch.

It may be challenging to determine the exact cause of contact dermatitis. But once the irritating factor is identified and removed, most cases go away on their own.

To help the healing process, try soaking in a lukewarm bath with a few tablespoons of baking soda for up to 15 minutes a few times a day.

Severe cases of contact dermatitis may require treatment with a prescription steroid cream.

BV is an infection caused by an overgrowth of “bad” bacteria.

In addition to itching, BV can cause:

BV is treated with oral or topical antibiotics.

If left untreated, BV can raise your risk of contracting a sexually transmitted infection (STI), developing pelvic inflammatory disease (PID), or experiencing preterm labor.

If vaginal itch is accompanied by white spots on your vulva, you may have a condition called lichen sclerosus. The cause of lichen sclerosus is unclear.

The first-line treatment for genital lichen sclerosus is usually corticosteroids. If that doesn’t work, your healthcare professional may recommend immune-modulating medication.

Untreated lichen sclerosus may lead to vaginal scarring, blistering, or vulvar cancer.

As you age, your estrogen levels decline. Nursing also causes estrogen levels to drop. Low estrogen may cause the lining of your vagina to thin, resulting in itching and irritation.

If you’re nursing, these symptoms should resolve when you stop, as estrogen will return to its previous level. Otherwise, you might consider talking with your healthcare professional about hormone replacement therapy (HRT).

Topical estrogen cream, for example, can help reduce vaginal itching, dryness, and burning.

These tiny, crab-like creatures cause intense itching in the vaginal area. They usually attach to pubic hair. They may also attach to other areas of the body that are covered in coarse hair.

Pubic lice can be treated with an OTC lice-killing lotion. Severe cases may require a topical prescription medication.

What else itches like a vaginal yeast infection?

Vaginal infections like BV and cytolytic vaginosis (CV) can cause itching, similar to a yeast infection.

Certain sexually transmitted conditions can also trigger unexpected itching, including:

What causes vaginal itching without a rash?

BV, CV, and other vaginal infections can cause symptoms like itching without a rash or other skin changes. So can gonorrhea‍ and trichomoniasis.

Stress and hormone-related itching may also develop without visible symptoms.

What can you do to prevent vaginal itching?

You can help keep your vagina healthy and prevent irritation by:

Don’t assume vaginal itch is a yeast infection. It may be, but treating a yeast infection that doesn’t exist may make it more difficult to diagnose the real reason for vaginal itch. It may also further upset your vagina’s delicate balance of bacteria.

Vaginal itching can be difficult to ignore. But if possible, fight the urge to scratch. Scratching sensitive vaginal tissues may increase irritation and lead to infection.

Unless you’re positive you have a yeast infection, consult a healthcare professional for a proper diagnosis. You should also consult a healthcare professional if the itching continues after using an OTC yeast infection remedy.