A rash in your vaginal area can have many different causes, including contact dermatitis, an infection or autoimmune condition, and parasites. If you’ve never had a rash or itch there before, it’s a good idea to consult a doctor.

Treatment varies, depending on the cause of the rash. Home remedies may also relieve the symptoms.

Usually, a vaginal rash will feel uncomfortable and itchy. Your symptoms may get worse if you scratch the area.

Symptoms of a vaginal rash can include:

  • itching, burning, or irritation
  • bumps, blisters, lesions, or sores
  • skin that’s discolored (red, purple, or yellow)
  • patches of thickened skin
  • inflammation
  • pain during urination or sex
  • discharge
  • odor
  • fever
  • pain in your pelvic area
  • enlarged lymph nodes

Most causes of vaginal rash aren’t medically serious and can be cured. But sometimes an underlying condition is serious or incurable.

Contact dermatitis

Contact dermatitis is the most common cause of vaginal rash. According to a 2014 study, it’s responsible for about 50 percent of the cases of vaginal itching in adult women. It also can affect children.

Usually, contact dermatitis caused by a reaction to a skin allergen such as cleaning or skin products, or clothes.

Symptoms include:

  • mild to severe itching and burning
  • redness
  • swelling
  • irritation and rawness
  • pain with intercourse or tampon use

Topical steroids are used to treat inflammation. These include low-dose hydrocortisone or higher dose triamcinolone acetonide. These shouldn’t be used long term, as they thin the skin.

In severe cases, a healthcare provider may give you these drugs as an injection. In some cases, antidepressant or anticonvulsant drugs may be prescribed for pain.

Vaginitis

Vaginitis is also called vulvovaginitis when the vulva is involved. The vulva is the external part of the genitals surrounding the opening to the vagina.

According to the Centers for Disease Control (CDC), the following are the most common vaginitis causes:

  • Bacterial vaginitis occurs when certain bacteria multiply and change the normal bacterial balance in your vagina.
  • Yeast infections (Candida) most commonly involve the fungus Candida albicans. You normally have some of this fungus in your vaginal area. But certain factors can cause a decrease of good bacteria (Lactobacillus) in your vagina, allowing Candida to overgrow.
  • Trichomoniasis (trich) is caused by the protozoan parasite Trichomonas vaginalis. It’s spread person to person through intercourse.

Vaginitis symptoms include:

  • itching
  • changes in vaginal discharge
  • pain during urination or intercourse
  • vaginal bleeding

Some symptoms are particular to the type of infection:

  • Bacterial infections usually involve a yellowish or grayish discharge that may smell like fish.
  • Yeast infections may have a white discharge that looks like cottage cheese.
  • Trichomoniasis may have a strong odor and greenish-yellow discharge. According to the CDC, about 70 percent of infected people don’t have any symptoms.

Yeast infections are treated with over-the-counter (OTC) or prescription antifungals.

Bacterial infections are treated with prescription antibiotic or antibacterial cream.

Trichomoniasis is treated with antibiotics, such as metronidazole (Flagyl) or tinidazole (Tindamax).

Psoriasis

Psoriasis is an autoimmune condition affecting the skin, including the genitals. Psoriasis lesions on the vulva are more common in children than adults. It doesn’t affect the inside of the vagina.

A 2014 review reported that women with psoriasis commonly had vaginal itching.

The National Psoriasis Foundation estimates that between one-third and two-thirds of people with psoriasis will at some point have genital psoriasis.

In addition to itching, there are symmetrical red plaques in the vulva area, with no scaling. These can also be present in the anal area.

Psoriasis is usually treated topically with low-strength corticosteroids. You can also try light therapy.

Molluscum contagiosum

Molluscum contagiosum is a common viral infection that affects the skin. It’s contagious and spreads through contact, including sexual intercourse.

Symptoms include bumps between 2 and 5 millimeters (mm) in diameter that have these characteristics:

  • are round and firm
  • typically have an indentation in the center
  • start off flesh-colored
  • can become red and inflamed
  • can be itchy

The virus only lives on the skin’s surface. For most healthy people, the bumps disappear over time without treatment. When this happens, the infection is no longer contagious.

In other cases, an outpatient procedure can be used to treat the infection.

Scabies

A scabies rash is caused by the mite Sarcoptes scabiei, which burrows into the top layer of your skin to lay its eggs. The skin’s reaction to the mites produces little red bumps that are intensely itchy.

The mites are easily transmitted person to person, including via sexual intercourse. You can also pick up mites from infected clothing, towels, or bedding.

The main symptom of scabies is severe itchiness, especially at night. Scratching can open the skin to bacterial infection.

The usual treatment for scabies is prescription scabicide.

Pubic lice

Pubic lice are tiny parasitic insects that infest pubic hair in the genital area. They feed on human blood.

They are transmitted by sexual contact. You can also catch them from contact with the bedding, towels, or clothing of someone who has lice.

Lice don’t infest the vagina, but they can make the genital area itchy. The crab-like insects may be visible, and you may see their eggs (nits).

Pubic lice are usually treated with OTC medication, such as permethrin (Nix).

Genital herpes

Genital herpes is caused by the herpes simplex virus, usually type 2 (HSV-2). It’s one of the most common sexually transmitted infections (STIs).

Once you have the virus, it stays inside your body’s nerve cells and can cause future outbreaks. Recurrent outbreaks are usually less severe and shorter.

Symptoms appear four to seven days after sexual transmission. They include small, painful, or burning blisters and lesions around the vagina, buttocks, and anus that last up to three weeks.

These lesions may rupture, ooze pus, and crust over. Your vulva may then become inflamed, swollen, and painful.

The following are also symptoms of genital herpes:

  • swollen lymph glands
  • fever
  • headache and body aches

There isn’t a cure for herpes, but drugs like acyclovir (Zovirax), famciclovir, or valacyclavir (Valtrex) can relieve the severity of the outbreak and shorten the time it lasts.

Syphilis

Syphilis is an STI caused by the bacteria Treponema pallidum. It’s a progressive disease with four stages, and is disabling and even fatal if not treated.

In the primary stage of syphilis, a small sore called a chancre develops at the infection site. It usually appears three to four weeks after the initial transmission of the bacteria.

The chancre is painless but highly contagious. Because it’s not painful, it sometimes goes unnoticed. The chancre resolves after about three weeks, but the bacteria continue to spread through your body.

In the secondary stage of syphilis, a rash appears, including on your vagina. Other symptoms include:

  • fatigue
  • fever
  • swollen lymph nodes
  • headache and body aches
  • weight loss
  • hair loss

Syphilis is treated with penicillin or other antibiotics for people allergic to penicillin.

Genital warts

Highly contagious genital warts are caused by some types of the human papillomavirus (HPV). They’re one of the most common STIs.

They usually appear in clusters, but there may be only one. They can also appear in your mouth, throat, or anal area. They have a range of traits:

  • In color, they vary from light (flesh-toned and pearly) to dark (purple, gray, or brown).
  • The warts can be tiny to large in size, round or flat in shape.
  • The texture varies from rough to smooth.

While usually painless, they can become uncomfortably large, irritated, or itchy.

Often, genital warts will go away on their own within a year, so you may want to wait. Treating the warts can shrink them, but the virus will still be present. Prescription drugs used to treat the warts include:

  • imiquimod (Aldara)
  • podophyllin (Podocon-25) and podofilox (Condylox)
  • trichloroacetic acid, or TCA

A doctor can also remove the warts in an outpatient procedure.

Neurodermatitis

Neurodermatitis is an itchy skin condition also called lichen simplex chronicus. It’s not contagious. It can develop anywhere on your body. In the genital area, it often affects the vulva.

Scratching intensifies the itching and is thought to irritate the nerve endings in the area you’re scratching. The nerves then appear to signal to you that there’s an itch.

The exact cause isn’t known, but neurodermatitis may be triggered by an insect bite or stress. It also may occur secondary to another condition, such as contact dermatitis or diabetic neuropathy.

As you keep scratching the vaginal itch, the area becomes thick and leathery (lichenified).

Neurodermatitis is treated with an OTC or prescription medication to relieve the itching.

Vulvar ulcers

Vulvar ulcers are sores that appear in this area. They can be either extremely painful or painless.

The most common causes are STIs, as well as bacterial or fungal infections. Noninfectious causes include:

Vulvar ulcers might start out looking like bumps, a rash, or broken skin. Other symptoms include:

  • pain or discomfort
  • itchiness
  • leaky fluid or discharge
  • painful or difficult urination
  • enlarged lymph nodes
  • fever

Treatment will depend on the cause of the ulcer.

Bartholin’s cyst

Bartholin’s cyst is a small swelling on one of the glands that secrete lubricating fluid on each side of the vaginal opening.

The cyst fills with fluid when the gland is injured or infected. The cyst may become infected and filled with pus, forming an abscess.

The Bartholin’s cyst is often painless and slow-growing. But there may be swelling and redness near the vaginal opening, and discomfort during sex or other activities.

Treatment may include OTC pain relievers or an outpatient procedure to remove the cyst.

Lichen planus

Lichen planus results from your immune system attacking your skin cells or the cells of your mucous membranes, including the vagina. This skin condition isn’t contagious.

Symptoms include:

  • itching, burning, soreness, and pain
  • redness or purplish bumps
  • erosions of the skin with a lacy, white border
  • scarring and discomfort during sex

Lichen planus is treated with topical steroids. Long-term treatment is recommended in the erosive type of lichen planus, because there’s a small risk of squamous cell carcinoma.

Lichen sclerosus

Lichen sclerosus is rare and usually affects only the vulva. It occurs mostly in prepubertal girls and postmenopausal women.

It’s characterized by a white plaque in the shape of a figure eight around the vulva and anus.

In children, it sometimes resolves on its own. In adults, it can’t be cured. But its symptoms can be treated with topical corticosteroids or immune-modulating medications like pimecrolimus (Elidel).

Other causes of vaginal itching

  • clothes or underwear that is too tight
  • irritation from shaving pubic hair
  • pubic hair shaft that becomes infected and forms a red bump
  • obesity (overlapping skin folds increase friction and sweat, leading to vaginal irritation)

The most likely causes of a rash around the vagina are contact dermatitis and vaginitis.

Vaginal discomfort may also be caused by a Bartholin’s cyst.

A rash on the vulva can be:

  • neurodermatitis
  • psoriasis
  • lichen sclerosus
  • herpes

Many factors can be responsible for swelling and redness of your labia (the “lips” around the vagina), including:

  • allergies
  • bacterial or yeast infection
  • trich
  • lack of lubrication during sex

If your rash is contagious, talk with a doctor about when you can safely have sexual intercourse. Also discuss how to prevent other kinds of transmission. If you’re pregnant, ask about transmission to your baby.

Stopping the itch is most important. Scratching aggravates the rash.

  • Eliminate anything that could be irritating your skin, such as detergents and soaps, dryer sheets, talcum powders, and skin creams.
  • Wear loose clothing and cotton underwear, and avoid synthetic materials.
  • Don’t use vaginal sprays or douches (unless your doctor has recommended it).
  • Use a fragrance-free moisturizer to prevent dryness.
  • Use coconut oil and tea tree oil, which have antifungal properties.
  • Use boric acid suppositories, which an also be effective against yeast and bacterial infections.
  • Try a cold compress to reduce itchiness. It will also help a corticosteroid penetrate your skin better.
  • Take an oatmeal bath.
  • Eat yogurt with live cultures to help prevent yeast infections.
  • Use a probiotic if you’re taking antibiotics.
  • Wipe from front to back after you have a bowel movement.
  • Use a barrier method, such as condoms, during intercourse.

It’s a good idea to see a doctor if you haven’t had a vaginal rash before. You might also want to consult a skin doctor (dermatologist) or an infectious disease specialist who may have more experience with a range of conditions, including STIs.

Once the cause of your rash is identified and you have a successful remedy, you may be able to treat a recurrence of the rash yourself.

A doctor will examine you and take a medical history. They may be able to identify the cause by looking at your rash.

The doctor may take a swab from the area if there is vaginal discharge, or a skin scrape or biopsy to look at the cells under a microscope. They’ll be able to see a parasite like scabies, or identify psoriasis cells under the microscope.

A blood test may be used to identify herpes simplex or syphilis.

You may be referred to a gynecologist, dermatologist, or an infectious disease specialist for treatment.

Practicing good hygiene is important. So is maintaining a healthy diet and lifestyle. Being in good shape can help you ward off infections.

You can help guard against STIs by:

  • using barrier methods when having sex, such as condoms or dental dams
  • managing existing STIs
  • not sharing towels and clothing that may have come in contact with an open lesion
  • avoiding irritants (if you have contact dermatitis)

Vaginal rashes are treatable, and symptoms can be alleviated with medication and home remedies. In some cases, the underlying disease (such as herpes or psoriasis) has no cure, but the symptoms can be managed with medication.

It’s important to see a doctor to diagnose and treat the cause of your rash. Sometimes you may have to work with a doctor over time to find the right treatment plan for you and to prevent the rash from recurring.