Your vulva can become irritated due to a skin condition, an infection, or another health condition. Treatment can depend on the underlying condition and you can treat some causes at home.
Irritation usually refers to pain, itching, or swelling in the vaginal area. It can affect any part of your vulva, including your labia, clitoris, urethra, and vaginal opening.
Temporary irritation usually isn’t a cause for concern and can often be treated at home. You’ll likely experience other identifiable symptoms if the irritation results from an underlying condition.
Here’s what to watch for, how to find relief, and when to see a healthcare provider.
Folliculitis occurs when one or more hair follicles are inflamed or infected. It can happen anywhere that hair grows and often appears as small, red, sometimes painful bumps.
In the pubic area, it typically results from:
- shaving
- waxing
- other forms of hair removal
This itchiness is usually called “razor burn.” Unexpected bumps are often ingrown hairs.
Other symptoms include:
- soreness
- swelling
- pus
How to treat it
Razor burn, ingrown hairs, and other forms of folliculitis typically go away without treatment. You should leave the area alone for a couple of weeks to prevent further irritation.
You may find it helpful to:
- Wear loose clothing.
- Apply a cool compress to decrease swelling.
- Apply a warm compress to soothe pain and tenderness.
- Apply an over-the-counter (OTC) hydrocortisone cream to relieve itching.
- Apply an antibiotic ointment (Neosporin) to prevent infection.
If the bumps do not go away or get bigger, you should seek help from a health care professional as you may need additional treatment.
Contact dermatitis occurs when a substance irritates your skin. It can happen anywhere on your body.
Substances that might cause contact dermatitis on the vulva include:
- laundry detergents
- chemicals on new clothes
- fragrances in menstrual products
- douches or feminine sprays
- latex condoms
- lubricants
Your reaction to the offending substance may be immediate or appear gradually over the course of 1 or 2 days.
Symptoms may include:
- itching
- burning
- swelling
- tenderness
- rawness
- red rash
- hives
- blisters
How to treat it
The most important step in treating contact dermatitis is to identify the offending substance. Once you eliminate that substance, your rash should clear up on its own.
You may also find it helpful to:
- Wash your skin with mild soap and lukewarm water to help remove any irritants.
- Use ice packs or cold compresses to reduce irritation.
- Apply a thin layer of petroleum jelly to protect the skin
- Take an oral antihistamine, such as diphenhydramine (Benadryl), to help reduce overall symptoms.
- Apply a topical anti-itch medication, such as hydrocortisone cream (Cortisone10).
- Take a warm (not hot) oatmeal bath to soothe the skin.
A number of different things can cause your hormones to fluctuate.
During your monthly menstrual cycle, your body goes through changes to prepare for the possibility of pregnancy.
Each part of this process — from ovulation to menstruation —
Pregnancy and breastfeeding can also cause hormonal changes. Certain medical conditions, such as polycystic ovarian syndrome (PCOS) can also cause these changes.
Menopause also causes hormonal changes that result in vulvar sensitivity.
If, for example, your estrogen levels drop, the skin on your vulva may become drier, thinner, and less elastic. This may make it more vulnerable to irritation.
Symptoms may include:
- itching
- stinging
- dryness
- tiny cracks or cuts
- tenderness
- redness
How to treat it
If you haven’t already, consider trying an OTC vaginal moisturizer or lubricant.
Vaginal moisturizers offer a continuous moisturizing effect and help your vaginal tissues retain moisture.
Water-based or silicone-based lubricants can be applied before masturbation, foreplay, and intercourse to reduce friction and discomfort.
If these options don’t provide relief, talk to a healthcare provider.
They may recommend hormonal birth control, including the pill or an IUD, or estrogen-based vaginal therapy, including cream or vaginal ring, to help ease your symptoms.
Vaginal yeast infections are
They rarely happen before puberty and after menopause. However, as many as
Symptoms noticed in the vagina or vulva may include:
- itching
- swelling
- burning
- pain during penetration
- soreness
- rash
- redness
- thick, white, cottage cheese-like discharge
How to treat it
Most yeast infections can be treated with OTC antifungal medications. These medications come as creams or suppositories that you use for between 1 and 7 days.
Make sure that you take the entire course of medication. The infection may return if you stop taking the medication too soon.
You should also abstain from sexual activity until you’ve cleared the infection to allow the medication to work properly.
If OTC treatments aren’t working, see a healthcare provider. They can confirm whether you’re experiencing a yeast infection and may be able to prescribe stronger medication.
As the name might suggest, BV is a bacterial infection of the vagina.
It
According to the Centers for Disease Control and Prevention (CDC), it’s the
Many people with BV won’t notice any symptoms.
When symptoms do occur, they
- white or gray discharge
- thin or foamy discharge
- a strong, fishy odor, especially after sex or menstruation
- pain or burning of the vagina and vulva
How to treat it
If you suspect BV, see a healthcare provider. They can prescribe an oral or topical antibiotic.
Make sure that you take the entire course of medication. The infection may return if you stop taking the medication too soon.
You should also abstain from sexual activity until you’ve cleared the infection to allow the medication to work properly.
STIs are
A number of STIs can cause vulvar irritation, including:
STIs don’t always cause symptoms.
When they do, you may experience:
- pain during or after sex
- painful urination
- itching
- unexplained spotting
- unusual discharge
- unusual rash
- fever or chills
- pain in the lower abdomen
- blisters, bumps, and sores in the genital or anal area
How to treat it
If you suspect you have an STI or have been exposed to one, see a healthcare provider.
Treatment
Make sure that you take the entire course of medication. The infection may return if you stop taking the medication too soon.
You should also abstain from sexual activity until you’ve cleared the infection to avoid passing it onto your partner.
Psoriasis is a common autoimmune condition that causes a rapid buildup of skin cells.
There are several different types of psoriasis, including genital and inverse psoriasis.
Genital psoriasis may develop directly on the vulva.
Inverse psoriasis can only form in the skin folds around the groin, thighs, and buttocks.
Both types usually present as darkened, purple, or brown patches on skin of color. On caucasian skin, they may appear as bright shiny red patches. They don’t cause the thick, white scales seen in other types of psoriasis.
How to treat it
If you suspect psoriasis, see a dermatologist or other healthcare provider. They may recommend a prescription-strength steroid cream to relieve itching and discomfort, or systemic medications for more severe cases.
Your healthcare provider may also recommend light therapy, an in-office procedure that uses special UV lights to heal the skin.
Lichen planus is an inflammatory condition that affects the:
- skin
- hair
- mucus membranes
While it’s more common on other parts of the body, such as inside the mouth and on the wrists, elbows, and ankles, lichen planus can also affect the vagina and vulva.
On the vulva or vagina, symptoms may include:
- itching
- bright red patches or sores
- painful sores, blisters, or scabs
- purplish, flat bumps
- pain with penetration
How to treat it
Lichen planus typically goes away on its own after about a year. Treatment aims to reduce symptoms and speed up healing of skin lesions.
However, you may be able to ease your systems by:
- soaking in an oatmeal bath to help relieve itching
- using a moisturizing treatment on the rash
- applying a cold compress to soothe pain and reduce inflammation
- applying an OTC hydrocortisone cream to help with itching, irritation, and redness
- taking an OTC antihistamine to relieve itching and reduce inflammation
Mild cases of lichen planus that affect the skin may clear up within a few years. If vaginal mucus membranes are involved, cases may be more difficult to treat.
If your symptoms are not resolved with simple home remedies, make an appointment to see a healthcare provider.
They may prescribe one or more of the following:
- topical estrogen cream
- topical, oral, or injection corticosteroids
- topical or oral immune response drugs
- topical or oral retinoids
- UV light therapy
Vulvodynia is chronic, unexplained pain around the vulva.
Pain from vulvodynia may:
- feel like burning, stinging, throbbing, or soreness
- be triggered by touch, like during sex
- become worse when sitting down
- be constant or come and go
Pain may be felt over the entire vulva and genital area or only in specific places, like the vaginal opening.
In some individuals, pain may be triggered by inserting a tampon, having sex, or wearing tight underwear.
How to treat it
See a healthcare provider if you have persistent pain around your vulva. Vulvodynia is
Because chronic pain
A
- antinociceptive agents (lidocaine, capsaicin, NSAIDs)
- anti-inflamatories (corticosteroids)
- neuromodulating medications (antidepressants, anticonvulsants)
- hormonal agents
- muscle relaxants
- dietary changes
- biofeedback training
- self-care measures
- pelvic floor physical therapy
- sexual counseling
- surgery (vestibulectomy for provoked vestibulodynia)
Lichen simplex chronicus is the result of rubbing or scratching of the skin over a long period of time. It may be the result of contact dermatitis, eczema, or other chronic skin conditions.
It appears as localized, well-defined areas of thick, inflamed, raised skin, called plaques. They are frequently linear, oval, or round.
These plaques cause intense itching that may interfere with sleep and daily life.
How to treat it
Treatment involves topping the “itch-scratch” cycle so that the skin can heal.
Treatment
- topical corticosteroids for larger areas
- intralesional steroids for smaller plaques
- topical emollients
- occlusive dressings to prevent rubbing and itching
- antibiotics if an infection is present
- psychological therapies to reduce emotional stress
- anxiety-reducing medications
- cryosurgery
- surgical excision of small, localized legions
Perimenopause is the time leading up to menopause. Menopause begins when you don’t have a menstrual period for more than one year.
Perimenopause
When your estrogen levels drop, the lining of your vagina becomes thinner and less flexible. You also produce less vaginal secretions, which can result in an uncomfortable dryness. This is called atrophic vaginitis.
As the skin in and around your vagina changes, friction, sexual activity, and the chemicals in products may cause irritation more easily.
How to treat it
If you haven’t already,
Vaginal moisturizers offer a continuous moisturizing effect and help your vaginal tissues retain moisture. They can be safely used long-term.
Water-based or silicone-based lubricants can be applied before masturbation, foreplay, and intercourse to reduce friction and discomfort.
If these OTC products don’t help — or you’re experiencing other uncomfortable symptoms — talk to a healthcare provider.
They
Hormone replacement therapy may also be an option.
Lichen sclerosus is a skin disorder that causes small patches of shiny, white skin to form on the genitals or other parts of the body. It may also appear as white bumps with dark purple coloring.
Other symptoms may include:
- itching
- pain or tenderness
- blotchy, wrinkled patches
- burning
- pain during sex
- easy bruising or tearing of the skin
- lesions that bleed or blister
How to treat it
Lichen sclerosus cannot be cured. However, a healthcare provider can prescribe steroid creams to help relieve symptoms.
Methods that may help relieve symptoms include:
- washing with an emollient soap substitute instead of regular soap
- gently dabbing your genitals after urinating
- regularly applying a barrier cream or ointment like petroleum jelly to affected areas
- wearing loose cotton or silk underwear
- using a vaginal lubricant during sex
Vulvar intraepithelial neoplasia (VIN), also known as dysplasia, results from changes in the skin cells covering the vulva. These changes range from minor to severe.
VIN is a precancerous condition. While it’s not cancer, if the changes become more severe, vulvar cancer may develop after many years.
Symptoms may include:
- itching
- sensations of tingling, burning, or soreness
- changes in appearance, such as redness or white, discolored skin
- minor raised skin lesions that may look like moles or freckles
- pain during intercourse
How to treat it
Treatment options vary depending on:
- how much the skin cells have changed
- the scope of the affected area
- the estimated risk of the condition developing cancer
Treatments can include:
- topical steroid creams to address inflammation
- removing abnormal cells with topical chemotherapy cream
- targeting affected areas with laser therapy
- surgery to remove the area of abnormal cells
- vulvectomy, which removes the whole vulva and is a rare procedure that’s only used when the affected areas are very large
Regular follow-up visits are advised as VIN can reoccur after treatments. The HPV vaccine may help prevent VIN.
Vulvar cancer is caused by the growth of abnormal tissue cells in the vulva. It may be caused by infection with HPV, melanoma (skin cancer) or Paget disease.
It commonly occurs in the outer lips of the vagina, but can affect other areas of the vulva, particularly as the cell abnormality spreads.
This type of cancer often spreads slowly. It typically begins with vulvar intraepithelial neoplasia. Without treatment, the tissue cell abnormality can develop into cancer.
Symptoms include:
- unusual bleeding
- vulvar itching
- discoloration of the skin
- painful urination
- vulvar pain and tenderness
- swollen areas on the vulva like lumps or wart-like sores
How to treat it
Vulvar cancer is typically treated after consultation with a cancer specialist.
Treatments vary based on the severity and scope of cancer, but tend to fall under four categories:
- Laser therapy.Laser therapy uses high-intensity light to target and kill cancer cells
- Surgery to remove the cancerous areas. Depending on how much the cancer has spread, the area surgically removed could range from patches of skin to a vulvectomy, or in rare cases, pelvic exenteration
- Radiation treatment. This is an external treatment that uses high-energy radiation to reduce the size of a tumor or destroy cancer cells.
- Chemotherapy. Chemotherapy is an aggressive form of chemical drug therapy designed to either reduce or completely stop the growth of cancer cells.
Regular follow-up visits with your healthcare provider after treatment are highly recommended.
If your symptoms are mild, you may be able to manage them at home.
Talk with your healthcare provider if the symptoms don’t lessen after lifestyle changes and OTC treatment. They may order a biopsy to help them make an accurate diagnosis.
You should also seek medical attention if you:
- suspect you have or have been exposed to an STI
- have signs of an infection, such as fever or swollen lymph nodes
- have recurrent pain during sex
Your healthcare provider can help determine whether an underlying condition is causing your symptoms and advise you on any next steps regarding treatment.