External vaginal itching is not only annoying and embarrassing, but it can cause ongoing discomfort and pain with intercourse. The most common cause of external vaginal itching, otherwise known as vulvar itching, is dermatitis or inflammation of the skin. Dermatitis can be caused by an allergy or exposure to something irritating, such as soap, fabric or lotion. Certain chronic skin conditions, infections of the vagina and vulva and low estrogen levels can also cause external vaginal itching.
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Most Common Cause
Approximately 50 percent of external vaginal itching is related to dermatitis or skin inflammation, according to a March 2014 "BioMed Research International" review. Many things can cause an allergy or vaginal irritation -- including soaps, lubricants, spermicides, sweat, semen and urine. Dermatitis can also be caused by friction against the sensitive genital skin. As a result, synthetic underwear, tight clothes, sanitary or incontinence pads and toilet paper are also potential irritants and can cause itching. Antibacterial or antifungal creams and ointments, which are often prescribed to treat itching, can also cause burning and irritation.
Lichen sclerosus, lichen planus and psoriasis are chronic inflammatory skin disorders that can affect the vulva. Lichen sclerosus causes whitening and thinning of the skin, which results in cracks and tears that often lead to permanent scarring. Itching is the most common symptom of this condition. Lichen planus is a similar condition that can affect the vagina as well as the vulva. Common signs and symptoms include painful red patches, itching, burning and discharge. Psoriasis may affect the external vaginal skin in addition to more common sites like the scalp, elbows and knees. Itchy, red skin patches typically develop on both sides of the vulva with this condition.
Infections of the vagina and vulva commonly cause external itching. Yeast infections cause itching, burning and pain with intercourse, along with a thick white discharge. Bacterial vaginosis and trichomoniasis are other vaginal infections that can cause discharge, burning and external vaginal itching. Low estrogen levels after menopause can result in thinning and dryness of the genital skin. This often leads to itchiness, sensitivity to irritants and an increased risk of vaginal infections.
Human papillomavirus, or HPV, infections cause genital warts. While most cause no symptoms, some genital warts are itchy or painful. Additionally, certain strains of HPV sometimes lead to vulvar cancer, which might cause external vaginal itchiness. Paget disease is a rare disorder that can be a source of external vaginal itching. It is often mistaken for the more common skin disorders such as psoriasis, eczema or genital warts. The intestinal disorder Crohn disease can also lead to external vaginal inflammation and itching.
When to See Your Doctor
While dermatitis is the most common cause of external vaginal itching, this symptom can be caused by more serious conditions. See your doctor if you have persistent itchiness, especially if you notice sores or other skin changes.
- Obstetrics and Gynecology: ACOG Practice Bulletin Number 93: Diagnosis and Management of Vulvar Skin Disorders
- BioMed Research International: Pruritus in Female Patients
- Obstetrics and Gynecology: ACOG Practice Bulletin Number 72: Vaginitis
- BioMed Research International: Vulvar Skin Disorders Throughout Lifetime: About Some Representative Dermatoses
- Australian Family Physician: Vulval itch