15175 Vulvitis

Overview

Vulvitis is a word for inflammation (redness, swelling or soreness) of the vulva. The vulva is the area of skin around the opening of the vagina, including the inner and outer lips (labia) and the clitoris.

Yes, vulvitis is one of the most common reasons that women go to see a doctor about itching or soreness in the vulval area.

It can affect females of any age, from babies to older adults. It is not a sexually transmitted illness itself, but some infections passed through sex can cause vulvitis.

Symptoms

Common symptoms

• Itching around the vulva
• Redness and swelling
• A burning or stinging feeling
• Soreness or discomfort
• Pain when passing urine
• Thick or unusual vaginal discharge
• Small cracks, blisters or open sores on the skin

Symptoms in children

• Red skin around the vulva that looks raw
• Itching or fussiness, especially when changing or washing
• Pain or crying when passing urine
• A strong odor or discharge from the area
• Not wanting to touch the area or telling a parent it hurts

Symptoms in older adults

• Dry, thin or fragile skin on the vulva
• Itching or burning that worsens after urination
• Soreness or stinging even when the area is not touched
• Skin that looks lighter or whiter than usual
• Pain during wiping or cleaning

Causes

Main causes

• Harsh soaps, bubble baths, scented wipes or intimate sprays
• Tight or synthetic clothing that traps moisture
• Perfumed laundry detergent or fabric softener
• Persistent dampness from sweat, urine or vaginal discharge
• Infections such as vaginal thrush (yeast), bacteria or sexually transmitted infections
• Skin conditions like eczema or lichen sclerosus
• Hormone changes, especially during the menopause

Risk factors

• Using scented products near the genital area
• Wearing tight, non-cotton underwear or trousers
• Poor hygiene or over-washing (washing more than once a day with soap)
• Diabetes, especially if blood sugar levels are high
• Being overweight, which can cause extra dampness and rubbing
• Having a weakened immune system

When to see a doctor

See a doctor urgently if:

• If you have sudden severe pain or a high fever, you need same-day medical help.
• If there is thick green or yellow discharge, open sores, or a strong bad smell, see a doctor urgently.
• If you cannot urinate at all, seek care immediately.

Book a routine appointment if:

• Symptoms that last longer than two days
• Recurring itching or soreness that keeps coming back
• Pain during sex
• A lump, ulcer or hard area on the vulva that does not heal
• Changes in bladder or bowel habits along with vulval symptoms

Diagnosis

A doctor will ask about your symptoms, the products you use near the area, and your health history. They will also look gently at the vulva. This may feel a little awkward, but it is quick and usually painless.

Tests that may be done

• A swab – a soft cotton bud gently wiped over the skin or vagina to check for infection
• A urine test if passing urine burns or is painful
• Sometimes a small scrape of the skin or a patch test if an allergy or skin condition is suspected

What to expect at your appointment

The doctor will explain what might be causing the irritation and suggest a plan to soothe the skin. If they are unsure, they may refer you to a specialist clinic. You can ask for a nurse or another person to be present during the examination.

Treatment

Treatment for vulvitis depends on the cause. For many women, stopping the use of scented or harsh products near the area and following a gentle skin care routine will make a big difference. If an infection or a skin condition is present, a doctor may prescribe treatment to clear it.

Self-care at home

• Wash the vulva gently with plain water once a day. Do not use scented soap, bubble bath, wipes or intimate sprays.
• Pat the area dry with a clean towel – do not rub.
• Wear loose cotton underwear and avoid tight jeans, leggings or tights.
• Avoid scratching, as this can damage the skin further.
• Apply a cool (not icy) compress wrapped in a clean cloth to calm itching.
• If the skin is very dry or you have incontinence, ask your pharmacist about a plain barrier cream.

Medical treatments

Depending on the cause, a doctor may prescribe creams or ointments to reduce redness and itching, medicines to clear a fungal or bacterial infection, or a topical hormone treatment for changes related to the menopause. Always follow the doctor's instructions and let them know if symptoms do not improve after treatment.

When is surgery considered?

Surgery is rarely needed for vulvitis. It may be considered only if a specific skin condition, such as lichen sclerosus, causes scarring or damage that needs a specialist procedure. Most people never need surgery.

Living with this condition

With simple changes, most people manage vulvitis well. The key is to treat the area gently every day, avoid known irritants and keep the skin cool and dry. If symptoms flare up, go back to your doctor rather than waiting.

Lifestyle tips

• Use fragrance-free laundry detergent and rinse clothes twice.
• Change underwear and sanitary pads frequently.
• After urinating, wipe from front to back.
• Do not use vaginal deodorants, douches or 'feminine' washes.
• Take a break from very tight or synthetic clothing, especially on active days.

Diet and exercise

A balanced diet and plenty of water help keep your skin healthy. Regular physical activity is also good for overall health and can help you keep a healthy weight, which may reduce dampness and rubbing in the area. If you have diabetes, keeping your blood sugar well controlled helps prevent yeast infections that can lead to vulvitis.

Mental health and emotional wellbeing

Having vulvitis can feel uncomfortable, embarrassing and stressful. It can affect sleep, relationships and confidence. These feelings are normal and you are not alone. Speak to your doctor about the distress it causes, and consider talking to a counsellor if it is affecting your mood. If you ever feel you cannot cope, reach out to your local crisis line or your local emergency number.

Prevention

Vulvitis cannot always be prevented, but many causes can be avoided. Using only plain water on the vulva, choosing unscented products, wearing cotton underwear and keeping the area dry are all helpful. It also helps to treat underlying conditions such as diabetes or a repeated yeast infection early.

Complications

If left untreated

• If the cause is an infection, it may spread or take longer to heal.
• Long-term itching and scratching can cause skin thickening, cracks or bleeding.
• Rarely, an untreated skin condition can lead to scarring or changes in how the vulva looks.
• A missed diagnosis may mean a treatable skin condition or infection gets worse, making it harder to manage.

Long-term outlook

The outlook for vulvitis is very good. Most cases settle with simple skin care and avoiding the cause. Even when a skin condition such as lichen sclerosus is present, people usually respond well to treatment and live normal, active lives. Working with your doctor and taking gentle care of the area can keep symptoms under control.

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