Pain and itching in the genital area could be a sign of vulvar dermatitis. The condition occurs when the skin of the vulva gets irritated or inflamed, often due to heat, moisture, or perfumed products.
Lifestyle changes or over-the-counter medications can treat most cases of vulvar dermatitis.
On this page:
What Is Vulvar Dermatitis?
Vulvar dermatitis occurs when the skin of the vulva — the outer part of the female genitals — gets irritated or inflamed. This irritation may happen in response to an allergen, like a scented laundry detergent. It can also occur due to your environment, such as sitting in a wet swimsuit or sweaty gym clothes too long.
Dermatitis can cause pain and itching, but it typically isn’t serious. You can usually treat it at home.
Most cases of vulvar dermatitis respond to over-the-counter medications, like hydrocortisone ointments or antihistamines. However, preventing vulvar dermatitis by eliminating the irritant is most effective. For example, you may be able to stop inflammation by switching to an unscented soap, showering immediately after returning from the gym, or wearing clothes made of natural fibers, like cotton.
If the pain and itching continue, you should see your medical provider. Vulvar dermatitis can sometimes be mistaken for other, more serious conditions, like an infection or even cancer. It’s best to have your provider rule out other causes.
What are the types of vulvar dermatitis?
Vulvar dermatitis is a specific type of vulvar dermatoses.
Dermatitis is usually caused by external irritants, like moisture and perfumes. Other types of dermatoses are caused by faulty immune responses or autoimmune disorders.
Other types of dermatoses include:
- Lichen planus — This condition causes a rash of small bumps on the skin. On the vulva, it can cause raw, red patches that burn. Doctors aren’t sure of its cause but believe it is linked to the immune system.
- Lichen sclerosus — This chronic inflammatory condition causes thick white patches on the vulva and can leave scarring if it goes untreated. It’s more common in people with low estrogen levels, such as prepubescent girls and postmenopausal women. Doctors believe it could be caused by an autoimmune disorder.
How common is vulvar dermatitis?
Vulvar dermatitis is a common condition that affects women and girls of all ages.
What causes vulvar dermatitis?
Anything that irritates the skin of the vulva can cause dermatitis. That includes allergens, environmental factors, and health conditions.
Some of the most common irritants are:
- Astringents.
- Baby powder.
- Baby or adult moist wipes.
- Bubble baths or bath salts.
- Deodorants.
- Douches.
- Fabrics treated with chemicals.
- Hemorrhoid preparations.
- Laundry detergents and fabric softeners with perfumes.
- Lotions.
- Lubricants.
- Panty liners.
- Prolonged heat.
- Scented soaps.
- Spermicides.
- Tight clothing that traps heat and moisture.
- Underwear made from synthetic material.
- Urine or feces due to incontinence.
- Wetness, such as from sitting for hours in a wet bathing suit or sweaty workout clothes.
Vulvar dermatitis risk factors
- Low estrogen — Girls who haven’t gone through puberty or women who are postmenopausal have lower levels of estrogen in their bodies. This can make the skin around the vulva drier and more delicate, increasing your chances of developing dermatitis.
- Urinary or fecal incontinence — If urine or feces stay on the skin (such as on a pad), you may develop skin irritation or dermatitis.
Vulvar dermatitis complications
The most common complication of vulvar dermatitis is infection. Repeated itching can break open the delicate skin of the vulva and make it easier for bacteria to enter. If you do develop an infection, your doctor will likely prescribe antibiotics.
How can I prevent vulvar dermatitis?
Your doctor may suggest the following to help prevent vulvar dermatitis:
- Avoid fabric softeners, which can contain irritating perfumes.
- Avoid tight pants, tights, thongs, and other close-fitting or constricting clothing.
- Choose clothing — especially underwear — made from natural fabric. Cotton underwear is breathable and less likely to trap moisture and irritate the skin.
- Don’t use a washcloth to cleanse your vulva; use plain water and your hands and fingers once daily. (If you use soap, choose a gentle, nonalkaline cleanser.)
- Make sure your skin is dry before getting dressed.
- Remove wet or sweaty clothing as soon as possible.
- Wash as soon as possible after working out.
- Use unscented laundry soap to wash clothing. You may also run an extra rinse cycle to make sure your clothing is free of laundry soap.
- Use unscented panty liners.
What Are the Signs and Symptoms of Vulvar Dermatitis?
Symptoms of vulvar dermatitis include:
- Burning or stinging.
- Dry, cracked skin.
- Extreme itchiness.
- Pain during sex.
- Pain when urinating.
- Pain when using tampons.
- Raw, irritated skin.
When should I see a doctor about my vulvar dermatitis symptoms?
Contact your provider if your symptoms don't improve after a week or two of home treatment, or if they worsen.
You should also contact your provider if you have dermatitis symptoms and:
- A fever.
- Foul-smelling vaginal discharge.
- Pain or burning when you urinate.
- Pain, warmth, swelling, or redness in your vaginal area.
- A rash that spreads.
Vulvar dermatitis can resemble other, more serious conditions. It’s important to see your provider if your dermatitis persists.
They can rule out other causes, such as:
- Lichen planus — This condition causes a rash of small bumps on the skin. On the vulva, it can cause raw, red patches that burn.
- Lichen sclerosus — This condition can cause itching, white patches, and loss of architecture on the vulva. It’s more common in people with low estrogen levels, such as prepubescent girls and postmenopausal women.
- Psoriasis — This chronic disease produces red, scaly patches, usually on the knees, elbows, and scalp. Psoriasis can also develop on the genitals, where it can cause intense itching.
- Sexually transmitted infections (STIs) — STIs can produce inflamed, sore skin. They may cause itching, burning, pain during sex or urination, and rashes on the vulva.
- Vulvar cancer — Vulvar cancer is rare, but in some cases symptoms include pain and persistent itching.
- Yeast infections — According to the Centers for Disease Control and Prevention, about 75% of women will have a yeast infection during their lifetime. Signs of a yeast infection include abnormal vaginal discharge, pain during sex, vaginal itching and soreness, and pain when urinating.
How Do You Diagnose Vulvar Dermatitis?
Providers can often diagnose vulvar dermatitis based on a review of your symptoms and a physical exam. However, if you have dermatitis along with abnormal discharge, your doctor may test the discharge for infection.
If your vulvar dermatitis appears to be an allergic reaction, your doctor may also do a patch test.
Tests to diagnose vulvar dermatitis
- Test for infection — If you are experiencing abnormal vaginal discharge, your doctor may use a cotton swab to collect a sample for testing. Sometimes, vulvar dermatitis can turn into an infection. Other times, what appears to be vulvar dermatitis may actually be a yeast infection or bacterial vaginosis.
- Vulvar biopsy — In some cases where the doctor is evaluating for signs of cancer, pre-cancer, or some of the other vulvar conditions listed above, a biopsy is collected. To do this, your doctor will inject numbing medication under the skin and then remove a small area of skin. They will either place a chemical scab on the site or a small stitch to prevent bleeding.
How Do You Treat Vulvar Dermatitis?
You can treat most cases of mild vulvar dermatitis at home. You may need to visit your medical provider for more severe cases.
Lifestyle changes to treat vulvar dermatitis
To help ease your vulvar dermatitis symptoms, your provider may suggest the following:
- Don’t have sex until your skin has healed.
- Don’t use douche, powders, or vaginal sprays.
- Place cold compresses against the vulva to relieve itching.
- Sleep without underwear.
- Soak in a sitz bath (lukewarm, shallow water).
- Wash your vulva with cool water.
- Wear loose, breathable clothing and natural fibers, like cotton.
Medicine to treat vulvar dermatitis
Some over-the-counter treatments can help to relieve vulvar dermatitis symptoms.
- Antihistamine — Over-the-counter antihistamines, such as Benadryl, can help to relieve some of the itching associated with vulvar dermatitis. This may be especially helpful at night if the itching prevents you from sleeping.
- Hydrocortisone ointment — Applying a thin layer of 1% hydrocortisone ointment can also help to relieve itching.
If your dermatitis is severe, you should see your medical provider. They can give you prescription antihistamines, steroid creams, or anti-itch medications.
How effective is treatment for vulvar dermatitis?
Over-the-counter medications are effective for the short-term treatment of vulvar dermatitis. Lifestyle changes to prevent dermatitis will be more effective in the long run.
Some of the best ways to prevent dermatitis include:
- Avoiding tight or constricting clothing.
- Removing wet or sweaty clothing as soon as possible.
- Using unscented laundry soap and skip fabric softeners with heavy perfumes.
- Using unscented panty liners and tampons.
- Wearing clothing made from natural fibers.
