Vulval irritation is common in women of all ages, and most causes aren’t serious.
The skin of the vulva is very delicate, making it vulnerable to irritation from a range of products and chemicals.
Symptoms can include itching, burning, swelling, and vaginal discharge.
If you’re concerned about vulval irritation, see your doctor and ask them to check your vulva.
What is vulval irritation?
Vulval irritation is when infections, products, clothes and other factors affect the sensitive skin of the vulva. Your vulva is the external part of your female genitals that you can see. Your vagina is inside your body.
Most causes of vulval irritation are not serious. But there are a few rare conditions that can become serious if left untreated.
Every now and then you might have vaginal discharge. This is normal. The discharge helps to keep your vulva and vagina moist. It also removes bacteria and dead cells.
It’s a good idea to know what your normal discharge looks like and pay attention to any changes. The discharge can change in colour and consistency with an infection. It can also change depending on the stage of your menstrual cycle.
If you’re concerned about your discharge, see your doctor.
Symptoms of vulval irritation
Vulval irritation can be associated with other symptoms, including:
Vaginal discharge, which can be caused by imbalance or overgrowth of bad bacteria in the vagina, may cause irritation.
Sweat can also irritate the vulva.
Certain products can cause irritation. For example:
period products, such as pads and tampons
soap, bath and hair products
laundry detergent
perfumed products such as feminine hygiene sprays
scented or coloured toilet paper or wipes
hair removal and bleaching products
douches or vaginal washes
condoms, spermicides and lubricants.
Tight or synthetic clothing, such as polyester underwear and stockings, can cause irritation, as can wet bathers – especially after swimming in chlorinated water.
Yeast infections of the vulva and vagina, such as thrush (candidiasis), can cause irritation. Symptoms include itching, redness, swelling and a cottage cheese-like vaginal discharge.
Bacterial vaginosis is a bacterial infection of the vagina that produces a thin white, grey or greenish discharge that can cause irritation.
Certain skin conditions can cause irritation. For example:
dermatitis or eczema – a common skin condition that can make the vulva feel itchy
psoriasis – a chronic skin condition that can affect vulval skin, causing red, inflamed patches
lichen sclerosus – a chronic skin condition that can affect the vulva and anal areas, causing white patches and scarring
lichen planus – a chronic condition that can affect the vulva, causing itchy bumps.
trichomoniasis – common symptoms include itchiness and a smelly, frothy, green discharge
genital herpes – a virus spread by skin-to-skin contact during vaginal, oral or anal sex
other STIs including chlamydia, gonorrhoea and genital warts.
Bartholin glands are located on either side of the lower part of the vaginal opening. They produce lubricating fluid during sex. If a gland is blocked, it can cause a cyst, leading to discomfort or pain.
Varicose veins (enlarged, twisted veins) can develop in the vulva, particularly during pregnancy, which may cause discomfort.
Hormonal changes, especially a drop in oestrogen hormone levels, can make the vulval and vagina tissues:
thinner
drier
more uncomfortable.
This can happen after having a baby, while breastfeeding or around the time of menopause.
Some medicines and local anaesthetic can cause vulval and vaginal irritation.
Symptoms of vulval cancer may include:
a persistent itch
rough skin
a non-healing sore or a lump.
Vulval cancer is rare, but it’s important to know your vulva and contact your doctor if you notice any changes.
Medical treatments for vulval irritation
Treatments for vulval irritation depend on the cause. Your doctor may recommend different options, including:
external treatments – medicated creams (corticosteroid, antibiotic, antifungal or local anaesthetic), barrier creams and gels
internal treatments – vaginal creams, gels, tablets and pessaries (antibiotic, antifungal, acidic or hormonal)
tablets – taken orally.
It’s important to follow treatment instructions. See your doctor again if symptoms don’t improve.
Self-care treatments for vulval irritation
If you have vaginal irritation, you can try the following self-care treatments.
Soothe the irritation by sitting in a wash basin or bath once or twice a day for 5 to 10 minutes.
If you’re using a basin or tub, add 2 tablespoons of bicarbonate of soda or one-quarter teaspoon of salt per litre of water.
If you’re having a bath, add one cup of bicarbonate of soda or a handful of salt to the water.
Make up a saltwater spray bottle. Add one teaspoon of salt to 600 ml of water.
Spray this mix onto your vulva while sitting on the toilet. You can do this while weeing, to reduce the stinging, and again after you’ve finished to remove any traces of wee from your vulva.
Cold packs (wrapped in a cloth) may ease itching and pain.
Reduce any burning feeling by leaning forward while weeing. In this position, your wee will go directly into the toilet and won’t run down your vulva.
Keeping your vulva and vagina healthy
The vagina has an ecosystem or microbiome that includes many types of tiny living organisms, mainly bacteria. This ecosystem plays an important role in preventing vaginal infections.
When there is an imbalance or overgrowth of bad bacteria in the vagina, it can cause symptoms such as:
vaginal discharge
redness
itchiness.
It can also cause common fungal infections, such vaginal thrush, or bacterial infections, such as bacterial vaginosis (BV).
Vulval irritation is not always due to an imbalance of vaginal bacteria. Studies suggest that your vaginal bacteria may be connected to the bacteria in your digestive system. So, what you eat may affect the health and populations of bacteria in your gut and vagina. But more research is needed in this area.
Some foods contain good bacteria (Lactobacillus). For example:
live cultured yoghurt
kimchi
sauerkraut
kefir.
When you eat these foods regularly, they help maintain good bacteria in your digestive system.
A wholefood diet rich in fruits, vegetables and fibres is associated with good bacteria in the gut.
Another option is to take probiotic supplements. They contain good bacteria in much higher quantities than what you would get from fermented foods alone.
Some evidence suggests that probiotic supplements can be useful in preventing and treating vaginal infections, especially bacterial vaginosis, but more research is needed to support this.
There are many kinds of probiotic supplements available. You can take them orally as a capsule or powder. Ask a qualified health professional to recommend the best probiotic for you.
When to see your doctor
Sometimes vulval irritation involves a cycle of itching, scratching, skin splitting and then a secondary infection.
You may find it hard to talk about the problem. But, if you experience vulval irritation and your symptoms are not getting better, it’s important to see your doctor.
They will take your medical history and ask about your symptoms. If they don’t check your vulva, ask for an examination.
Your doctor might ask you to do a urine (wee) or blood test, or take a small sample of your vulva or vagina for testing. This process will ensure you get the right diagnosis and treatment.
The sooner you seek help, the sooner your symptoms will improve.
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