Anyone of any age can experience mild to severe external vaginal itching that is intermittent or continuous. The vaginal itching may or may not be associated with a skin condition. Some common causes of external vaginal itching are:
- Infections — Your vagina or vulva may feel itchy due to a candida infection or genital warts from a viral infection. Bacterial vaginosis can sometimes result in vulvar itching (although it’s rare), likely due to contact dermatitis.
- Inflammation of the skin — Irritant contact dermatitis can cause itching of the vagina as a skin reaction to friction, environmental or chemical factors.
- Neoplasia (abnormal tissue growth) — Vulvar intraepithelial neoplasia, Paget’s disease, squamous cell cancer, and vulvar cancer can cause external vaginal itching.
- Severe itching of the vulva can occur due to lichen planus, lichen simplex, or lichen sclerosus.
- Neuropathy can also cause itching of the vulva.
Some other common skin disorders that can result in external vaginal itching are:
- Psoriasis
- Allergic contact dermatitis
- Seborrheic dermatitis
- Allergic or irritant contact urticaria (immediate swelling that occurs after a contact with an aggressive substance)
- Folliculitis
Pubic lice are small insects that live on thick or coarse body hair (like pubic hair). The lice can also live in the hair on the legs, underarms, back, abdomen, chest, eyebrows, eyelashes, and face such as in mustaches and beards.
Symptoms of pubic lice are intense itchiness in the affected regions – particularly at night, irritation and inflammation due to scratching, and tiny blue spots or spots of blood on the skin of your lower abdomen or thighs from lice bites.
You should see your doctor if you think you’re experiencing an itchy vagina with no discharge because of pubic lice.
You can treat pubic lice at home by using an insecticide lotion, cream, or shampoo. In some cases, applying treatment only to the affected region is enough. Other times, you may have to treat the whole body. Depending on the product’s instructions, you may have to repeat the treatment after seven days to treat any lice that may have hatched from eggs during this time.
Lichen sclerosus causes white, patchy areas of skin that appear thinner than normal skin. It generally affects the anal and genital regions, and its cause is unknown. A hormonal imbalance or a hyperactive immune system may play a role. The condition often occurs in women after menopause. Symptoms and signs of lichen sclerosus are:
- Redness
- Severe itching
- Pain or discomfort
- White, smooth patches on the skin
- Wrinkled, blotchy patches
- Bleeding or tearing
- Painful sex
- Blistering, ulcerated, or bleeding sores in severe cases
Your doctor may suggest corticosteroid creams/ointments that can help your skin return to a normal appearance and reduce the likelihood of scarring. Lichen sclerosus can recur, so you may need follow-ups in the long term.
Contact dermatitis is an itchy, red rash that occurs from an allergic reaction to a substance. Irritants and allergens can cause irritant contact dermatitis and allergic contact dermatitis, respectively.
Symptoms and signs of contact dermatitis are:
- A red-colored rash
- Severe itching
- Cracked, scaly, dry skin
- Blisters and bumps, sometimes with crusting and oozing
- Burning, swelling, or tenderness
Visit a doctor in any of the following scenarios.
- The rash is making you lose sleep or distracting you from your routine activities.
- The rash appears suddenly and is severe, widespread, and painful.
- The rash isn’t better after three weeks.
- The rash is in your genital area.
You should ask for immediate medical help in the following scenarios:
- The skin is infected, indicated by oozing pus from blisters and a fever.
- There is inflammation of your eyes, nasal passages, or lungs (usually when you inhale an allergen).
You can treat the rash by using corticosteroid creams for a short time. Once you’ve figured out what caused the reaction, avoid coming into direct contact with that substance.
Eczema is an inflammatory condition that disrupts the surface of the skin and causes thin cracks and red patches, crust formation, and weeping. On the vulva, eczema can trigger a cycle of itching and scratching, leading to the occurrence of lichen simplex chronicus (thick and extremely itchy skin). If eczema affects the vestibule on the vulva (between your urethra and vaginal opening), it can produce burning and stinging. Eczema often starts after exposure to an allergen or irritant. You can use corticosteroid ointments twice a day for two to four weeks. You can then decrease the frequency gradually until there are no symptoms.
Psoriasis is a skin disorder in which there is a rapid production of new skin cells resulting in scaly, thickened patches of red and inflamed skin on different areas of your body. On the vulva, psoriasis often appears as pink patches of skin with well-defined edges. Your doctor may recommend a steroid ointment or cream.
Lichen simplex is a localized patch of chronic lichenified dermatitis/eczema. You may have one or multiple patches. It is also referred to as neurodermatitis. It can cause intense external vaginal itching, which may disturb your sleep. Your doctor may give you treatment to stop the usual itch-scratch cycle to help heal the skin. They may also recommend steroid creams, moisturizers, and cooling creams.
Genital herpes is a type of sexually transmitted infection, and it can be caused by two kinds of viruses: the herpes simplex virus 1 and herpes simplex virus 2. The symptoms of genital herpes are small blisters, which may burst to form open sores near the genitals, thighs, or anus; burning, tingling, or external vaginal itching; pain during urination; and unusual vaginal discharge.
Your doctor may prescribe antiviral medicines to keep the symptoms from getting worse. You can apply a painkiller cream or petroleum jelly to the affected area to decrease pain while urinating.
You can develop razor burn from shaving pubic hair on your vulva. This can cause symptoms of burning, red bumps, pain, and intense vaginal itching without discharge.
Razor burn can get better on its own, but don’t shave the affected region again until you’ve completely healed. If you develop itching and pain, you can use a low-strength hydrocortisone cream to relieve the symptoms. Make sure not to get it inside your vagina.
Sweating around the vaginal area is a normal process through which your body regulates its temperature. But excessive sweating can cause irritation and discomfort, leading to external vaginal itching. There are a lot of sweat glands on the labia majora. Protein is one of the components produced by sweat glands, and when it’s broken down by bacteria, it can result in a distinct odor.
Excess sweating in the groin can also cause itchiness and sometimes infections, including vaginal yeast infections and bacterial vaginosis.
You can minimize the production of excessive sweat while exercising by wearing clothes made of cotton.
Pubic hair can trap heat in your skin, causing excess sweat. Furthermore, most panty liners and pads are made from non-breathable material. This can cause even more heat in your pubic area and the production of more sweat.
If you can’t avoid wearing panty liners and pads, you can use unscented products and change them every couple of hours to decrease odor and sweating.
Yeast infections of the vagina (vaginal candidiasis) are a common issue. The most common signs and symptoms are irritation and soreness of the vulva, external vaginal itching, pain while urinating, pain while having sex, and a red and swollen vagina. Some people have no discharge, and others experience a watery or curd-like (white and clumpy) discharge. You may have to take an oral pill or vaginal treatment to treat vaginal candidiasis.
You may not always be able to prevent external vaginal itching, but you can optimize your vaginal health. Keep your genital area clean by changing your underwear and showering or bathing once a day. Avoid more frequent washing because it can irritate the external genitals and increase itching. Wash your external genitals with plain lukewarm water. If you want to use soap, make sure it’s non-allergenic. Avoid applying products such as feminine hygiene sprays, creams, or douches in your vaginal area. Take care while inserting tampons or using reusable menstrual cups. Change your panty liners and pads frequently.