Vulvitis

Overview

What is vulvitis?

Vulvitis is inflammation in your vulva, or your genitals. Your vulva includes the soft folds of skin that surround your vagina, including your labia majora (the outer folds), labia minora (vaginal lips) and your clitoris. Your vulva may become inflamed because of an infection, allergic reaction or injury that irritates your skin.

Your vulva is a particularly moist and warm part of your body, making it especially vulnerable to irritation and infection.

What is the difference between vulvitis and vaginitis?

Both vulvitis and vaginitis describe inflammation that affects your reproductive parts. Vulvitis refers to inflammation affecting your genitals, or vulva — the outer part of your reproductive anatomy. Vaginitis refers to inflammation that affects your vagina inside your body. Inflammation affecting both your vulva and your vagina is called vulvovaginitis.

Your gynecologist may use terms like vulvitis, vaginitis and vulvovaginitis interchangeably.

Who is affected by vulvitis?

Anyone with a vulva can experience vulvitis, but it’s more common in children and people who’ve gone through menopause. People assigned female at birth who haven’t reached puberty have lower estrogen levels than people who menstruate. People who are in post-menopause have less estrogen too. Low estrogen levels can lead to thinner, dryer vulvar tissues. This may increase your risk of injury and inflammation.

Symptoms and Causes

What are the symptoms of vulvitis?

Symptoms of vulvitis may include:

  • Itching.
  • Burning.
  • Vaginal discharge.
  • Small cracks on the skin of your vulva.
  • Blisters on your vulva that may burst, ooze and form a crust.
  • Redness and swelling on your inner labia (lips of your vagina) and elsewhere on your vulva.
  • Thick, whitish patches of skin on your vulva that feel scaly.

These symptoms are common enough that they may suggest various disorders or diseases affecting your genitals. Talk to your healthcare provider if you notice these symptoms.

What causes vulvitis?

Infections, allergies, irritants and injuries can all cause inflammation in your vulva. Any of the following can cause vulvitis:

  • Dyed or perfumed toilet paper.
  • Pads, pantyliners or tampons that are scented or contain harsh ingredients.
  • Bubble baths, soaps, vaginal sprays and douches that contain harsh ingredients.
  • Wearing a wet bathing suit of sweaty workout clothes for too long.
  • Irritation from a chlorinated swimming pool or hot tub water.
  • Synthetic underwear that traps moisture and irritates your vulva.
  • Laundry detergents and fabric softeners that irritate your skin.
  • Injury from activities like cycling or horseback riding.
  • Spermicides that trigger an allergic reaction.
  • Skin conditions such as eczema or dermatitis.
  • Fungal or bacterial infections, including yeast infection, scabies and pubic lice.
  • Viral infections, such as genital herpes.
  • Vaginal atrophy during menopause.

Is vulvitis contagious?

Vulvitis isn’t contagious, but some of its causes are. For instance, many bacteria that can cause vaginal infections are highly contagious. Vulvitis that results from an allergy or skin irritation isn’t contagious.

Diagnosis and Tests

How is vulvitis diagnosed?

Your healthcare provider will review your medical history and ask about your symptoms and habits related to hygiene. They’ll do a physical exam and a complete pelvic exam. They’ll look for skin changes that may indicate vulvitis, like redness, blisters or lesions. They may also check your vaginal fluid for signs of an infection.

Tests may include:

Many causes of vulvitis produce the same symptoms, so your provider needs to pinpoint what’s causing your inflammation. Once your provider determines whether the cause is an infection, irritation or a skin condition, they can recommend treatments that can help.

Management and Treatment

What is the treatment for vulvitis?

Treatment for vulvitis depends on what’s causing the inflammation. Often, protecting your vulva from potential irritants and practicing proper vulvar care can relieve vulvitis. Your provider may recommend that you:

  • Avoid vulvar irritation: Stop using any products (like feminine hygiene products, soap and detergents) that may irritate your vulva. Wear loose-fitting, breathable white cotton undergarments to air out your vulva and vagina.
  • Try provider-recommended creams: Your healthcare provider may prescribe an over-the-counter hydrocortisone ointment to reduce the irritation and itching. They may prescribe a topical estrogen cream to ease the itching and other symptoms of vulvitis.
  • Take regular sitz baths: A sitz bath is a shallow, warm bath that can help relieve itching and burning caused by vulvitis.

Your provider may order additional tests to rule out rarer, more serious conditions that may be causing vulvitis, like lichen sclerosus or vulvar cancer if these treatments don't help. More targeted treatments will be needed for these conditions.

What vulvitis treatments should I avoid?

Don’t attempt to self-diagnose vulvitis. Many people purchase over-the-counter anti-itch products to ease their symptoms, but this is a mistake. Using the wrong treatment for what’s causing your vulvitis may worsen your symptoms and make the itching and irritation last longer.

Instead, schedule a visit with your provider to begin the right treatment.

Prevention

Can vulvitis be prevented?

The same good habits used to treat vulvitis can prevent it from happening in the first place.

  • Use mild, unscented soaps and warm water to clean your genitals, or just use warm water.
  • Avoid douching and using fragranced feminine products, like tampons, pads and pantyliners.
  • Change into clean, dry clothes soon after swimming or exercising.
  • Wear breathable, loose-fitting cotton underwear during the day.

Outlook / Prognosis

What is the prognosis for vulvitis?

The prognosis for vulvitis is excellent. Vulvar inflammation is common, and most people experience relief once they begin treatment.

How long does vulvitis last?

Itching and other symptoms can usually be relieved within a few weeks of your diagnosis, depending on what’s causing your vulvitis.

Living With

How do I take care of myself if I have the symptoms of vulvitis?

Schedule a visit with your provider if you notice signs of vulvitis. Without treatment, vulvar inflammation can progress to an infection. The warmth and moisture of your vulva and vagina make it an especially hospitable environment for bacteria to grow.

Your provider can help prevent a rash from becoming infected. They can prescribe treatments for infections that have already started.

What questions should I ask my doctor?

  • What tests are needed to figure out what’s causing my vulvitis?
  • Has the inflammation spread to my vagina, or is it only in my vulva?
  • What treatments would you recommend?
  • How long should it take for my symptoms to disappear?
  • How can I care for my vulva and vagina to prevent inflammation and irritation?

Frequently Asked Questions

What does vulvovaginitis look like?

With vulvitis or vulvovaginitis, your genitals may look red or swollen. Your skin may look scaly, white and patchy and you may have blisters. In more severe cases, your skin may be so irritated that it sticks together. Don’t postpone scheduling an appointment with your provider if your vulva looks or feels abnormal.

What is a whiff test?

Your provider may do a whiff test if they suspect that your inflammation is related to a common vaginal infection called bacterial vaginosis. Major symptoms of BV include an off-white or gray discharge and a fishy smell. Your provider may smell (take a “whiff” of) your discharge to see if it’s fishy.

A note from Cleveland Clinic

Don’t be embarrassed if you notice redness, itching, burning or any other signs of inflammation in your genital area. You’re not alone. Vulvitis is a common complaint that people discuss with their gynecologists. Still, it’s important to get treated and diagnosed immediately. Often, proper vulvar care can cure vulvitis. Sometimes, though, you may need treatments like antibiotics or creams to resolve your vulvitis before it gets worse. Either way, your provider can help.

Last reviewed by a Cleveland Clinic medical professional on 06/21/2022.

References

  • Raef HS, Elmariah SB. Vulvar pruritus: a review of clinical associations, pathophysiology and therapeutic management. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058221/) Front Med (Lausanne). 2021;8:649402. Accessed 6/21/2022.
  • van Schalkwyk J, Yudin MH; Infectious Disease Committee. Vulvovaginitis: screening for and management of trichomoniasis, vulvovaginal candidiasis, and bacterial vaginosis. (https://pubmed.ncbi.nlm.nih.gov/26001874/) J Obstet Gynaecol Can. 2015;37(3):266-274. Accessed 6/21/2022.
  • Woelber L, Prieske K, Mendling W, et al. Vulvar pruritus-causes, diagnosis and therapeutic approach. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081372/) Dtsch Arztebl Int. 2020;116(8):126-133. Accessed 6/21/2022.

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