Vulvar Dermatitis

Vulvar dermatitis is a common skin condition that causes an irritated, itchy vulva. “Vulva” is another name for your genitals. It includes the folds of skin that surround your vagina. The condition may cause dry, itchy skin in these folds.

Vulvar dermatitis isn’t a sexually transmitted infection (STI). It happens when noninfectious things in your environment, like soaps or dyes, cause irritation in your vulva. It could also be autoimmune or an allergic reaction.

Many other conditions have the same symptoms as vulvar dermatitis. It’s important to see a healthcare provider so they can give you a correct diagnosis. That way, you can get the right treatment and start feeling better sooner.

Types

Vulvar dermatitis can be scarring or non-scarring:

• Scarring types: Lichen sclerosus and lichen planus, which are inflammatory conditions, can lead to scarring on your vulva. They can change the appearance of your vulva. It may be permanent in some cases.
• Non-scarring types: These types include contact and irritant dermatitis and lichen simplex chronicus.

Symptoms of vulvar dermatitis

Vulvar itching (vulvitis) is the most common symptom of vulvar dermatitis. It can range from mild to severe. Other symptoms may include:

• Skin that feels as if it’s burning, stinging or raw
• Skin patches that feel thicker than the surrounding skin
• Skin patches that look red or darker than the surrounding skin
• A wet feeling in your vulva from damaged skin with fluid seeping out
• Pain when you have intercourse or insert a tampon

Your symptoms may get worse:

• At night
• During intercourse
• When you’re on your period
• When you’re hot or sweating

Vulvar dermatitis causes

Vulvar dermatitis happens when the skin of your vulva touches something that irritates it or causes an allergic reaction. The condition is common because the skin on your vulva is fragile and more likely to get damaged compared to skin elsewhere.

Products that may cause vulvar dermatitis include:

• Soap, bubble bath, shampoo and hair conditioner
• Deodorant, perfume, douches and talcum powder
• Underwear made of synthetic materials, like nylon
• Laundry detergent and dryer balls
• Pads, panty liners and tampons
• Food preservatives
• Toilet paper
• Tea tree oil
• Spermicides
• Medications
• Nickel
• Dyes

Risk factors

You may be at higher risk for vulvar dermatitis if you:

• Haven’t gone through puberty
• Are in postmenopause
• Have urinary or fecal incontinence

Lower levels of estrogen (a hormone) may make the skin on your vulva drier and more fragile. With incontinence, pee and poop can rub against your skin, irritating it.

Complications of this condition

It’s possible to develop an infection as a complication of vulvar dermatitis due to excessive itching. You could break open the skin on your vulva, making it easier for bacteria to enter.

How doctors diagnose this condition

To get a diagnosis of vulvar dermatitis, your provider will have to rule out other possible causes of your symptoms. They’ll ask questions and do exams or tests. The process may include:

• Asking about your medical history, especially if you have a biological family history of skin conditions (like eczema)
• Asking about your symptoms, like when they happen and when they’re most severe
• Doing a physical exam to look at the irritation
• Testing your vaginal discharge to rule out infections
• Doing a patch test to see if you react to certain allergens

You may need a biopsy if the irritation becomes worse despite treatment.

How is it treated?

Often, you can get rid of vulvar dermatitis by avoiding the things that irritate it. Practicing better vulvar care helps, too. And medicines can calm pain and itching while the dermatitis clears.

Medications

Your provider may prescribe pills, creams or ointments that can help keep itching under control.

Medicines may include:

• Anti-itch medications that can help you sleep, like hydroxyzine or doxepin
• Corticosteroid ointments, like hydrocortisone, desonide, triamcinolone or clobetasol
• Anti-itch emollients, like Balneum Plus^®, E45 Itch^® or Dermacool^®

Lifestyle changes

Avoid any products that may cause an allergic reaction or skin irritation. Your healthcare provider can help you think of all the things you use that may cause dermatitis.

In the meantime, make sure to care for your vulva with gentle cleaning. Choose clothes that allow your skin to breathe.

For instance, you should:

• Wash your vulva with mild, unscented soap and warm water no more than once a day.
• Wash your vulva with your hands and fingers instead of a washcloth.
• Pat your vulva dry with a clean towel instead of rubbing.
• Wear 100% cotton underwear or no underwear instead of synthetic fabrics.
• Wear loose-fitting cotton clothing instead of tight-fitting underwear or jeans.
• Wash your clothes with mild, unscented detergents.
• Avoid douching.
• Avoid using scented feminine hygiene products.

When should I see my healthcare provider?

Schedule a visit with a healthcare provider before using any over-the-counter (OTC) treatments to relieve itching. Vulvar itching is a common symptom of many conditions that require different treatments. Without a proper diagnosis, you may choose a treatment that contains the irritant you need to avoid.

What can I expect if I have this condition?

Vulvar dermatitis can be pretty uncomfortable. But it’s not harmful to your health.

The time it takes for it to improve depends on the specific cause. For instance, contact dermatitis may take a couple of weeks or up to one month to go away once you remove the offending product. If you have an infection along with dermatitis, the recovery period may be longer.