Vulvitis is the inflammation of the soft skin on the outside of the female genitalia. This area is called the vulva. The moist and warm conditions that are a necessary part of the vulva make it especially susceptible to vulvitis.
Any female can be affected by vulvitis, especially if they have allergies, sensitivities, infections, or diseases that make them more vulnerable.
Prepubescent girls and postmenopausal women have a higher risk because they tend to have lower estrogen levels.
It is important to see a doctor if symptoms, such as vaginal discharges or skin lesions on the vulva, occur.
Allergies or sensitivities to certain products, items, or habits usually provoke vulvitis. Any of the following may be the cause:
Certain hygiene products, including:
- colored or perfumed toilet paper
- vaginal sprays or douches
- shampoos and hair conditioners
- laundry detergents
- topical creams and medications
Allergic reaction to:
- bubble bath or soap used on the genitals
- sanitary napkins
Irritation caused by:
- a yeast infection
- chlorinated water in swimming pools or hot tubs
- synthetic underwear or nylon pantyhose
- wearing a wet bathing suit for a long time
- bike or horseback riding
- poor personal hygiene
Other factors, such as:
Postmenopausal women can be particularly susceptible to vulvitis. As estrogen levels drop, the vulvar tissues become thinner, drier, and less elastic. This makes women more vulnerable to irritation and infection.
Symptoms of vulvitis can manifest in different ways. Some of the most common are:
- itching, redness, burning, and swelling
- soreness, and thickened or white patches
- vaginal discharge
The following symptoms can affect the skin on the vulva:
- clear fluid-filled blisters
- a scaly appearance
- severe and prolonged itching
- a burning sensation
- small cracks
Over-cleaning of the affected area can make symptoms worse. It is best to wash once a day, and only with warm water.
The symptoms of vulvitis can suggest other disorders or diseases, including allergies, infections, and injuries.
Vulvitis can develop for many reasons, and finding the exact cause can be tricky. Clinical assessment usually starts with:
- a medical history
- a pelvic examination
The aim is to look out for redness, blisters, or anything else that may support a diagnosis of vulvitis. Any vaginal discharge may be tested for infections. Other conditions such as dermatitis or Lichen sclerosus are rare but need to be ruled out.
A diagnostic exam may include checks for sexually transmitted infections (STIs) and may include analysis of a urine sample. These two checks are usually done to rule out other issues that have similar symptoms.
Diagnostic tools may also include blood tests and pap tests. Pap tests involve laboratory testing of cells from the cervix. These can reveal changes in the cells that may be linked to infection, inflammation, or cancer.
Vulvitis can have many different causes, as outlined here, and this can sometimes make a diagnosis difficult.
However, provided that any underlying cause is accurately diagnosed, vulvitis is easily treated. Itching and other typical symptoms can usually be resolved within weeks of diagnosis and treatment.
If the inflammation is thought to be a result of reduced estrogen due to menopause, a doctor may prescribe a topical estrogen cream.
Hydrocortisone, anti-fungal, and estrogen creams can be helpful for symptom-relief. Self-help treatments include warm, soothing baths, compresses and calamine lotion.
Separate treatment of other conditions, such as vaginal infection or herpes, is essential if these are causing symptoms of vulvitis.
If these measures do not reduce the irritation, or if the symptoms worsen, then further tests will be needed. These may include a skin biopsy to rule out abnormal skin growth on the vulva, known as vulvar dystrophy, and vulvar dysplasia, which can be a precancerous condition.
Similarly, a skin biopsy may be needed If skin lesions are present on the vulva.
Irritants are a common cause of vulvitis, but the condition can also be linked with STIs. Prevention of STIs is through abstinence or condom use.
It is worth noting here that for some women condoms and associated lubricants can be irritating in themselves and, therefore, do not work as preventative measures for vulvitis caused by STIs.
For many women, the chances of a flare-up of vulvitis can be reduced with some basic self-care. Reducing stress, getting enough sleep and a nutritious, healthful diet can be helpful.
If vulvitis is reoccurring, a woman should consider wearing cotton panties and paying extra attention to perineal hygiene.
Treating yeast or other infections promptly, is equally important, as is talking to a doctor about other ways to prevent vulvitis.
Vulvitis is fairly common and is usually not serious in most cases. Symptoms, such as itching and irritation, can usually be relieved quickly.
On the other hand, vulvitis can sometimes be indicative of other underlying conditions, some of which can be serious if untreated. Hence, it is important to have a complete and conclusive diagnosis by a doctor, as soon as symptoms start to appear.