Although some conditions can cause vulvar itching to worsen at night, it is more likely that the itchiness gets worse during this time because a person has fewer distractions.

Keep reading to learn about some of the common causes of vulvar itching that worsens at night, why this is the case, and what to do to get relief.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Possible causes of vulvar itching at night include:

Bacterial vaginosis

According to the Centers for Disease Control and Prevention (CDC), bacterial vaginosis is the most common vaginal infection in females ages 15–44 years old.

Bacteria exist naturally in the vagina, but an overgrowth can lead to bacterial vaginosis. This infection is more common among people who are sexually active.

Not everyone with bacterial vaginosis will have noticeable symptoms. However, common symptoms include:

Yeast infections

The vagina naturally contains a fungus called Candida, which typically does not cause any problems.

However, Candida can cause a yeast infection if a change in the environment allows it to grow excessively.

Changes that may facilitate infection typically occur in the immune system or involve certain medications or hormone levels.

The symptoms of a vaginal yeast infection may include:

Sexually transmitted infections

Some sexually transmitted infections (STIs), including pubic lice and trichomoniasis, may cause vaginal itching.

Pubic lice, which people often refer to as crabs, often cause vulvar itching that may feel worse at night. It is often possible to see pubic lice during a self-examination, but it is best to contact a doctor for a diagnosis.

Trichomoniasis is another STI that may cause vulvar itching. As with some other STIs, it does not always cause symptoms.

When symptoms do occur, they may include:

  • an unpleasant vaginal odor
  • vaginal or vulvar itching
  • thick discharge that is yellow-green in color
  • pain during urination and sex

Lichen sclerosus

Lichen sclerosus is a chronic skin condition. It can occur nearly anywhere on the body, but it is most common on the genitals and anus.

Lichen sclerosus causes the skin to thin, which leads to irritation, itching, and blisters. At first, lichen sclerosus may not produce any symptoms.

However, as it progresses, some of the following symptoms may start to develop:

  • vulvar itching
  • pain with urination
  • white spots that grow over time
  • pain during intercourse
  • anal itching or bleeding
  • blisters

The exact cause of lichen sclerosus remains unknown. However, the condition may run in families, result from hormone imbalances, or stem from an immune disorder.

Lichen planus

Lichen planus is an abnormal immune response that occurs when the immune system starts to attack the mucous membranes and skin.

It can affect many different parts of the body, including the vulva.

When lichen planus appears inside the vagina, it typically presents as white patches or painful sores.

If it appears on the outside of the vagina on the vulva, it can take the form of itchy, flat, red or purple bumps.

Eczema or dermatitis

Vulvar dermatitis occurs when the vulva becomes itchy and inflamed. The area may look discolored.

Heat, moisture, or irritants can cause dermatitis, but so can eczema. Eczema is a long-term skin condition that causes dry, cracked, scaly, and itchy skin. It can affect any part of the body, including the genitals.

If itching due to eczema or dermatitis becomes worse at night, this may be because the skin is too dry or because trapped sweat is causing irritation. A person can often ease this symptom by washing with water and mild soap before moisturizing the affected area.


Psoriasis is an autoimmune condition that can cause dry, painful, and itchy patches on the vulva and surrounding area. In rare cases, it can also develop inside the vagina.

A type of psoriasis called inverse psoriasis is more common on the vulva, but dryness can increase the risk of plaques forming.

Vulvar cancer

In very rare cases, vulvar itching can be a sign of vulvar cancer. Types of cancer and precancerous conditions that can cause itching around the vulva include:

Invasive squamous cell cancer and vulvar melanoma also cause symptoms such as a lump, pain, or bleeding outside of the typical menstrual cycle.

Many people with VIN do not experience any initial symptoms. If they do, the only symptom is typically persistent itching. VIN is not cancer, but it can lead to cancer over time.

Paget’s disease of the vulva causes soreness and discolored, scaly patches.

Although vulvar itching can present at any time, for some people, it can be more noticeable during the night.

This mostly happens due to a reduction in distractions, which leads to heightened sensitivity to the itching sensation.

The act of lying still when attempting to fall asleep often contributes to this increased awareness of bodily sensations.

In the case of pubic lice, vulvar itching may feel worse at night due to the lice becoming more active at this time.

People can try several at-home treatments to help relieve an itching vulva. However, unless the itch is clearly due to an allergen or irritant, it is best to contact a doctor for a diagnosis and medical treatment.

Some home remedies that may help ease itching at night include:

  • taking an oatmeal bath before bed
  • using appropriate topical anti-itch creams on the vulva
  • placing towel-wrapped ice packs on the vulva
  • using an appropriate topical antihistamine
  • trying over-the-counter antifungal treatments for yeast infections

Also, some common allergens and irritants to avoid include:

  • tight clothing
  • soap
  • spermicides
  • nylon underwear
  • perfumes
  • latex condoms
  • bubble bath
  • lubricants
  • laundry detergent
  • douching
  • talcum powder
  • baby wipes
  • some medications
  • panty liners

The cause of vulvar itching that gets worse at night will determine the treatment.

In cases of bacterial vaginosis and trichomoniasis, a doctor is likely to prescribe antibiotics to cure the infection.

If the itching is due to a yeast infection, a doctor may recommend an antifungal medication.

If the cause of the itchiness is an allergic reaction, the doctor may prescribe an antihistamine to relieve the symptoms.

Corticosteroids or oral medications can help stop the immune system response that causes lichen planus.

If the itching occurs as a result of lice, a person will need to destroy the insects and their eggs and then wash all of the clothing and bedding in the home thoroughly.

In cases of lichen sclerosus, a doctor may prescribe or recommend topical steroids, steroid injections, or tricyclic antidepressants to help with the pain.

Treating underlying conditions such as psoriasis or eczema with emollient creams and topical medications can help relieve symptoms. There are many other treatment options for these conditions, including phototherapy, corticosteroids, and vitamin D supplements.

Doctors will treat cancer on a case-by-case basis. The treatment plan may include:

Below are some commonly asked questions about an itchy vulva.

Why am I so itchy down there at night?

There are many potential reasons why a person is experiencing itchy genitals or anus at night. These include but are not limited to:

What causes severe vulvar itching?

Potential causes of severe vulvar itching include:

  • bacterial vaginosis
  • yeast infection
  • STI
  • lichen sclerosus
  • lichen planus
  • eczema or dermatitis
  • psoriasis
  • vulvar cancer

Vulvar itching, including itching that gets worse at night, is often the result of an allergic reaction or medical condition that will need treatment.

People should contact a doctor for itching that does not go away after some time, or that occurs with other symptoms.

In most cases, treatment can effectively get rid of the infection or condition and relieve the itchiness.