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.
Possible causes of vulvar itching at night include:
According to the Centers for Disease Control and Prevention (CDC), bacterial vaginosis is the most common vaginal infection in females ages
Not everyone with bacterial vaginosis will have noticeable symptoms. However, common symptoms include:
- pain, itching, or burning
- burning urination
- white or gray vaginal discharge
- itching of the vulva
- a strong fishy odor, particularly after sex
The vagina naturally contains a fungus called Candida, which typically does not cause any problems.
The symptoms of a vaginal yeast infection may include:
- pain during sex
- vaginal soreness or itching
- discomfort, pain, or burning when urinating
- unusually thick, white discharge from the vagina
Sexually transmitted infections
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 is a chronic skin condition. It can occur nearly anywhere on the body, but it is most common on the genitals and anus.
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
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 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
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
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.
- vulvar intraepithelial neoplasia (VIN)
- invasive squamous cell cancer of the vulva
- vulvar melanoma
- Paget’s disease, which can occur on the breasts
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
The cause of vulvar itching that gets worse at night will determine the treatment.
If the itching is due to a yeast infection, a doctor
If the cause of the itchiness is an allergic reaction, the doctor may prescribe an antihistamine to relieve the symptoms.
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.
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
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
- lichen sclerosus
- lichen planus
- eczema or dermatitis
- 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.