A vaginal rash is usually not in the vagina but on the vulva. Treatment will vary depending on the underlying cause, but may include topical treatments, antibiotics, or antiviral medication.

The vagina is the internal part of the female genitals, while the vulva is the outer part surrounding the opening to the vagina. These combine with the labia to form what many people call the vagina. A rash in this area can cause severe discomfort, especially when a person is sitting or having sex.

This article explores the causes and treatments for a rash on the vulva. It also discusses when to seek help from a healthcare provider.

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Image credit: Cavan Images/Getty Images

There are many reasons for a rash in a person’s vaginal area, and there are several types of rash. Below are the most common.

Contact dermatitis

Contact dermatitis may cause a person to experience a rash in their genital area. Because the skin in the vaginal area can be more sensitive than elsewhere on the body, a person may experience a rash here without experiencing one anywhere else on their body.

Symptoms can include:

  • redness and itchiness
  • swelling and blisters
  • dryness and bumps

Often, this reaction can be due to changes in toiletries or laundry products. In this scenario, a person can resolve the rash by removing the allergen. In more serious cases, people can use topical steroids to treat inflammation.

Bacterial infection

When something disturbs the normal balance of bacteria in the vagina, a person may contract a bacterial infection, also known as bacterial vaginosis (BV).

This can occur, for example, if a person uses a douche, which can change the delicate balance of bacteria in the vagina.

Symptoms of BV may include:

  • a thin white or gray vaginal discharge
  • pain, itching, or burning in the vagina
  • a strong fish-like odor, especially after sex
  • burning when urinating
  • itching around the outside of the vagina

Sometimes, bacterial infections will resolve without medical intervention, but a person can also treat them using antibiotics.

Yeast infection

Vulvovaginal candidiasis, also known as a vaginal yeast infection, is a common condition worldwide. More than 75% of females experience a yeast infection at least once in their lifetime, according to the Centers for Disease Control and Prevention (CDC).

Symptoms can include:

  • vulval itch
  • vaginal discharge
  • soreness
  • burning
  • swelling

Disturbing the natural environment of the vagina may trigger yeast infections, so a person may wish to avoid using perfumed soaps or wipes within the genital area.

Treatment involves over-the-counter (OTC) creams or suppositories. Occasionally, a person may need prescription-strength remedies.

Syphilis

Syphilis is a sexually transmitted infection (STI), which usually begins with firm, round, and painless sores in the genital region.

These sores are highly contagious, and people can acquire the infection by coming into contact with them. The CDC categorize the syphilis infection into four stages, each with its own symptoms.

Symptoms of the second stage can include:

Without medical treatment for syphilis, it can develop through to the final stage. This is called tertiary syphilis, which can affect the heart, brain, and other body organs.

Antibiotics can treat syphilis. The sooner a person seeks treatment, the better the outcome, as doctors cannot reverse the damage that the disease can inflict.

Scabies

The World Health Organization (WHO) estimate that 200 million people worldwide have scabies at any one time. Human scabies is a parasitic infestation. A microscopic mite triggers it by burrowing into the skin and laying eggs.

A rash occurs after the body develops an allergic reaction to the mite proteins and feces present where scabies burrow.

Symptoms may include:

  • itchiness
  • small red bumps
  • burrow lines where the mites have traveled
  • skin sores

Treatment usually involves applying a topical scabicide. The WHO recommend the entire household receive simultaneous treatment, as some people in the household may already have contracted the infection but may be asymptomatic.

Pubic lice

Pubic lice, or crabs, are parasitic insects that can live in the genital area of humans. They are passed on through sexual contact and are highly contagious.

Symptoms may include:

  • itching in the affected area
  • inflammation and irritation, which may be due to a person scratching the area
  • black powder in a person’s underwear
  • small spots of blood on the skin of the vaginal area due to bites

Treatment for pubic lice can include OTC lotions or mousses or prescription medication for persistent cases.

Genital herpes

If a person contracts the herpes simplex virus, they will always have it, though it may lie dormant for years at a time.

Up to 1 in 5 adults may have acquired genital herpes, but most of them have few to no symptoms. This means that some people may be unaware they are carrying the virus.

Symptoms can include:

  • small, closely grouped blisters on a red base
  • shallow ulcers
  • fever
  • headache
  • muscular aches and pains

While nothing can prevent future flare-ups of genital herpes, antiviral drugs, such as acyclovir, can shorten and prevent episodes while a person is taking the medication.

Genital warts

Also known as anogenital warts, genital warts are common superficial skin lesions in the vaginal area. The human papillomavirus triggers this very contagious condition, which is one of the most common STIs.

Symptoms may include:

  • flesh-colored raised warts, a few millimeters in diameter
  • flat thickened lesions
  • a cluster of bumps that look similar to cauliflower, which are raised or flat and smooth or rough in appearance

These warts can be various colors, ranging from the same color as the person’s skin to dark purple, gray, or brown.

Prescription medications, including ointments and creams, can treat genital warts.

If medication is not effective, a physician may freeze the warts off with liquid nitrogen, remove them, or use other surgical treatments to destroy them.

A person should speak with a healthcare professional if they notice an unusual rash in their vaginal area or vulva, particularly if pain or discomfort are accompanying symptoms.

If a rash is recurring, a person should also seek medical advice.

There are many reasons for a rash in a person’s vaginal area or vulva, and not all of them are serious.

A person can treat some of them at home, while others may require medical intervention.

Seek medical advice if there are any concerns about a rash in the vaginal area.