Dermatitis is the term for skin irritation. Vulvar dermatitis affects the skin of the vulva and the surrounding area. The affected skin may become inflamed, itchy, and irritated.

One of the primary causes is female genital eczema, also called vulvar eczema or vulvar atopic dermatitis. Other possible causes include infections, allergies, and irritants, as well as psoriasis and other inflammatory conditions.

Vulvar dermatitis is treatable, and many of the causes of vulvar dermatitis are curable. Although there is no cure for atopic dermatitis or psoriasis, it is possible to treat dermatitis of the vulva resulting from these conditions.

A person can also try adjusting their skin care routine and other habits to help manage this condition.

Common symptoms of vulvar dermatitis include:

  • itchy skin around the vaginal area
  • inflamed, discolored skin around the vaginal and vulvar area
  • dry, scaling, or blistered skin around the vaginal and vulvar area
  • oozing or crusting of the affected skin
  • swelling of the affected skin

A person may also have these symptoms on other parts of their body, including around the anus and between the buttocks.

The symptoms may range from mild to severe. If atopic dermatitis is the cause, the person may experience flares, during which the symptoms worsen, alternating with periods of remission.

Scratching can cause the affected skin to bleed and become infected.

Many factors can cause vulvar dermatitis. Some common causes include:

  • friction from clothing or sexual intercourse
  • hormonal shifts
  • moisture due to undergarments
  • soaps or cleansers

Irritation can also be the result of infections, such as:

  • Candida albicans, which is a yeast infection
  • discharge due to bacterial vaginosis
  • genital warts
  • pinworms
  • genital lice
  • scabies

One cause of vulvar dermatitis is eczema. Eczema, or atopic vulvar dermatitis, results from an overactive immune system. Experts do not know exactly why the immune system becomes overactive, but they think that genetic and environmental factors likely play a role.

Certain irritants or allergens can trigger eczema symptoms. Eczema triggers vary from one person to another.

Common triggers include:

  • hot or cold temperatures
  • scented personal care products
  • scented laundry detergents and fabric softeners
  • isothiazolinone, an antibacterial in wipes and other personal care products
  • household disinfectants and antiseptic solutions
  • certain fabrics, such as wool and polyester
  • certain metals, including nickel
  • friction
  • stress

Vulvar eczema is not the only condition that can cause inflamed, itchy, sore, or dry skin around the vagina. Other potential causes include:

  • psoriasis
  • lichen sclerosus
  • contact dermatitis

Anyone with a vulva can experience vulvar dermatitis. Some steps that may reduce the potential for irritation include:

  • wearing cotton or bamboo undergarments
  • minimizing scratching of the area
  • avoiding scented soaps or detergents
  • refraining from using moist wipes or antiperspirants in the area
  • changing menstrual pads or incontinence pads frequently
  • keeping the area clean through daily washing with fragrance-free cleansers or clean water

In the case of vulvar atopic dermatitis, people are more likely to develop vulvar eczema if they have:

  • eczema on other parts of their body
  • a family history of eczema, hay fever, asthma, or food allergies
  • frequent exposure to irritants, such as scented skin care products

If a person develops symptoms of vulvar dermatitis, they should make an appointment with a primary care physician or dermatologist. A dermatologist is a doctor who specializes in skin conditions.

The diagnostic procedure may involve the doctor:

  • asking the person about their symptoms and medical history
  • examining the affected area
  • ordering a skin biopsy or other tests

To conduct a skin biopsy, the doctor will take a small sample of the affected skin and send it to a laboratory for testing. This can help them determine whether the symptoms are due to eczema or another condition.

It is important to get a diagnosis from a doctor to identify the cause of the symptoms and get effective treatment.

The treatment for vulvar dermatitis will depend on the cause.

In the case of contact dermatitis or an allergic reaction, a person may need to change their soaps or detergents to avoid irritants.

If an infection is responsible, the doctor might prescribe medications such as oral antibiotics or topical creams.

Although there is no cure for atopic dermatitis, many treatments are available. Doctors may prescribe one or more of the following treatments to manage the symptoms and prevent complications:

  • moisturizing creams
  • topical treatments, such as steroid creams
  • antihistamines
  • oral or injectable medications, for moderate to severe eczema

The severity of a person’s symptoms and the amount of their body that eczema affects will determine the treatment plan. People may need to try more than one treatment.

Alongside treatment, lifestyle changes may help reduce the symptoms of vulvar dermatitis.

Skin care

Proper skin care is important for managing the symptoms of vulvar dermatitis. Keeping the area clean and avoiding irritants can help reduce irritation.

If the issue is due to eczema, the American Academy of Dermatology Association (AAD) encourages people to get symptom relief by:

  • taking a 5- to 10-minute bath or shower each day, using lukewarm water
  • using mild, fragrance-free skin care products
  • applying a moisturizer after bathing

If a person has urinary or fecal incontinence, they should speak with a doctor about strategies to manage it. Urine and feces can irritate the skin and make irritation worse.

Avoiding triggers

Identifying and avoiding triggers may help limit vulvar dermatitis symptoms.

For example, people may find the following beneficial:

  • using lukewarm water rather than hot water to bathe or shower
  • using only gentle, fragrance-free cleansers to wash the skin around the vagina and anus
  • refraining from using soap, moist tissue wipes, antiseptic washes, vaginal douches, vaginal deodorants, and scented products
  • using an emollient rather than shaving cream when removing hair around the vagina or anus
  • avoiding waxing
  • wearing underwear made from 100% cotton, silk, or bamboo and not wearing tight trousers, tights, or thongs
  • using fragrance-free laundry detergent and avoiding fabric softener
  • removing any nickel vulvar piercings

Taking steps to minimize stress may also help limit eczema flares.

Sex

Barrier contraceptives, such as condoms, diaphragms, and cervical caps, are often made of latex. These products do not cause problems for most people. However, 1–2% of people have a latex allergy and should use latex-free alternatives, such as barrier contraceptives made from polyurethane or silicone.

Certain spermicides may irritate the skin. If a person suspects that their spermicide is triggering symptoms, they should speak with a doctor or pharmacist about alternatives.

Using a water- or silicone-based personal lubricant, known as lube, during sex may help reduce friction and discomfort. Avoiding scented and flavored lubricants may help prevent irritation.

If a person uses topical steroids to treat vulvar eczema, they should avoid applying the steroids shortly before sex. They should leave enough time for the skin to absorb the medication fully first.

In some cases, contact with semen may worsen vulvar eczema. Using condoms can limit contact with semen.

Mental health support

Vulvar dermatitis may negatively affect a person’s mood, body image, or mental health. They may feel stressed, anxious, or embarrassed about the condition. Support from a mental health specialist may help them cope.

Vulvar dermatitis is treatable, and, in many cases, it resolves in time. In other cases, although the condition may be chronic, it is still possible to manage it.

Getting treatment, practicing good skin care, and avoiding triggers can help reduce the symptoms and improve quality of life.

If a person develops new or worse symptoms of vulvar dermatitis, they should speak with a doctor. They should also seek medical advice if their symptoms do not improve with treatment. The doctor may adjust their treatment plan or recommend lifestyle changes.