When it comes to down-there care, you may think you've got it completely covered. You know the dos and don'ts of daily cleaning, but what happens when you experience a bout of vaginal itching?
The discomfort may be intolerable, but vaginal itching is actually very common, and there are a lot of reasons why you might have it, says Alyssa Dweck, MD, an ob-gyn in Westchester County, New York. In fact, it is one of the main reasons people go see their gynecologist, notes Katharine O'Connell White, MD, an ob-gyn and associate professor in the department of obstetrics and gynecology at Boston University.
Itchiness down there can be a sign of a vaginal infection, such as a yeast infection or bacterial vaginosis. It could also be caused by other conditions such as eczema, psoriasis, genital warts, or pubic lice, says Leah S. Millheiser, MD, a clinical professor in the department of obstetrics and gynecology at Stanford Medicine.
But itching doesn't always indicate disease. Sometimes your vagina can be irritated by detergent residue on your underwear, by menstrual pads, or a lubricant or spermicide, notes Dr. White, among other things. It can also be because your clothes are too tight, Dr. Millheiser says. If it persists beyond seconds or a few minutes, though, there’s a good chance your itchiness is due to a medical issue, says Kimberly Langdon, MD, a retired ob-gyn.
Let’s make one thing clear: When women talk about vaginal itching, Mary Jane Minkin, MD, an ob-gyn and a clinical professor at Yale University School of Medicine, says many are actually referring to itching in the vulva, the outer part of the female genitalia. “True vaginal itching is less common,” she says.
Here's a comprehensive list of all the possible reasons you feel the need to scratch your nether region—and how to take care of it for good.
1. You have bacterial vaginosis (BV).
Bacterial vaginosis is a pretty common condition caused by bacterial overgrowth and a pH imbalance in the vagina. Though it can affect all women, higher rates of BV are particularly prevalent among Black women. Experts don't really know why yet, says Carroll Medeiros, MD, an ob-gyn in Rhode Island. It may be related to a genetic predisposition, per one 2016 study in the American Journal of Reproductive Immunology.
But itching actually isn’t the primary symptom of BV—the hallmarks are typically a loose discharge, strong odor, and general irritation (though it definitely can make you itchy too), says Mary Jane Minkin, MD, a clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University.
 |
| Bacterial Vaginosis |
To treat it, you can try an OTC medication like RepHresh to help up the acidity of your vagina, according to Dr. Minkin. Sounds counterintuitive, but acidity in the vagina is actually a good thing since it kills off bad bacteria, she says. If that doesn’t work, your doc might prescribe antibiotics.
2. You have eczema or psoriasis.
"Skin conditions like eczema and psoriasis can occur due to an allergy or autoimmune issue,” says Natasha Chinn, MD, an ob-gyn with Brescia and Migliaccio Women’s Health in New Jersey. Eczema often appears in the crevices of arms, folds, the groin area, and on the labia, she explains. Psoriasis can also present on the skin around the vagina, she adds.
Most people with eczema and psoriasis are well-versed in the appearance (and treatment) of these red, patchy rashes. But if you’ve never had these symptoms before, make an appointment with your doctor. Both conditions can be managed if they’re flaring up, and Dr. Chinn says that psoriasis sometimes warrants a prescription for an oral pill or a topical cream.
3. You have contact dermatitis.
Ever try a new body cream and wind up with dried out, flaky skin or a full-blown rash a few days later? Well, the same thing can happen to the skin around the vagina. “Soaps, detergents, and bubble baths, a new kind of underwear—really any new products at all that come in contact with your vagina [can cause itching],” explains Dr. Minkin.
If your vagina feels itchy and irritated, but you don’t have any other symptoms, it’s worth thinking about whether you’ve recently started using any new products. Pads and tampons, condoms and lubricants, shaving products, and even toilet paper can all be to blame (basically anything with added perfumes or chemicals, so stick with hypoallergenic stuff if you’re sensitive).
In the meantime, stop using whatever you think is bugging you, treat the itch with an Epsom salt bath or an OTC hydrocortisone cream applied externally, and wait a few days to see if the itch resolves. If not, go see your doctor.
4. You have a yeast infection.
Vaginal yeast infections, which occur when there is an overgrowth of the fungus Candida, are probably the first thing people think of when they feel that telltale itching down there. “A cottage cheese-like discharge, redness around the labia and vulva, and itching are all classic signs of a yeast infection,” Dr. Minkin says.
 |
| Vaginal yeast infection Information |
But she also notes that only about one-third of women who experience itching and irritation truly do have a yeast infection. The easiest way to tell which category you fall into is to use an OTC treatment like Monistat. Dr. Minkin says that if you really do have a yeast infection, it should do the trick; if it doesn’t, check in with your provider.
5. You have a sexually transmitted infection (STIs).
Itching isn't really a classic symptom of most STIs, though it can sometimes be a first sign that something is up, says Dr. Minkin. From there, symptoms may progress to burning, painful urination, smelly discharge, sores on your genitals, or painful intercourse, at which point you should definitely head to your ob-gyn for a vaginal culture.
The STIs below are most commonly associated with vaginal itchiness, among other symptoms. Here's what to look out for.
- Genital warts. Genital wars are small, flat, flesh-colored bumps or tiny, cauliflower-like bumps that appear on the skin, resulting from exposure to the human papilloma virus. “This type of STI can shift the pH in the vagina, which then causes dryness and itching," says Dr. Chinn.
- Herpes. Genital herpes causes clusters of red, blistery bumps on the vulva, which come and go as outbreaks. You may experience itching in the areas the sores appear in even before they show up.
- Chlamydia. Chlamydial infections will usually not show any symptoms. But in rarer cases chlamydia can lead to itching and irritation of the genital area, discomfort when urinating, and an unusual discharge.
- Gonorrhea. Gonorrhea is an infection of the genitals, rectum, or throat. Symptoms can include itching, increased vaginal discharge, and a painful or burning sensation when peeing.
- Trichomoniasis. This STD is caused by an infection from a protozoan parasite called Trichomonas vaginalis. Only about 30 percent of people with the infection show symptoms, but they can include itching, burning, redness, or soreness of the genitals.
6. You have pubic lice.
No one wants to think about bugs crawling around on any part of their body, but especially not down there. Unfortunately, that’s exactly what pubic lice (a.k.a. crabs) is: an easily transmittable infestation of little bugs in your genital area that makes you itch like crazy.
 |
| Have You Heard About Pubic Lice? |
There are two reasons for the itching, says Dr. Chinn: bites from the crabs and the eggs (nits) they lay on your skin, both of which cause irritation.
Fun fact: You can get pubic lice from hotel room sheets.
Now for the really bad news: Having sex isn’t even the only way to get pubic lice. “They’re passed from skin to skin,” says Dr. Chinn. “[For example], you go to a dirty hotel and there are nits or lice in the sheets you slept on, and then you go home to your partner and have sex. Or maybe you loan your sister your pants and [she] had them, then you wear the pants and the crabs crawl into the vaginal area."
Though treatable with an OTC medication like permethrin cream (just like head lice), the morals of the story here are as follows: practice safe sex, read hotel ratings carefully, and maybe don’t let anyone borrow your pants (and vice versa).
7. You have lichen sclerosus.
Another dermatology issue, lichen sclerosus is a patchy white rash that causes intense itching and often pops up in your genital area (though it can appear on other parts of the body too). It can be treated with a prescription-strength topical steroid, but Dr. Minkin says a lichen sclerosus rash can often mimic vulvar cancer, so its appearance may complicate things a little.
“In young women, it’s more likely to be lichen sclerosus than cancer, but I’ll often bring patients back in a few weeks to see how it’s looking, especially if they are older,” says Dr. Minkin. “We want to make sure we’re not missing cancer, so if it hasn’t cleared up with steroids, I may do a biopsy to scan it.”
8. You're going through hormonal changes or perimenopause.
When your hormones fluctuate during your menstrual cycle, you might end up with drier vaginal tissue than normal, which can cause itching. But Dr. Minkin points out that perimenopause (that time period before you actually start menopause) is a more common time for vaginal dryness and itching, thanks to the drop in estrogen.
An OTC moisturizer like Replens can usually provide relief from internal itching for about three days, Dr. Minkin says, and your provider can give you a prescription estrogen cream for any external itching. (And if any vaginal dryness is impacting your sex life, just know adding lube down there will do just the trick, too.)
And yup, it’s possible for pregnancy to cause vaginal itchiness and dryness, too. How so? Well, the common hormonal changes during pregnancy can disrupt the vaginal biome’s typical pH, says Dr. Dweck. This is what makes yeast infections pretty darn regular during pregnancy, explains Dr. Dweck. (Ugh.)
9. You have a urinary tract infection (UTI).
A urinary tract infection is a bacterial infection that crops up anywhere in your urinary tract (read: kidneys, urethra, ureters, and bladder), and will commonly cause pelvic pain, a strong urge to pee, a burning sensation when you pee, and cloudy or foul-smelling urine.
 |
| Urinary Tract Infection in Women |
But Dr. Minkin confirms that it can also cause itching in the form of a tingling, irritated sensation, especially if the infection is located near your urethra. You need to snag an appointment with your doctor ASAP and get a urinalysis to check for the presence of bacteria (which an antibiotic can clear up).
10. Your beauty treatments are causing irritation.
In the past few decades, women have grown more preoccupied with the appearance of their vulvas, says Dr. Minkin—something she attributes to the trend of having less hair down there. That means many women have also tried out some pretty unconventional beauty treatments, like activated charcoal vulva masks (basically a facial for your vagina) and vaginal steaming.
Dr. Minkin says these are a no-no, not only because they’re totally unnecessary, but because they can cause reactions in the form of itching and irritation.“The vulva tissue is the most sensitive, delicate tissue in the body,” she says. “Treat it with respect and a gentle hand. The less stuff you do to it, the better.” Noted.
11. You have a tanning bed burn.
Reminder: You should *not* be using tanning beds. Not only can they up your risk of developing skin cancer, but tanning in the nude can give you a burn on the skin around the vagina. “Redness and peeling of the skin causes itching—that's what tends to happen when women go to a tanning bed,” says Dr. Chinn.
So yeah, just don't do this in the first place, please. But if you do somehow end up with a burn downstairs, Dr. Chinn says you can mix a little aloe vera with coconut oil or tea tree oil and apply it topically (it’s perfectly safe for the vaginal area).
12. You have a razor burn down there.
Your bikini area is just as sensitive—if not more so—to razor burns and irritation from shaving or waxing your hair. "When we wax or shave anywhere on the body we disrupt the skin's integrity,” says Dr. Chinn. “Redness, itching, and burning can occur if you're sensitive to it.”
If you have curly or coarser hair down there, you're more at risk for razor bumps and ingrowns, since it's easier for this kind of hair to become caught under the skin's surface. Dr. Medeiros adds that not having access to good quality depilatories and shavers can also put you at a greater risk of developing itching from hair removal irritation.
Dr. Chinn recommends applying hypoallergenic cream or lotions to protect the skin, as well as keeping it dry and clean. If it’s becoming an ongoing problem for you, you may have to stop waxing, wax less frequently, or change up your shaving products to something gentler on your skin, she adds.
13. You have vulvar cancer.
Vulvar cancer is a rarer cancer that's typically diagnosed in older women, says Dr. Medeiros. It's caused by an abnormal growth of cancerous cells in the vulva. Most women who get it don't really noticed they have it until a doctor sees an irregularity, like a lesion, on their skin, she explains.
Itching that's associated with this condition tends to be localized to the area where the cancer is. "The kind of itching you have from a vulvar malignancy tends to turn into pain really quickly; as the cancer grows superficially and deeply, it pinches upon nerves and causes pain," says Dr. Medeiros.
Remember: This is pretty rare. And though vulvar cancer may cause itching, you'll probably experience other symptoms like skin changes too. If you're concerned your vaginal itching is related to vulvar cancer, it's best to consult your doctor who will advise you on the best course of treatment for the itching.
14. You have lichen planus.
Itching is a very common symptom of the skin condition lichen planus, especially when it occurs in the vaginal area, says Dr. Medeiros. Other symptoms can include painful sores and blisters.
A topical low-potency or high-potency steroid is the mainstay treatment for lichen planus, but Dr. Medeiros recommends consulting a dermatologist to figure out the best avenue of treatment if you think you have this condition.
So, why does my vagina itch more at night?
If the temptation to scratch becomes even more unbearable at night, you're not alone. Because you aren't distracted by work, phone calls, and all that other daytime stuff, you can become hyper-aware of an itchy vagina (or any part of the body) at night, says Dr. Medeiros.
Is it possible to have itching without discharge?
Vaginal itching is typically accompanied by symptoms like unusual discharge, a foul odor, redness, or abnormal bleeding, says Dr. Dweck.
That said, it’s quite possible that you’re experiencing vaginal itching without noticing any discharge. “While discharge and itching often go hand in hand, it's totally possible to have one without the other,” Dr. White says.
In short, don’t worry if you feel like your symptoms are atypical. Consult your doctor to talk through what you’re experiencing before stressing out. (Odds are it’s nothing serious!)
At-home remedies for vaginal itch
First things first, always consult your gynecologist before trying any kind of DIY treatment, experts advise. Once you’re on the same page as your gyno, there are ways to reduce your itching symptoms at home.
If your itching is the result of a yeast infection, you can try a mixture of yogurt and honey as treatment before opting for an OTC anti-fungal cream, one study shows. That said OTC creams like Monistat are curative in most cases for a vaginal yeast infection, Dr. Dweck says.
If your itching is due to a rash from an external irritant (hi, laundry detergent and pesky thongs), an OTC hydrocortisone cream can be helpful in reducing symptoms, Dr. Dweck says. You’d only need prescription-strength cortisone if your symptoms are on the severe side.
Store-bought treatments not your thing? Remedies like cold compresses or ice packs to the vulva can ease the itching too, Dr. Dweck says. (Though do not to put ice directly on your skin. Make sure you place a cloth in-between!)
You can also try taking oatmeal baths or baking soda soaks for 10 to 15 minutes at a time, a few times per day, Dr. White says. (Just add four to five tablespoons of baking soda to lukewarm water and relax.)
When do you need to see a doctor?
The following symptoms are indicators that you need to check in with your gyno, according to Drs. Langdon and Millhesier.
- An abnormal vaginal discharge associated with itching
- Any sort of rash or lumps
- Burning or pain
- Changes in the appearance of the vulvar skin associated with itching;
- Excoriation of the labia minora, perineum
- Foul-smelling discharge
- Lesions of the vulva that cause itching
- Moderate to severe persistent itching
- Swelling of the labia minora
- White cottage cheese discharge
If your vaginal itchiness does not go away with washing, drying, and a change of panties, Dr. Langdon says you should see your doctor.
Can you prevent vaginal itching?
Yep, vaginal itching is preventable. (Though not always!) The key is to follow a few different hygiene tips that’ll ensure you’re not messing with your vagina’s pH.
In general, Dr. Medeiros recommends staying away from harsh cleansers, and instead going for something like a Dove fragrance-free wash. Her rule of thumb is if you wouldn't put it on your face, don't put it near your vagina.
When you’re out of the shower, be sure to pat your vulva dry—don’t rub, White explains. And if you’re doing the shopping, make sure you buy soft, white, unscented toilet paper. You don’t need to use any powders or sprays on your vulva either, as it’s totally normal for your vagina to have its own natural scent, Dr. White says.
If you find that you’re sensitive to menstrual hygiene products, try swapping out your usual ones for organic cotton tampons and pads, or a medical-grade silicone menstrual cup, Dr. Dweck says. And yup, your undies can cause vaginal itchiness too. Opt for 100 percent cotton panties, and don’t let yourself linger in any wet workout clothes or bathing suits when you wear them, Dr. Dweck advises.
Comments
Post a Comment