Vulvar Symptoms

Symptoms

DEFINITION

  • Itching or dryness of external female genital area (vulva)
  • Rashes of external female genital area including: sores, redness, blisters, lumps

Causes of Vulvar Symptoms

  • Any preexisting skin disorders/rashes can also occur on the vulva (e.g., psoriasis, eczema, drug rashes)
  • Bartholin's cyst
  • Candidal vulvovaginitis (aka "yeast infection")
  • Contact dermatitis (e.g., soaps, feminine hygiene products)
  • Irritation after sexual intercourse (e.g., inadequate lubrication, latex-condom allergy)
  • Poison ivy
  • Skin cancer
  • Skin dermatoses (e.g., lichen sclerosis, squamous hyperplasia)
  • STD's (e.g., Herpes simplex, Syphilis, pubic lice, genital warts)

Common Causes of Vulvar Itching

  • Contact Dermatitis - Irritant: There are two different types of vulvar contact dermatitis: irritant and allergic. Products like soaps, detergents, and douches can cause local irritation. Urinary incontinence can result in the vulva being irritated by constant moisture. The treatment for irritant contact dermatitis is to avoid irritating products and to keep the vulvar area clean and dry (maintain good genital hygiene).
  • Contact Dermatitis - Allergic: Women can develop an allergic skin reaction to a number of different OTC products. These products include: benzocaine (in Vagisil anti-itch cream), neomycin (antibiotic ointment), latex condoms, nail polish, and perfumes. The treatment for allergic contact dermatitis is to avoid allergic products and to keep the vulvar area clean and dry (maintain good genital hygiene).
  • Menopause: At menopause the ovaries stop functioning, and as result the body produces less estrogen. Without estrogen, the skin in the genital area can become thin and women notice increased dryness. There are estrogen-based vaginal crèmes or lubricants that the physician can prescribe to reduce this itching and dryness.
  • Yeast Vulvovaginitis (Yeast Infection): Sometimes itching can be caused by a yeast infection (candida). Often there is a new or increased vaginal discharge (thick, white, cottage cheese-like, non-odorous discharge). There are a number of over the counter medications for the treatment of vaginal yeast infections.

See More Appropriate Topic (instead of this one) If

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Now (night or day) If

  • You feel weak or very sick
  • Severe pain
  • Genital area looks infected (e.g., draining sore, spreading redness) and you also have a fever 

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think you need to be seen
  • Genital area looks infected (e.g., draining sore, ulcer, rash is painful to touch)
  • Rash with painful tiny water blisters

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • You are worried you might have a sexually transmitted disease
  • Itching that is moderate-severe (i.e., interferes with school, work, or sleep)
  • Abnormal color vaginal discharge (i.e., yellow, green, gray)
  • Antibiotic treatment for 3 or more days for a Sexually Transmitted Disease (STD) and you are not improving
  • Home treatment for 3 or more days for a "yeast infection" and you are not improving
  • All other vulvar symptoms (EXCEPTION: feels like prior yeast infection, or painless rash present less than 24 hours)

Self Care at Home If

  • Symptoms of a yeast infection (i.e., itchy, white discharge, not bad smelling), which feels like prior vaginal yeast infections, and you don't think you need to be seen
  • Painless rash (e.g., redness, tiny bumps, sore) of genital area present less than 24 hours, and you don't think you need to be seen
  • Mild itchiness, and you don't think you need to be seen

Care at Home

HOME CARE ADVICE

General

  1. Pregnancy test, when in doubt:
    • If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.
    • Follow the instructions included in the package.
  2. Call Your Doctor If:
    • Pregnancy test is positive or if you have difficulties with the home pregnancy test
    • Rash lasts longer than 24 hours
    • Rash spreads or becomes worse
    • Fever occurs
    • No improvement after 3 days
    • You become worse

Symptoms of a Vaginal Yeast Infection

  1. Genital Hygiene:
    • Keep your genital area clean. Wash daily.
    • Keep your genital area dry. Wear cotton underwear or underwear with a cotton crotch.
    • Do not douche.
    • Do not use feminine hygiene products.
  2. Antifungal Medication for Yeast Infection: There are a number of over-the-counter medications for the treatment of yeast infections.
    • Available in the U.S.: Femstat-3, miconazole (Monistat-3), clotrimazole (Gyne-Lotrimin-3, Mycelex-7), butoconazole (Femstat-3).
    • Available in Canada: miconazole (Monistat-3) and clotrimazole (Canesten-3,
      Myclo-Gyne).
    • Do not use yeast medication during the 24 hours prior to a physician appointment (Reason: interferes with examination).
    • CAUTION: If you are pregnant, speak with your doctor before using.
    • Read the package instructions thoroughly on all medications that you take.
  3. Expected Course: If there is no improvement within 3 days, then you will need to be examined.

Mild Vulvar Itching

  1. Reassurance: Common causes of mild vaginal itching are new soaps/detergent, perfumed toilet products, hormone changes, and excessive perspiration. Sometimes itching can be caused by a yeast infection.
  2. Genital Hygiene:
    • Keep your genital area clean. Wash daily.
    • Keep your genital area dry. Wear cotton underwear or underwear with a cotton crotch.
    • Do not douche.
    • Do not use feminine hygiene products.
  3. Cleansing: Wash the area once thoroughly with un-scented soap and water to remove any irritants.
  4. SITZ Bath:
    • Sit in some lukewarm water for 10-15 minutes once or twice a day (or apply moist washcloth). This will help soothe the irritated skin.
    • Gently dry the area by patting the area with a towel.
    • Afterwards apply a small amount (1/2 tsp) of ointment or cream to help seal in the moisture. Good choices for this are vaseline ointment or Eucerin.
  5. Call Your Doctor If:
    • Any rash lasts longer than 24 hours
    • Fever occurs
    • Yellow or green vaginal discharge occurs
    • No improvement in "yeast infection" within 3 days
    • You become worse.

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Photo Example

 

Pubic Lice

The photo shows pubic lice in the pubic hair of groin area. Pubic lice are tiny wingless insects that live only on human beings. The are also called "crabs".

Typical symptoms of pubic lice are:

  • Itching of the pubic area is the main symptom.
  • Pubic hair contains gray bugs (lice) 1/16-inch long, that move quickly, and are difficult to see.
  • Nits (white or tan eggs) cemented to hair shafts near the skin (usually within 1/2 inch or 12 mm). Unlike dandruff or sand, nits can't be shaken off the hair shafts.

Pubic lice are very contagious:

  • The primary mode of transmission is via the skin-to-skin contact that occurs during sexual intercourse. There is a 95% chance of transmission during a single episode of sexual intercourse.
  • Rarely they can be transmitted via objects such as infected bed linens or toilet seats.


Source: CDC PHIL

From the CDC's Public Health Image Library (http://phil.cdc.gov), ID#4078, in the public domain.

Content Providers: CDC / Joe Miller

Author and Senior Reviewer: David A. Thompson, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.

Last Review Date: 6/1/2011

Last Revised: 6/5/2011

Content Set: Adult HouseCalls Symptom Checker

Version Year: 2012

Portions Copyright 2000-2012 Self Care Decisions LLC; Copyright LMS, Inc.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Instructions: The first purpose of Adult HouseCalls Symptom Checker is to help you determine how sick you are and if you need to call your doctor. The second purpose is to help you treat yourself at home when it is safe to do so. Your doctor's advice and your good judgment should always take precedence over information in these topics.

When to Call Your Doctor

Copyright 

View Anatomic Index of Topics

Are You Sick?

David A Thompson, MD is the author of Adult HouseCalls Symptom Checker. He is a board-certified emergency medicine physician at Northwestern Memorial Hospital in Chicago. He has a national reputation in telephone triage, decision support tools, medical information technology and quality improvement. Adult HouseCalls Symptom Checker is a decision support tool for adults that has been reviewed and approved by adult physicians.

Is Your Child Sick?

Pediatric HouseCalls Symptom Checker is a parent guide for treating your child at home, calling your child's doctor or seeking immediate medical attention. Developed by Dr. Barton Schmitt, MD, FAAP, a board-certified pediatrician on staff at Children's Hospital Colorado. Dr. Schmitt has developed other health tools for parents, including the 3rd edition of Your Child’s Health (available in bookstores) and KidsDoc, a new iPhone and Android app for parents (available online).

A Parent's Guide to Healthy, Happy Kids! Subscribe to have our quarterly newsletter mailed to your home.

Related Health Information

There are 119 related articles for parents. The top 5 are shown below.

View All