Vulvitis, or inflammation of the vulva, is treated based on what’s causing it. The approach ranges from simple changes in hygiene products to prescription medications, depending on whether the trigger is an irritant, an infection, or a hormonal change. Most cases improve within a few weeks once the underlying cause is addressed.
Identify the Cause First
The most important step in treating vulvitis is figuring out why it’s happening, because the wrong treatment can make things worse. Vulvitis falls into three broad categories: irritant or allergic reactions, infections, and hormone-related thinning of the skin.
Common non-infectious triggers include scented soaps, detergents, pads, and toilet paper. Chlorinated pool water, wet bathing suits left on too long, non-breathable underwear, and friction from cycling or horseback riding can also inflame vulvar skin. Skin conditions like eczema or contact dermatitis are another frequent cause. On the infectious side, yeast infections, bacterial infections, and viral infections like genital herpes all produce vulvar inflammation. In postmenopausal women, declining estrogen levels thin and dry the vulvar tissue, making it easily irritated.
If you’ve never had these symptoms before, or if you’re unsure whether you’re dealing with a yeast infection versus something else, getting an accurate diagnosis matters. Over-the-counter yeast treatments won’t help bacterial infections or dermatitis, and using the wrong product can prolong your discomfort.
Soothing Symptoms at Home
Regardless of the cause, a sitz bath is one of the simplest ways to relieve vulvar itching, burning, and swelling. Fill your bathtub or a plastic sitz bath basin with about 3 to 4 inches of warm water (around 104°F or 40°C) and soak for 15 to 20 minutes. Plain warm water works well on its own. Salts, oils, and other additives can actually cause more irritation, so skip them unless a provider specifically recommends one. You can repeat this up to three or four times a day when symptoms are active.
Between baths, a fragrance-free moisturizer designed for the vulvar area can help protect irritated skin. For postmenopausal dryness in particular, nonhormonal vaginal moisturizers used regularly can significantly improve dryness, burning, and itching. Water-based gels vary in quality, though. Some are hyperosmolar, meaning they can actually draw moisture out of cells and cause further irritation, so look for products specifically formulated for sensitive vulvar or vaginal tissue.
Removing Irritants
If your vulvitis stems from contact with an irritant or allergen, eliminating that trigger is the treatment. This often resolves symptoms completely without medication. Key changes include:
- Switch your cleanser. Conventional soaps have a pH between 8.5 and 11, far higher than vulvar skin’s natural pH of 4 to 6. Soap-free liquid cleansers (sometimes called syndets) have a pH closer to 5.5 to 7 and are much less likely to cause irritation. Wash once a day, ideally after a bowel movement, using your hands rather than a washcloth.
- Avoid fragranced products. This means scented pads, pantyliners, tampons, toilet paper, laundry detergent, and any deodorant or perfume applied near the genital area.
- Skip antiseptics. Products containing antiseptic ingredients like triclosan are not recommended for vulvar use. The FDA flagged these ingredients back in 2016.
- Wear cotton underwear. Synthetic fabrics trap moisture and heat. Change into dry clothes promptly after swimming or exercising.
- Wash front to back. This prevents introducing bacteria from the anal area.
One less obvious point: genital hair acts as a natural barrier against environmental irritants. Complete permanent hair removal may increase long-term vulnerability to vulvar inflammation, particularly from friction and moisture.
Treating Infectious Vulvitis
Yeast Infections
Vulvitis caused by a yeast infection is typically treated with antifungal creams applied inside the vagina, antifungal suppositories, or a single oral dose of fluconazole. Over-the-counter antifungal creams work for straightforward cases, but severe infections often require a longer course of treatment, ranging from 7 to 14 days of a topical antifungal or two oral doses spaced 72 hours apart.
Recurrent yeast infections (four or more per year) call for a different strategy. Treatment usually starts with an extended initial course of 7 to 14 days to fully clear the infection, followed by a weekly oral antifungal for six months to prevent it from coming back. If you’re pregnant, only topical antifungal treatments applied for seven days are considered safe.
Bacterial Infections
Bacterial vulvovaginitis requires antibiotics, either applied topically or taken by mouth. Because the symptoms of bacterial and yeast infections overlap significantly (itching, discharge, irritation), self-treating with antifungal products when bacteria are the real culprit delays proper treatment. A provider can usually distinguish between the two with a simple exam or lab test.
Viral Infections
When vulvitis is caused by a viral infection like genital herpes, antiviral medications manage outbreaks and reduce symptoms. These require a prescription, and treatment works best when started early in a flare-up.
Steroid Creams for Skin-Related Vulvitis
When vulvitis is driven by eczema, dermatitis, or an inflammatory skin condition like lichen sclerosus, topical corticosteroid creams are the standard treatment. Medium-potency formulations are typically used for vulvar skin conditions. Because the vulvar area is sensitive and absorbs medication more readily than other skin, treatment is usually applied in short intervals of one to two weeks at a time, though some conditions require courses of up to 12 weeks with medium-potency products.
The goal is to use the lowest effective strength for the shortest time needed. Overuse of steroid creams on vulvar skin can thin the tissue further, so these are best used under guidance from a provider who can adjust the strength and frequency as your symptoms improve.
Hormone Therapy for Postmenopausal Vulvitis
Vulvitis caused by low estrogen after menopause responds well to topical estrogen, which restores moisture and thickness to the vulvar and vaginal tissue. Several delivery methods are available, and the choice often comes down to personal preference and convenience.
Vaginal estrogen cream is applied with an applicator, usually daily for the first one to three weeks, then tapered to one to three times per week. Vaginal suppositories follow a similar pattern: daily for two weeks, then twice weekly. For women who prefer a hands-off approach, a vaginal ring delivers a steady dose of estrogen and only needs to be replaced every three months. Vaginal tablets inserted with an applicator are another option, again starting with daily use and then stepping down to twice weekly.
These are all low-dose, local treatments, meaning the estrogen stays primarily in the vaginal and vulvar tissue rather than circulating throughout the body. For women who cannot or prefer not to use hormones, regular use of nonhormonal vaginal moisturizers is considered a reasonable first-line alternative. In one study, a zinc-containing moisturizing gel significantly improved vaginal dryness, burning, and itching scores, with dryness showing the largest improvement.
How Long Recovery Takes
Vulvitis from a simple irritant often clears within days to a couple of weeks once the offending product is removed. Yeast infections typically resolve within one to two weeks of starting treatment. Bacterial infections improve within a similar timeframe with antibiotics. Hormone-related vulvitis takes longer because the tissue needs time to rebuild; most women notice meaningful improvement after two to three weeks of topical estrogen, though full benefit develops over several weeks of continued use.
Inflammatory skin conditions like lichen sclerosus may require ongoing management, with periodic use of steroid creams to control flare-ups. If your symptoms haven’t improved after two weeks of at-home care, or if you develop open sores, bleeding, or new lumps on the vulva, those warrant a closer evaluation to rule out less common causes.