Vaginal fissures are small tears or cracks that can form in the delicate skin of the vulva or at the vaginal opening. These can lead to discomfort, pain, and sometimes light bleeding. Understanding their causes is important for prevention, effective treatment, and managing symptoms.
Common Direct Causes
Friction or direct trauma is a common cause. Vigorous sexual activity, especially without adequate lubrication, can create micro-tears in the delicate vulvar and vaginal tissues. Tight-fitting clothing or exercises involving repetitive rubbing can also contribute to mechanical stress on the skin.
Vaginal dryness is another contributor to fissure formation. Hormonal changes, such as during menopause or breastfeeding, can reduce estrogen levels, making vaginal tissues thinner, drier, and less elastic. Certain medications, including some antihistamines or antidepressants, may also decrease natural lubrication. Insufficient arousal before sexual activity can also result in inadequate natural lubrication, increasing friction and the likelihood of tears.
Irritation from various products can also cause fissures. Harsh soaps, perfumed feminine hygiene products, douches, or certain laundry detergents can disrupt the natural pH balance and protective barrier of the vulvar skin. This irritation can lead to inflammation, dryness, and increased susceptibility to cracking. Allergic reactions, specifically contact dermatitis, might also trigger fissures when the skin reacts to substances like latex in condoms, certain lubricants, or ingredients in personal care items, causing redness, itching, and potential skin breakdown.
Underlying Conditions and Contributing Factors
Certain dermatological conditions can predispose individuals to vaginal fissures. Conditions like lichen sclerosus can make vulvar skin thin, stiff, and fragile, increasing its proneness to tearing. Eczema or psoriasis affecting the vulvar area can also lead to inflamed, itchy skin more susceptible to fissuring. These conditions weaken the skin’s natural resilience, increasing vulnerability to minor trauma.
Infections contribute to inflammation and fragility of vulvovaginal tissues. Yeast infections (candidiasis) can cause intense itching, redness, and swelling, leading to tears, especially if scratching occurs. Bacterial vaginosis (BV) can also cause irritation and inflammation, increasing fissure risk. Sexually transmitted infections (STIs) like genital herpes can present as sores or small cuts, making the skin more fragile and prone to further tearing.
Hormonal imbalances, beyond general dryness, can impact the health of vulvar and vaginal tissues. Estrogen deficiency, often seen during perimenopause, menopause, or as a side effect of certain medical treatments, can lead to significant thinning and reduced elasticity. This atrophy makes the skin more delicate and less able to withstand normal stresses without tearing. Chronic illnesses, such as poorly managed diabetes, can also affect vulvar skin health. High blood sugar levels can impair healing and make skin more susceptible to infections and damage, potentially exacerbating fissure formation or delaying resolution.
Factors That Worsen or Delay Healing
Continued exposure to the initial cause can impede fissure healing. For instance, if a fissure resulted from vigorous sexual activity, repeated friction will prevent healing and may enlarge the tear. Similarly, continued use of an irritating product will perpetuate inflammation and prevent the skin barrier from recovering. Avoiding the specific trigger is important for resolution.
Poor hygiene practices, including excessive washing, can strip away the skin’s natural protective oils. This can lead to increased dryness and irritation, hindering healing. Conversely, inadequate cleaning might allow for bacterial overgrowth, complicating fissures. Scratching, often a response to itching caused by underlying conditions or irritation, directly damages the healing skin. This mechanical trauma reopens wounds and can introduce bacteria, prolonging discomfort and increasing the risk of secondary infection.
Stress can also indirectly affect the body’s ability to heal. Chronic stress can impact the immune system and inflammatory responses, potentially slowing tissue repair. While not a direct cause, prolonged stress may contribute to delayed recovery from physical injuries like fissures.
When to Consult a Healthcare Professional
Consult a healthcare professional if vaginal fissures do not heal within a few days to a couple of weeks, or if they cause persistent pain or discomfort. Recurrent fissures, appearing frequently without a clear cause, warrant evaluation for underlying conditions. This pattern often suggests a deeper issue requiring diagnosis and specific management.
Signs of infection accompanying a fissure require immediate medical attention. These symptoms can include increased redness, swelling, warmth, pus-like discharge, a foul odor, or fever. Such indicators suggest a bacterial or fungal infection that requires targeted treatment to prevent further complications.
Severe symptoms, such as intense pain that interferes with daily activities, significant bleeding, or consistent pain during sexual activity, warrant a visit to a healthcare provider. A professional can provide an accurate diagnosis and recommend appropriate treatment options. If there is uncertainty about the cause of the fissures, or if an underlying medical condition is suspected, consulting a doctor can help identify the root problem and establish an effective care plan.