Vulvitis is inflammation of the vulva, the collective term for the external female genitalia. This condition is not a specific diagnosis but rather a symptom or reaction to a wide range of underlying causes. The resulting irritation and discomfort can be significant, prompting people to seek information and relief. Vulvitis affects individuals across all age groups, from prepubescent girls to post-menopausal women, due to the sensitive nature of the tissue.
What Vulvitis Is and How It Presents
Vulvitis is inflammation of the vulva, which encompasses the labia majora, labia minora, clitoris, and the opening of the vagina. Because the vulvar skin is delicate and often moist, it is vulnerable to irritation and inflammation from external and internal factors. The primary characteristic is a noticeable inflammatory response in the tissue.
The physical manifestations of vulvitis often begin with intense itching (pruritus), which can be constant and severe. This is typically accompanied by redness (erythema) and visible swelling (edema) of the labial folds and surrounding skin. A burning or stinging sensation is a frequent complaint, especially during urination (dysuria) or sexual intercourse (dyspareunia).
In some instances, the inflammation can lead to changes in the appearance and texture of the skin. Affected individuals may notice small cracks or fissures in the vulvar skin, or the development of clear, fluid-filled blisters that may burst and crust over. Depending on the cause, the skin may also become scaly, thickened, or display whitish patches, which are signs that warrant immediate medical evaluation.
Identifying the Underlying Causes
The most frequent triggers for vulvitis involve simple contact dermatitis, where the skin reacts to an irritating chemical or substance. This irritation can stem from harsh soaps, bubble baths, or fragranced hygiene products like feminine sprays and douches. Even common household items, such as laundry detergents and fabric softeners containing strong perfumes or dyes, can leave residue on underwear that irritates the vulvar skin.
Friction or prolonged moisture is a common cause, creating a warm environment conducive to inflammation. Wearing tight, non-breathable synthetic clothing, especially underwear without a cotton crotch, can trap heat and moisture against the skin. Activities like cycling or horseback riding can cause mechanical irritation. Prolonged exposure to chlorinated water or wearing a wet bathing suit for an extended period can also strip the skin of its protective barrier.
A significant number of vulvitis cases are linked to microbial infections that spread to the external tissue. Yeast infections, caused by fungal overgrowth, are a frequent culprit, causing both vaginal discharge and intense vulvar inflammation. Bacterial infections, such as bacterial vaginosis, can also irritate the vulva, though the infection itself is typically internal. Certain sexually transmitted infections, including genital herpes and human papillomavirus (HPV), manifest with vulvar lesions and inflammation.
Allergic reactions occur when the immune system overreacts to a specific compound. This can happen with exposure to products like latex from condoms, certain spermicides, or topical medications. Chronic skin conditions like eczema or psoriasis can also affect the vulva. Hormonal changes, particularly the decline in estrogen after menopause, can thin and dry vulvar tissues, making them more susceptible to irritation and inflammation.
Medical Diagnosis and Treatment
A diagnosis of vulvitis begins with a thorough review of the individual’s medical history, including hygiene habits and recent product changes, followed by a physical and pelvic examination. The healthcare provider will visually inspect the vulva for signs like lesions, blisters, or scaly patches, which offer clues about the underlying cause. Because vulvitis is a symptom of various conditions, finding the trigger is necessary for effective treatment.
To pinpoint the cause, the provider may order diagnostic tests, especially if an infection is suspected. This often involves taking a sample of any vaginal discharge for a wet mount or culture to check for yeast, abnormal bacteria, or parasites. Blood tests and tests for sexually transmitted infections may also be performed to rule out other causes of genital irritation. In cases where the cause remains unclear or the condition is chronic, a patch test may be used to identify a specific allergen.
Treatment is directly tailored to the identified underlying problem, as a single approach does not work for all cases of vulvitis. For cases caused by irritants or allergies, the primary management involves identifying and avoiding the offending substance, such as switching to unscented soaps and white, cotton underwear. Self-care measures, like taking cool sitz baths, can also provide immediate relief from burning and itching sensations.
When an infection is confirmed, targeted medications are necessary to eliminate the pathogen. A yeast infection is treated with antifungal medications, which can be prescribed as topical creams or oral doses. For bacterial causes, a course of antibiotics is typically administered. For symptom relief while the root cause is being addressed, a healthcare provider may temporarily prescribe low-dose topical corticosteroid ointments to reduce severe inflammation and itching.