Vulvitis is the inflammation of the vulva, which encompasses the external female genitalia, including the labia majora, labia minora, and clitoris. This condition is common and can affect people of any age, often causing significant discomfort. Vulvitis is not a diagnosis itself but rather a symptom or reaction to an underlying cause, such as an infection, an allergy, or skin irritation. The condition is generally treatable once the specific trigger is identified by a healthcare provider.
Symptoms and Presentation
The primary physical manifestation of vulvitis is persistent, intense itching (pruritus), which is typically the most distressing complaint. This itch is frequently accompanied by a burning sensation, especially upon contact with water or urine. The affected area often displays erythema (redness), along with swelling in the labia and surrounding tissues.
A person may also experience general soreness or a raw, irritated feeling in the vulvar region. In some cases, the inflammation can lead to the formation of small skin cracks (fissures) or fluid-filled blisters that may eventually crust over. An abnormal vaginal discharge may also accompany the vulvitis, often signaling an underlying infectious cause affecting both the vulva and the vagina.
Identifying the Underlying Causes
Vulvitis has a wide variety of triggers, making it a reaction rather than a single disease. Identifying the root cause is necessary for effective management. One of the most frequent causes is contact dermatitis, where the sensitive vulvar skin reacts to direct contact with irritants or allergens.
Common irritants include heavily scented products such as bubble baths, perfumed soaps, feminine hygiene sprays, laundry detergents, or fabric softeners. Wearing tight clothing or synthetic fabrics that trap heat and moisture can also generate mechanical irritation.
Infections represent another common category of causes, often involving the vagina as well (vulvovaginitis). Yeast infections, typically caused by an overgrowth of Candida albicans, are a frequent culprit. Bacterial vaginosis (BV), which results from an imbalance in the normal vaginal flora, is also common. Sexually transmitted infections (STIs) such as herpes or trichomoniasis can also present with vulvar inflammation.
Chronic skin conditions can also manifest on the vulva, leading to persistent inflammation. These include generalized inflammatory disorders like eczema (atopic dermatitis) or psoriasis. More localized vulvar disorders, such as lichen sclerosus and lichen planus, are autoimmune-related conditions that cause distinct changes in skin texture and color. Hormonal changes also play a role, as low estrogen levels after menopause or before puberty can cause the vulvar tissue to thin and become dry, making it more vulnerable to irritation.
Diagnosis and Medical Treatment
A healthcare provider begins the diagnostic process by taking a detailed medical history, focusing on hygiene habits, product usage, and the nature of the symptoms. A thorough physical and pelvic examination is then performed to visually inspect the vulva for signs like redness, swelling, lesions, or changes in skin texture. This examination helps distinguish vulvitis from other conditions and provides clues about the underlying trigger.
To determine the exact cause, several diagnostic tests may be employed. A wet mount or vaginal swab sample may be taken to check for infectious agents, such as yeast or bacteria, or to assess the vaginal pH level. If a chronic inflammatory skin condition is suspected or the vulvitis does not respond to initial treatment, a small skin biopsy may be necessary to examine tissue under a microscope. Identifying the cause is necessary because treatment is targeted to the trigger.
Medical treatment directly addresses the diagnosed cause of the inflammation. If an infection is confirmed, treatment involves specific medications, such as oral or topical antifungals (fluconazole or clotrimazole) for yeast infections. Bacterial infections, including BV or certain STIs, are managed with oral antibiotics or antibiotic gels, such as metronidazole. For irritation or allergic contact dermatitis, a brief course of a low-potency topical corticosteroid cream may be prescribed to reduce inflammation and itching. If vulvitis is linked to low estrogen levels, a topical estrogen cream can help restore the health of the vulvar tissues.
Self-Care and Prevention Strategies
Implementing self-care and prevention strategies is a practical way to relieve current symptoms and reduce the likelihood of recurrence. Maintaining proper vulvar hygiene involves gentle cleansing using only warm water, avoiding harsh scrubbing, and gently patting the area completely dry. Avoid the use of perfumed or harsh soaps directly on the vulva, as these can strip the skin’s natural barrier.
A main preventative step is to eliminate known irritants from daily routines. This involves:
- Switching to unscented or hypoallergenic laundry detergents.
- Avoiding the use of feminine deodorants.
- Avoiding douches.
- Avoiding scented sanitary products.
Opting for loose-fitting clothing and breathable cotton underwear helps to minimize friction and prevent moisture from being trapped against the skin, which can fuel irritation.
Change out of wet swimsuits or sweaty workout clothes immediately to avoid prolonged exposure to moisture and potential irritants. Applying a thin layer of a simple barrier ointment, such as petroleum jelly, can protect the skin from friction and moisture, particularly before exercise or at night. These home management steps, when combined with professional medical guidance, form a comprehensive approach to managing vulvitis.