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Vulvar Dermatitis: Causes, Symptoms, and Treatment

Medically reviewed by Steven Devos, M.D., Ph.D.
Posted on September 19, 2023

If you’ve been experiencing itchy, dry skin in the genital area, you may have vulvar dermatitis, a condition that’s sometimes related to eczema. “I’m 78 years old,” wrote one MyEczemaTeam member who was surprised to be dealing with the symptoms of vulvar dermatitis. “I’ve had no sexual contact.”

If you have eczema or any rash in the genital region, there’s nothing to be ashamed of. Knowing the signs of vulvar dermatitis and discussing them with a doctor can help you get quick relief.

What Is Vulvar Dermatitis?

Vulvar dermatitis is a type of rash on the vulva — the folds of skin around the vaginal area. This typically dry, itchy rash can be painful and uncomfortable.

It’s common to have itching and irritation of the vagina. If you’re experiencing this symptom, the first step is to see an experienced health care provider who can identify the cause.

Causes of Vulvar Dermatitis

Vulvar dermatitis can be caused by forms of eczema, including atopic dermatitis (the most common subtype) and seborrhoeic dermatitis. Although the dry, flaky skin that characterizes seborrhoeic dermatitis usually appears on the scalp — known as dandruff — it can also affect the genital region. Other common causes of vulvar dermatitis include contact dermatitis and hormonal changes.

Contact Dermatitis

With contact dermatitis, a rash develops after you touch something in the environment that either irritates your skin or triggers an allergic reaction.

When an irritant — a substance your skin is sensitive to — causes a rash, the condition is called irritant contact dermatitis. Symptoms usually develop soon after exposure to the irritant, such as a detergent or soap that is too strong for the sensitive vulvar region.

You can also have a delayed reaction that involves the immune system, a condition called allergic contact dermatitis.The rash that appears is an allergic reaction triggered by an allergen (irritant).

Common causes of contact dermatitis of the vulva include:

  • Talcum powder
  • Laundry detergents used to clean underwear
  • Bubble bath
  • Topicals (medications applied to skin)
  • Soaps (particularly those with fragrances)
  • Toilet paper
  • Panty liners
  • Nickel (the metal)
  • Spermicides (chemicals used to kill sperm and prevent pregnancy)

Hormonal Causes

Vulvar dermatitis can also be brought on by low levels of the hormone estrogen, a hormone that keeps the vaginal walls healthy and lubricated. Many people with eczema notice a link between flare-ups and hormonal shifts, such as pregnancy. Vulvar dermatitis is more likely to happen before puberty and after menopause, times of life when estrogen levels are lower, making the vulva’s skin thinner and dryer.

Symptoms of Vulvar Dermatitis

Vulvar dermatitis can be extremely uncomfortable. Recognizing the symptoms can help you receive treatment sooner. The major symptoms include:

  • Vulvitis (an itchy vulva)
  • A stinging or burning feeling on the vulva
  • Thickened skin around the vulva
  • Patches that are redder or darker than the surrounding skin
  • A wet feeling in or around the vagina

Experiencing pain when something is inserted into your vagina can also be a sign of vulvar dermatitis. This pain could arise during intimate moments, like sexual intercourse, or when you’re inserting a tampon. A speculum, the metal tool used during a pelvic exam, can also be irritating.

Symptoms might be heightened by certain triggers or at different times of the day. Many people have worse symptoms at night or when they’re hot and sweaty. One MyEczemaTeam member described losing sleep “due to the severe itching at night.”

Treatments for Vulvar Dermatitis

Treating vulvar dermatitis may include a combination of at-home and doctor-recommended remedies. Speaking with your doctor or a dermatologist (a specialty skin doctor) will be an important first step. They’ll make sure you get the correct diagnosis and the right treatment.

Most treatments aim to reduce itchiness and inflammation on the affected skin.

Ointments

Ointments are oily medications that are applied to the skin. Corticosteroid ointments contain steroid drugs that help reduce inflammation. These may include hydrocortisone or prescription ointments with corticosteroids.

Antihistamines

A class of medications called antihistamines can be used to help relieve itch from an allergic reaction. Your dermatologist may suggest you try an over-the-counter antihistamine such as diphenhydramine (sold as brand names such as Benadryl) or cetirizine (Zyrtec) to relieve itching from vulvar dermatitis.

Emollients

Your doctor might recommend emollients, which are creams or lotions that specifically help restore the skin barrier. An emollient may be soothing and restorative if your vulvar skin is raw and painful.

At-Home Remedies

Your recovery from vulvar dermatitis requires strictly following your doctor’s recommendations. At-home remedies may help with symptom relief, but first check with your doctor to make sure a strategy you want to try is a good fit for your case of vulvar dermatitis. Examples of symptom relief strategies you can try at home include:

  • Holding a covered ice pack to your vulva
  • Taking a cool bath

One MyEczemaTeam member shared that they were trying Lady Anti Monkey Butt powder: “Talc-free, plus it has calamine powder — so far it’s helping a lot with the itching.”

What you don’t do can also aid healing. If you have vulvar dermatitis, it’s important to avoid:

  • Scratching the affected area
  • Having sexual intercourse during recovery
  • Using a vaginal douche (a device to clean the vagina)

Hygiene Considerations

Keeping the genital area clean can help remove irritants, such as products or sweat. Washing your vulva daily with warm water and unscented soap may be helpful. Pat (don’t rub) dry with a clean towel. Don’t clean the area more than once a day, though — overbathing can cause irritation.

Clothing Recommendations

Loose-fitting clothing made of a soft, natural fabric like cotton, bamboo, or silk may be gentle on sensitive skin. It’s best to avoid tight-fitting clothes, which may be irritating, and synthetic materials like nylon that keep in heat and moisture. Sleeping without underwear will allow the genital area to air out and stay dry during the night.

Conditions That Resemble Vulvar Dermatitis

Other underlying conditions can cause symptoms similar to vulvar dermatitis — another reason getting seen by your doctor is so important. You want to make sure you have vulvar dermatitis and not something that calls for different treatment. Conditions that may be confused with vulvar dermatitis include:

  • Vaginitis — Inflammation inside and outside the vagina, which can be brought on by infections or overgrowth of yeast (yeast infection)
  • Lichen planus — A rash of small white dots that are of unknown origin but indicate an overactive immune system
  • Lichen sclerosus — Similar to lichen planus, but the white spots and patches often last longer and may lead to scarring
  • Psoriasis — An autoimmune condition (the immune system mistakenly attacks healthy tissue) that usually causes scaly, discolored skin

Be sure to check with your health care provider if you’re experiencing a rash, pain, or other symptoms in your genital region. The sooner you get the correct diagnosis, the sooner you can get the right treatment plan for your condition — whether it’s vulvar dermatitis or something else — and start to feel better.

Meet Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, more than 49,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Have you or a loved one had vulvar dermatitis? What helped you find relief? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on September 19, 2023
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Steven Devos, M.D., Ph.D. received his medical degree and completed residency training in dermatology at the University of Ghent, Belgium. Learn more about him here.
Hannah Actor-Engel, Ph.D. is a multidisciplinary neuroscientist who is passionate about scientific communication and improving global health through biomedical research. Learn more about her here.

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