Vulvitis Symptoms, Causes, Diagnosis, Treatment, and Prevention

Vulvitis is irritation or inflammation of the vulva, the skin right outside the vagina. It can be caused by dryness, skin abrasion, an allergy, infection, or injury. Usually, vulvitis is not serious, though it may cause persistent discomfort or pain.

Sometimes, vulvitis is a symptom of a condition that requires treatment, such as a sexually transmitted infection (STI) or fungal infection. If you have persistent irritation for several days, you should see your healthcare provider. Treatment depends on the cause of your vulvitis.

This article discusses the symptoms and causes of vulvitis. It also covers how it's diagnosed and treated as well as how it can be prevented.

Symptoms

The symptoms of vulvitis vary depending on the cause and how long it has been affecting you.

Common symptoms include:

• Itching
• Redness
• Swelling
• Soreness
• Pain with sexual activity
• Increased sensitivity when wiping with toilet paper

Some infections or allergies that cause vulvitis produce other symptoms as well, including:

• Thickened or whitish patches
• Fluid-filled, clear blisters that break open and form a crust
• Scaly appearance
• Bumps or warts
• Vaginal discharge

Causes and Risk Factors

Vulvitis can be caused by anything that irritates the vulva. The most common causes of vulvitis include:

• Infections: Vaginal infections, such as vaginitis, genital herpes, and yeast infections, often cause vulvitis.
• Irritants: Products made with irritating materials or added dyes or perfumes can cause vulvitis without an infection. For example, soaps, powders, sanitary napkins, underwear, pantyhose, and massage oils can all irritate the skin or cause an allergic reaction.
• Medication: Some medications, such as hormone supplements and anti-anxiety medicines can cause vaginal dryness, increasing the likelihood of vulvitis. Oral or intravenous (IV) antibiotics increase the risk of a vaginal or vulvar fungal infection, which can cause vulvitis.
• Vaginal douches: Douches change the fluid in and around the vulva, and can cause dryness and irritation. They also alter the normal bacteria of the vaginal area, potentially causing a vulvar infection.
• Hygiene habits: Not changing a pad or underwear, prolonged moisture around the vulva, and not wiping or drying properly can all lead to vulvitis.

If you are perimenopausal (the phase leading up to menopause) or have gone through menopause, you are susceptible to vulvitis. That's because decreased amounts of estrogen with these transitions make the vulva thinner, less lubricated, and more delicate.

Female children who haven't reached puberty are also at risk because they don't make adult levels of estrogen yet.

Diagnosis

You may already suspect the cause of your vulvitis. Perhaps symptoms started after you switched laundry detergents, for example. But sometimes, the cause may not be obvious. Either way, getting a healthcare provider to weigh in is a good idea.

Your healthcare provider can usually diagnose vulvitis with a pelvic examination. Several diagnostic tools may also be used. These include urinalysis (urine test), testing for sexually transmitted infections (STIs), and a Pap smear (test for abnormal cervical changes).

These can help narrow down a diagnosis if you haven't used a product that directly irritated your skin.

Treatments

The underlying cause of your vulvitis will determine the treatment needed.

Your healthcare provider's recommendations may involve these self-care strategies to reduce irritation and inflammation:

• Discontinue the use of soaps, lotions, bubble bath, and other products that cause or aggravate your vulvitis.
• Try not to scratch because this can lead to further irritation, as well as cause bleeding or an infection. 
• Wash the area only once daily with warm water. Overwashing can lead to further irritation.

These may be used alone or in conjunction with medication:

• Low-dose hydrocortisone creams may be prescribed for an allergic reaction.
• Antifungal creams or antibacterial creams may be needed for an infection.
• Topical estrogen may relieve inflammation and symptoms for people who are post-menopause.

While they won't resolve the condition, these tips may ease your discomfort as your vulvitis is being treated:

• Taking warm baths, or using a sitz bath
• Applying calamine lotion (external areas only)
• Using a hypoallergenic lubricant, particularly before sexual activity

Prevention

As a general rule, keep your vaginal and vulvar area clean, dry, and cool, especially during menstrual periods and after bowel movements. Be sure to gently cleanse the vaginal area. Avoid harsh rubbing with washcloths or towels.

Other ways to prevent vulvitis include:

• Wearing cotton underpants
• Avoiding excessively tight pants, pantyhose, or any clothes that are abrasive to the vulvar area or that don't allow for adequate air circulation
• Opting for unscented, white toilet paper and fragrance-free feminine products
• Using fragrance- and dye-free laundry detergent
• Avoiding fabric softener when washing underwear
• Avoiding vaginal sprays and powders
• Changing out of wet clothing promptly, such as after a swim or vigorous exercise
• Using external or internal condoms during sexual activities to reduce your risk of vulvitis, STIs, and other vaginal infections

Summary

Vulvitis is irritation around the vulva that leads to itchiness, redness, and pain. It can be caused by a number of things, including vaginal infections, medications, and products with dyes and perfumes.

Your healthcare provider can usually diagnose vulvitis with a pelvic exam. They may use other tests, like those for STIs, to help you find the cause. If it's caused by a fungus or bacteria, your doctor may prescribe a cream to treat the condition.

To prevent vulvitis, keep the area around your vagina clean and dry. Don't use soaps or bubble bath with irritants like dyes and perfumes. Use condoms during sexual activities to help avoid infection.

A Word From Verywell

Vulvitis is fairly common and usually resolves without complications. Lifestyle adjustments are typically effective unless it is caused by an infection, a medical condition, or a medication. Be sure to listen to your body and don't ignore itching, tenderness, or discomfort of the vulvar area. Vulvitis typically does not go away on its own.