How to Properly Care for Your Vulva

By: Dana Leslie, CNP • Posted on December 18, 2023

The Most Common Concerns About The Vulva

The vulva is the external part of the female genitalia. Vulvar concerns are some of the more common reasons that women seek gynecologic care.

Vulvar concerns that should lead to medical evaluation include the following symptoms:

Itching
Burning
Pain
Associated vaginal discharge
Lumps
Bumps
Ulcerations
Pigment changes
Pustules
Odors
Rashes

There can frequently be a combination of several of these symptoms. Occasionally, women try to diagnose these symptoms themselves and the most common culprit is “yeast.” Self-treatment can sometimes be successful, but it can also make the problem worse or even prolong the diagnosis of a more serious health concern.

Itching is a common vulvar complaint. There are many causes of itching. Sometimes it is a “yeast” infection. But many times, it is not.

An Itchy Vulva

Infections in the Vulva

Infections that can cause vulvar itching include:

Herpes
Vulvar Condyloma (Warts)

Vulvar Itching can also occur from the discharge that occurs with other infections such as:

Bacterial vaginosis
Trichomonas

Vulvar Cancer

Vulvar itching can also be a symptom of vulvar cancer. Which is often why your provider will stress an in-person appointment rather than an over-the-counter medication or called-in prescription. Symptoms of vulvar cancer include itching that does not go away, pain and tenderness, bleeding, skin changes and/or a lump or ulcer.

Non-Infections in the Vulva

Desquamative inflammatory vaginitis

A noninfectious cause of itching, pain and profuse vaginal discharge.

Skin dermatitis

Itching can occur from a skin dermatitis which can be caused either by an individual’s sensitivity (or allergy) to a substance or from the substance itself causing an actual irritation of the skin. Even products that have been used for years can cause a sensitivity.

Atrophic vaginitis

The skin of the vulva also changes with age, hormones and environmental concerns like heat and occlusion that can occur from wearing tight clothes or non-breathable fabrics like nylon.

Atrophic vaginitis is common in the menopausal years and the itching is caused by decreased hormone levels. This can make the skin even more vulnerable.

Substances To Avoid Using On the Vulva

Substances that can irritate the vulva include:

Creams
Gels
Wipes
Feminine products
Spermicides
Deodorant soaps
Avoid panty liner use

When the vulvar skin gets too dry it will cause itching and burning. Excessive washing can dry out or injure the skin. Very little soap should be used on the vulva, and it should be applied with fingertips, not a washcloth, which is too abrasive to this sensitive skin. A mild soap such as Cetaphil can be used heavily diluted with water and the skin should always be gently patted dry.

Vulvar Skin Diseases

Lichen simplex chronicus

Lichen simplex chronicus is a skin disease that can cause itching and is similar to eczema.

Chronic Vulvar Skin Diseases

Lichen sclerosis, lichen planus and psoriasis are chronic vulvar skin diseases that can cause severe itching along with other skin changes. Chronic vulvar skin diseases cannot be cured, but can be treated to reduce or eliminate symptoms.

Vulvar itching can occur even when there are no specific findings on an examination. This itching can be accompanied by the following symptoms:

burning
rawness
painful intercourse
irritation

Vulvodynia

An extreme sensitivity to touch, especially around the opening to the vagina is called vulvodynia. It can be a very frustrating condition to have, but treatments are available that can be very helpful.

Diagnosing a Vulvar Disorder

Bumps, lumps, skin cracks, ulcerations, pustules, peeling skin and skin color changes have both infectious and noninfectious causes. These can be both painful and non-painful. The symptoms may involve the entire vulva or only one small area.

Some infectious causes of the symptoms listed above include:

Herpes
Warts
Molluscum contagiousum
Yeast
Staph
Strep infections

Some of the noninfectious causes of these symptoms include:

Cysts
Varicose veins
Blood vessels nodules
Moles
Skin cancers

The diagnosis of a vulvar disorder involves a visit to your doctor so a physical exam can be performed. It's also important to share your history of symptoms and the duration of time they have been present.

Along with the exam, your doctor may obtain tests that can include cultures and sometimes skin biopsy. After obtaining results, a treatment plan will be determined depending on the cause of the vulvar disorder. There are many causes for vulvar concerns and it is important to have a thorough medical evaluation so the correct treatment can be implemented.

You do not have to suffer in silence, help is available!

Be Strong, Be Healthy, Be in Charge!

-Dana Leslie, CNP

Dana Leslie CNP is a certified nurse practitioner in the Cleveland Clinic's Center for Specialized Women's Health. Dana has her undergraduate degree from Youngstown State University and her graduate degree from the University of Cincinnati. She is certified as a Family Nurse Practitioner. Call 216-445-2720 to schedule an appointment.

women's health, vulva care, vaginal health, itchy vulva, yeast infections, vulva, vagina, vagina pain, vulva pain, vaginitis, vaginosis, vulvar cancer, bacteria infection, vulvodynia

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