Inflammation of the vulva (external female genitalia).

Causes, incidence, and risk factors

Possible causes include chronic dermatitis , seborrhea or eczema , allergies (particularly to soaps, bubble bath, materials, fragrances), or infections (such as fungal and bacterial infections, pediculosis , or scabies ). Vulvitis can occur in women of all ages. In prepubescent and postmenopausal women, the condition may be caused by low estrogen levels.

Signs and tests

A pelvic examination often reveals redness and thickening, and may reveal cracks or skin lesions on the vulva (external genitalia). If there is any vaginal discharge , a wet prep inspection may reveal vaginal infection as the source. See vulvovaginitis and vaginitis .

Treatment

Self-care options may be initiated if no vaginal discharge is present. These include discontinuing the use of any potential irritants, and following the recommendations given in the "Prevention" section. An over-the-counter topical cortisone cream (Corticosteroids - topical - low potency) may be used 2 or 3 times a day on the affected area for up to 1 week. If these measures do not alleviate symptoms, a primary health care provider should be seen. If discharge from a vaginal infection is the cause of vulvitis, the source of the vaginal infection should be treated and concurrent topical cortisone cream may be used to decrease vulvar itching . Note: If the infection is transmitted sexually, it is very important that your partner(s) receive treatment also, even if there are no symptoms. Many organisms can harbor themselves without producing symptoms. Failure of the partner(s) to accept treatment can cause continual reinfection which may eventually (if not taken care of) lead to more extensive problems, possibly limiting future reproductivity and effecting overall health. If treatment of vulvitis is not very effective, further evaluation may include biopsy of the skin to rule out the potential of vulvar dystrophy (a chronic vulvar skin condition) or vulvar dysplasia, a precancerous condition. A biopsy may also be necessary if any skin lesions are present.

Expectations (prognosis)

The scratch-and-itch cycle of vulvitis may be difficult to halt, but with adequate identification of the causative factors, it can usually be alleviated over several weeks.

Complications

Itching of the vulva may be a sign of genital warts (HPV - Human Papilloma Virus ), vulvar dystrophy, or vulvar dysplasia (a precancerous condition). Infection, when not treated, may eventually lead to more extensive problems, possibly causing reduced reproductive ability, total sterility, or problems with general health.

Calling your health care provider

Call for an appointment with your health care provider if symptoms occur and do not respond to self care measures, or if vaginal discharge accompanies the symptoms. Also call if skin lesions are noted on the vulva .

Prevention

Since one of the main causes of vulvitis is exposure of the vulva to chemicals (bubble bath, douches, detergents , fabric softeners, perfumes, etc.), or other irritating materials (wool, fibrous or " itchy " materials etc.), daily cleansing with mild soap, adequate rinsing, and thorough drying of the genital area is one of the best ways to avoid it. Also avoid using feminine hygiene sprays, fragrances, or powders in the genital area. Avoid wearing tight fitting pants or shorts, which may cause irritation by constantly rubbing against the skin and by holding in heat and restricting air circulation. Underwear made of silk or nylon is not very absorbant and also restricts air circulation. This can increase sweating in the genital area, which can cause irritation and may provide a more "likable" environment for some infection causing organisms. Wearing cotton underwear or pantyhose that have a cotton crotch will allow better air circulation and will decrease the amount of moisture in the area. For the above-mentioned reasons, you should also avoid wearing exercise clothing for prolonged periods. Removing underwear while sleeping will also allow more air circulation. Those infections which may be spread by intimate or sexual contact may be prevented or minimized by practicing abstinence, or monogamy and safer sexual behaviors , especially condom use.