Vulvar dermatitis: symptoms, causes and treatments

Dermatitis is the term for skin irritation. Vulvar dermatitis affects the skin of the vulva and the surrounding area. Affected skin may become inflamed, itchy and irritated.

One of the main causes is female genital eczema, also called vulvar eczema or vulvar atopic dermatitis. Other possible causes include infections, allergies, and irritants, as well as psoriasis and other inflammatory conditions.

Vulvar dermatitis is treatable and many of the causes of vulvar dermatitis are curable. Though there is no remedy for atopic dermatitis or psoriasis, it is possible to treat the dermatitis of the vulva resulting from these conditions.

A person can also try adjusting their skincare routine and other habits to help manage this condition.

Common symptoms of vulvar dermatitis include:

  • itchy skin around the vaginal area
  • inflamed, discolored skin around the vaginal and vulvar area
  • dry, scaly, or blistered skin around the vaginal and vulvar area
  • oozing or crusting from the affected skin
  • swelling of the affected skin

A person may also have these symptoms on other parts of their body, including around the anus and between the buttocks.

Symptoms can vary from mild to severe. If atopic dermatitis is the cause, the person may have flare-ups, during which the symptoms worsen, alternating with periods of remission.

Scratching can cause the affected skin to bleed and infect.

Many factors can cause vulvar dermatitis. Some common causes include:

  • friction from clothing or sexual intercourse
  • hormonal changes
  • moisture from underwear
  • soaps or cleansers

The irritation can also be the result of infections, such as:

  • Candida albicanswhich is a yeast infection
  • discharge due to bacterial vaginosis
  • genital warts
  • pinworms
  • genital lice
  • scabies

One of the causes of vulvar dermatitis is eczema. Eczema, or atopic vulvar dermatitis, results from an overactive immune system. Experts don’t know exactly why the immune system becomes overactive, but they believe that genetic and environmental factors probably play a role.

Certain irritants or allergens can trigger eczema symptoms. Eczema triggers vary from person to person.

Common triggers include:

  • hot or cold temperatures
  • scented personal care products
  • scented laundry detergents and fabric softeners
  • isothiazolinone, an antibacterial in wipes and other personal care products
  • household disinfectants and antiseptic solutions
  • certain fabrics, such as wool and polyester
  • some metals, including nickel
  • friction
  • stress

Vulvar eczema isn’t the only condition that can cause inflammation, itching, pain, or dry skin around the vagina. Other potential causes include:

  • psoriasis
  • sclero-atrophic lichen
  • contact dermatitis

Anyone with a vulva can suffer from vulvar dermatitis. Some steps that can reduce the potential for irritation include:

  • wear cotton or bamboo underwear
  • minimize area scratches
  • avoiding scented soaps or detergents
  • refraining from using wet wipes or antiperspirants in the area
  • changing menstrual pads or incontinence pads frequently
  • keep the area clean by washing daily with fragrance-free cleansers or clean water

In the case of vulvar atopic dermatitis, people are more likely to develop vulvar eczema if they have:

  • eczema on other parts of their body
  • a family history of eczema, hay fever, asthma, or food allergies
  • frequent exposure to irritants, such as scented skin care products

If a person develops symptoms of vulvar dermatitis, they should make an appointment with a primary care physician or dermatologist. A dermatologist is a doctor who specializes in skin conditions.

The diagnostic procedure may involve the doctor:

  • ask the person about their symptoms and medical history
  • examine the affected area
  • order a skin biopsy or other tests

To perform a skin biopsy, the doctor will take a small sample of the affected skin and send it to a laboratory for analysis. This can help them determine if the symptoms are due to eczema or another condition.

It is important to get a diagnosis from a doctor to identify the cause of symptoms and get effective treatment.

Treatment for vulvar dermatitis will depend on the cause.

In the event of contact dermatitis or an allergic reaction, a person may need to change soaps or detergents to avoid irritants.

If an infection is responsible, the doctor may prescribe medications such as oral antibiotics or topical creams.

Though there is no remedy for atopic dermatitis, many treatments are available. Doctors may prescribe one or more of the following treatments to manage symptoms and prevent complications:

  • moisturizing creams
  • topical treatments, such as steroid creams
  • antihistamines
  • oral or injectable medications, for moderate to severe eczema

The severity of a person’s symptoms and how much of their body is affected by eczema will determine the treatment plan. People may need to try more than one treatment.

Along with treatment, lifestyle changes can help reduce symptoms of vulvar dermatitis.

Skin care

Proper skin care is important for managing the symptoms of vulvar dermatitis. Keeping the area clean and avoiding irritants can help reduce irritation.

If the problem is due to eczema, the American Academy of Dermatology Association (AAD) encourages people to get symptom relief by:

  • take a bath or shower for 5 to 10 minutes each day, using lukewarm water
  • using gentle, fragrance-free skin care products
  • apply moisturizer after bathing

If a person has urinary or fecal incontinence, they should talk to a doctor about strategies to manage it. Urine and feces can irritate the skin and make the irritation worse.

Avoid triggers

Identifying and avoiding triggers can help limit symptoms of vulvar dermatitis.

For example, people may find the following benefits:

  • using lukewarm water rather than hot water for bathing or showering
  • using only gentle, fragrance-free cleansers to wash the skin around the vagina and anus
  • refraining from using soap, wet wipes, antiseptic washes, douches, vaginal deodorants, and scented products
  • using an emollient rather than shaving cream when waxing around the vagina or anus
  • avoid hair removal
  • wear 100% cotton, silk, or bamboo underwear and do not wear tight pants, tights, or flip-flops
  • use fragrance-free laundry detergent and avoid fabric softeners
  • remove all nickel vulva piercings

Taking steps to minimize stress can also help limit eczema flare-ups.

Sex

Barrier contraceptives, such as condoms, diaphragms, and cervical caps, are often made of latex. These products do not cause problems for most people. However, 1–2% of people are allergic to latex and should use latex-free alternatives, such as polyurethane or silicone barrier contraceptives.

Some spermicides can irritate the skin. If a person suspects that their spermicide is triggering symptoms, they should talk to a doctor or pharmacist about alternatives.

Using a water- or silicone-based personal lubricant, called a lube, during sex can help reduce friction and discomfort. Avoiding scented and flavored lubricants can help prevent chafing.

If a person is using topical steroids to treat vulvar eczema, they should avoid applying the steroids shortly before sex. They must allow enough time for the skin to fully absorb the medicine first.

In some cases, contact with semen can make vulvar eczema worse. Using condoms can limit contact with semen.

Mental health support

Vulvar dermatitis can negatively affect a person’s mood, body image or mental health. They may feel stressed, anxious or embarrassed by illness. Support from a mental health specialist can help them cope.

Vulvar dermatitis is treatable and in many cases goes away over time. In other cases, although the condition may be chronic, it is still manageable.

Getting treatment, practicing good skin care, and avoiding triggers can help reduce symptoms and improve quality of life.

If a person develops new or more severe symptoms of vulvar dermatitis, they should tell a doctor. They should also see a doctor if their symptoms do not improve with treatment. The doctor may adjust their treatment plan or recommend lifestyle changes.

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