Vulval problems - itchiness
Itchiness
of the vulva is almost never caused by a sexually transmitted
disease - it's usually as a result of thrush or a skin condition.
As the lips are covered by ordinary skin, the area can be affected
by conditions such as eczema and psoriasis. And sometimes only
the vulval skin is affected, so the diagnosis may come as a
surprise.
The usual
mistake with vulval itching is to assume that you have thrush,
and keep on applying anti-thrush creams from the pharmacy. This
may actually worsen the condition, as you can become allergic
to some of the ingredients. If an anti-thrush cream doesn't
deal with the problem within a few days, or if the itching comes
back, see your doctor. If you have a skin condition, and not
thrush, you need the appropriate treatment.
This section
deals with the common causes of vulval itching, and what you
can do about them:
thrush
trichomoniasis
psoriasis
lichen
sclerosus
allergies and sensitivities
excessive
washing
stress
or anxiety causes
Thrush
Thrush is a fungal infection caused by Candida albicans.
About 1 woman in 5 has Candida in her vagina without
it causing any symptoms. Hormones in the vaginal secretions
and the 'friendly' vaginal bacteria keep it at bay. But problems
can arise when this natural balance becomes upset, and the
Candida multiplies (see Table
for some common causes).
Thrush
doesn't always cause a discharge - the main symptom is itching
or soreness, and this gets worse in the week before a period.
If there is a discharge, it's usually only slight, doesn't
smell, and looks like cottage cheese.
Dr
Margaret's advice
You might
also like to read Dr Margaret's answer to the e-query 'Why
do I keep getting thrush?'
Times
when the normal vaginal environment can become disturbed
-
During pregnancy
-
When you take antibiotics (because these get rid of
the friendly bacteria)
-
If you have diabetes, especially if your blood sugar
levels are consistently too high
-
If you wear tight, non-porous underwear, such as nylon
knickers and tights (because Candida thrives
in warm, moist conditions)
-
If the vulva or vagina is sore for any other reason,
particularly if you scratch (because damaged tissue
is more susceptible to Candida infection)
-
If you are ill for any reason
-
If you are taking any drugs, such as steroids, which
lower the body's resistance to infection.
|
Trichomoniasis
This is caused by infection with Trichomonas vaginalis,
which is a protozoan organism, similar to an amoeba. The organism
is sexually transmitted, but men often don't have any symptoms
of infection, so they don't know they are carrying it. In
women, infection causes a foul-smelling discharge and vulval
itching, soreness or pain. Passing urine may be painful. If
you think you have this infection, go
to a genito-urinary clinic for treatment and to be checked
for other infections.
Psoriasis
This is a skin condition that can be extremely itchy when
the genitals are involved. The skin usually becomes bright
red, often with painful cracks. The affected area may extend
to the groin and to around the back passage (the anus) and
between the buttocks. Psoriasis on other parts of the body
is scaly (check your scalp, knees and elbows), but in the
vulval area it tends to be smooth. You can have psoriasis
on the vulva without having it anywhere else on your body.
Lichen
sclerosus
This is another extremely itchy skin condition affecting the
vulva. The itching is often so bad that it can affect's a
sufferer's sleep. It's most common around the menopause and
in girls just before puberty, though it can occur at any age.
Its cause is a mystery. The skin looks thin and pale, and
the area around the anus may also be affected. If it isn't
treated, the lips of the vulva eventually shrink, the vaginal
opening narrows and sex becomes painful.
Treatment
of this condition is simple, and your doctor can prescribe
a special steroid cream.
See 'Useful
contacts' for details of a support group.
Allergies
and sensitivities
These can cause redness and itching. The vulval area seems
to be very sensitive to chemicals, probably because the vulva
is moist and warm - conditions that favour the absorption
of chemicals by the skin. It's possible to develop an allergy
to almost any chemical substance that comes into contact with
the vulva, such as may be present in:
skin creams
perfumes
in soaps, bubble baths, shower gels and shampoos
disinfectants
washing
powders and fabric softeners
deodorants
(including 'intimate' ones)
Dr
Margaret's advice
Excessive
washing
This can irritate the vulval area. Older women who may find
it difficult to get into a bath may worry about personal hygiene,
with the result that they wash the area too much. There's
no need to wash several times a day - once is sufficient.
Stress
or anxiety
Being stressed or anxious can cause itching. I'm not implying
that you're imagining - the itching is real. But when you're
stressed or anxious, your nervous system is on alert, and
small sensations can become amplified into unpleasant itching
or even pain.
What
you can do
Start by trying to eliminate anything that could be causing
an allergy or sensitivity - also read my 'common-sense' steps.
Don't go swimming while you have the irritation - the chlorine
may make it worse.
If the
itch is really bad, you may be scratching in your sleep, causing
more damage. Keep your fingernails short and wear cotton gloves
when you go to bed (you can buy them from the pharmacy).
If you
think thrush is a possibility, buy an anti-thrush cream from
the pharmacist. This should work within a day or two. If it
doesn't, or if the itching soon returns, see you doctor. Vulval
itching is a common symptom, and one that your doctor deals
with all the time - there's no need to feel awkward.
[
back to Vulva problems main page
]
