More often than not, women who experience vulva irritation assume it’s yeast infection. They rush to buy over-the-counter medicine. Sometimes it is a yeast infection, but sometimes it is not. Regardless of the diagnosis, it is important to see your doctor to determine the best course of action.

What is the vulva? The vulva is made up of the opening of the vagina (vestibule), the outer lips (the labia majora), the inner lips (labia minora) and the clitoris. Treating for a yeast infection when you in do not have a yeast infection, will often dry out the skin causing more irritation. The treatment can perpetuate the scratch-itch cycle and leave you in constant discomfort.

Other things can cause itching in the vulva area besides yeast. Think about the answers to these questions:

• Does it occur around my cycle? Before, during, or after?

  • The pH of the vagina can change around your cycle and give you discomfort that is not necessarily caused by yeast.

• Am I constipated? Am I having loose stool?

  • If your stool consistency is off and/or there is straining, it can affect the pelvic floor muscles and cause similar vulvar symptoms.

• Did I try a new body product or detergent that I am sensitive to?

  • Certain chemicals in products can affect vaginal flora.

If the answer to these questions is “No”, then a medical examination may reveal one of the following skin conditions:

• Eczema is a common problem at the vulva and is often hard to diagnose. Eczema can start with exposure to an allergen or irritant, making it is important to know the ingredients in your skin care products, detergents, soaps, underwear and pant fabrics, lubricants, condoms etc. It is important to eliminate the allergen, seek proper treatment and do your best to not itch the vulva area. Applying an ice pack can be an effective, natural analgesic to stop the itching while the eczema is treated. 

• Lichens Sclerosis is an inflammatory skin condition that can affect the vulvar and anal area. It is especially common in those with psoriasis. Lichens Sclerosis is diagnosed by appearance and sometimes a biopsy. It needs to be treated to avoid changes in the vulvar tissues such as labia and/or clitoris scarring. Tissue should be inspected regularly to attend to new lesions or severe scarring

• Lichen Planus is caused by an overactive immune system and can be seen on the vulva, inside the mouth and other skin surfaces. The most common symptoms on vulvar skin are burning, itching and rawness as well as change in color of the vulva to a pale, pink and white streaky pattern. It may be accompanied by a yellow discharge. There is a possibility of labia scarring so it requires treatment and ongoing inspection. 

These skin conditions can be very uncomfortable, especially if they are lasting for weeks or months. We recommend seeing a vulvar dermatologist or a gynecologist for a proper diagnosis.

Once treated, the vulvar skin is still vulnerable and needs to be cleaned properly and taken care of. If you have a vulvar skin problem, or are prone to irritation in that area, we recommend doing these things to protect the tissue and allow for healing:

1. Wear loose clothing, cotton underwear when you go out and none when you are home.

2. Do not wash area with a washcloth, use your fingers with an unscented, non- alkaline cleanser (Cetaphil or just warm water)

3. Soak the vulva for 5-10 minutes with lukewarm water, pat dry and then apply prescribed medication or soothing substance being used. We recommend (good clean love).

4. Avoid moisturizing wipes that can irritate skin. If you feel like you need more moisture, use a spray bottle to moisten the tissue. Hyaluronic Acid also helps to put moisture back into the vulvar tissue such as Hyalogyn

5. Talk to your gynecologist before using oils. Many women use coconut oil but a safer oil may be grape-seed oil due to its ingredients and interaction with vulvar tissue.

6. Use a vaginal probiotic that has certain ingredients to replenish the microbiome of the vagina. We like these suppository probiotics.

If you have questions and want to speak with one of our physical therapists, email us at info@solsticept.com or call (929) 269-2505 to schedule a free,15-minute consultation.