Vulval irritation

What is vulval irritation?

Vulval irritation is when different products and chemicals affect the sensitive skin of the vulva. Most causes of vulval irritation are not serious and will improve with treatment. But there are a few rare conditions that can become serious if left untreated. If you are worried, talk to your doctor and have your condition treated as soon as possible.

Every now and then, you might have vaginal discharge. This is normal. It helps to keep the vulva and vagina moist. It also removes bacteria and dead cells. It’s a good idea to know what your normal discharge looks like and pay attention to any changes. Discharge can change in colour and consistency with an infection. It can also change depending on the stage of your menstrual cycle.

Symptoms

Vulval irritation can be associated with other signs and symptoms, including:

• burning
• itching
• redness
• swelling
• vaginal discomfort
• vaginal discharge
• skin cracking or splitting (fissuring)
• whitening of skin (leukoplakia)
• pain during sex (dyspareunia).

What causes vulval irritation?

Vulval irritation can be caused by many things. Common causes are listed below.

Bodily functions

For example:

• vaginal discharge – which may be caused by an imbalance in the bacteria and microorganisms that live inside the vagina
• sweat.

Products

For example:

• sanitary pads and tampons
• soap, bath and hair products
• laundry detergent
• perfumed products such as ‘feminine hygiene’ sprays
• scented or coloured toilet paper or wipes
• hair removal and bleaching products
• douches or vaginal washes
• condoms, spermicides and lubricants.

Clothes

For example:

• tight or synthetic clothing, Lycra and stockings
• wet bathers – especially after swimming in chlorinated water.

Skin conditions

For example:

• dermatitis or eczema – a common skin condition that can occur anywhere on the body, including the vulva. Scratching to relieve the itching may cause further skin damage and infection
• psoriasis – an inflammatory autoimmune skin condition that can affect vulval skin, causing reddened patches
• lichen sclerosus – an inflammatory autoimmune skin condition that can cause itching. Skin may become thin, white, wrinkled and cracked
• lichen planus – an autoimmune skin condition that’s itchy and painful. It can affect the vulva, vagina and other body parts, including the mouth.

Infections

For example:

• bacterial vaginosis – a bacterial infection of the vagina that produces a thin white, grey or greenish discharge and a strong fishy odour, especially after sex
• candidiasis or ‘thrush’ – a yeast infection of the vulva and vagina. Symptoms include itching, redness, swelling and a cottage cheese-like vaginal discharge.

Sexually transmitted infections (STIs)

For example:

• trichomoniasis – common symptoms include itchiness and a smelly, green, frothy discharge
• genital herpes – a virus spread by skin-to-skin contact during vaginal, oral or anal sex
• other STIs including chlamydia, gonorrhoea and genital warts.

Learn more about sexually transmitted infections.

Other conditions

For example:

• Bartholin glands cyst – these glands are located on either side of the lower part of the vaginal opening. They produce lubricating fluid during sex. If a gland is blocked, it can cause a cyst, leading to discomfort or pain.
• varicose veins – these can develop in the vulva, particularly during pregnancy.

Hormones

Hormonal changes (especially reduced levels of oestrogen) can make the vulva and vagina thinner, drier and more uncomfortable. This can happen after having a baby, while breastfeeding or around the time of menopause.

Medicines

Some medicines and local anaesthetic can cause irritation.

Cancer

Symptoms of vulval cancer may include a persistent itch, rough skin, a non-healing sore or a lump. Vulval cancer is rare, but it’s important to know your vulva and contact your doctor if you notice any changes.

Learn more about vulval cancer.

Treatment and management

The treatment of vulval irritation depends on the cause. Your doctor may recommend different options, including:

• external treatments – medicated creams (corticosteroid, antibiotic, antifungal or local anaesthetic), barrier creams and gels
• internal treatments – vaginal cream, gels, tablets and pessaries (antibiotic, antifungal, acidic or hormonal)
• tablets – taken orally
• a combination of the above.

It’s important to follow treatment instructions and see your doctor again if symptoms do not improve.

What you can do

If you have vaginal irritation, you can try the following treatments at home.

Bathing

Soothe the irritation by sitting in a wash basin or bath once or twice a day for five to 10 minutes.

If you are using a basin or tub, add two tablespoons of bicarbonate of soda or one-quarter teaspoon of salt per litre of water.

If you are having a bath, add one cup of bicarbonate of soda or a handful of salt to the water.

Saltwater spray bottle

Make up a saltwater spray bottle. Add one teaspoon of salt to 600 ml of water. Spray this mix onto your vulva while sitting on the toilet. You can do this while weeing – to reduce the stinging – and after to remove any traces of wee (or poo) from your vulva.

Cold packs

Cold packs (wrapped in a cloth) may ease itching and pain.

Going to the toilet

Reduce any burning feeling by leaning forward while weeing, so the wee goes directly into the toilet and doesn’t run down your vulva.

Learn more about vulval care.

Prevention

A healthy vaginal ecosystem

There are many types of tiny living organisms (microorganisms) that are found in the vaginal ecosystem. In a healthy vagina, there are different types of ‘friendly’ microorganisms (‘good bacteria’) that play an important role in preventing vaginal infections.

When there is an imbalance or overgrowth of ‘bad bacteria’ in the vagina, it can cause symptoms such as vaginal discharge, redness and itchiness. It can also cause common fungal infections, such vaginal thrush, or bacterial infections, such as bacterial vaginosis (BV).

Vulval irritation is not always due to an imbalance of vaginal bacteria. Studies suggest that your vaginal bacteria may be connected to the bacteria in your digestive system. So, what you eat may affect the health and populations of bacteria in your gut and vagina. But more research is needed in this area.

Live cultured yoghurt and other fermented food, such as kimchi, sauerkraut and kefir, contain good bacteria (Lactobacillus). When you eat these foods regularly, they help maintain good bacteria in your digestive system.

We know that a wholefood diet rich in fruits, vegetables and fibres is associated with good bacteria in the gut. Food such as refined carbohydrates (e.g. white bread and pasta), high sugar foods (e.g. chocolate and cakes) and high sugar drinks (e.g. soft drink and alcohol) may help bad bacteria to grow and flourish.

Probiotics

Probiotics are live microorganisms that, in the right amounts, can improve your health.

Probiotics can be taken orally as a capsule or as a powder. These probiotics contain good bacteria in much higher quantities than what you would get from fermented foods alone.

Some evidence suggests that probiotic supplements can be useful in preventing and treating vaginal infections, especially bacterial vaginosis, but more research is needed to support this.

There are many kinds of probiotic supplements available. Ask your health professional to recommend the best probiotic for you.

When to see your doctor

Sometimes vulval irritation involves a cycle of itching, scratching, skin splitting and then a secondary infection. Many women are embarrassed to discuss their problem and they may ignore symptoms for years before they seek help.

If you are experiencing vulval irritation and your symptoms are not getting better, it’s important to see your doctor. They will take your medical history and ask about your symptoms. If they don’t check your vulva, ask for an examination. You might also need to have a urine test, vulval or vaginal swab, blood test or vulval biopsy. This process will ensure you get the right diagnosis and treatment.

The sooner you seek help, the sooner your symptoms will improve.

Related resources

Download our fact sheets or visit resources for more information, including translated fact sheets.

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at April 2023.