Genital itch refers to the feeling of the skin in the female genital area that makes you want to scratch. It is normal to have occasional itching in that area. However, if the sensation of itch is persistent and you find yourself scratching often, this is abnormal.
There are many possible causes of genital itch. It is important to find the cause of the itch in order to receive the right treatment. Yeast infection is a common causes of itching but there are many other causes. This is why seeing a healthcare professional is important to help get rid of the itching.
Causes of genital itching include:
- Skin diseases: eczema (lichen simplex chronicus), dermatitis, psoriasis, lichen sclerosus, and others
- Irritations: personal hygiene products (lotions, soaps, over-the-counter medications such as Vagisil or prescription medications), laundry detergent, spermicide or lubricants
- Infections: bacterial vaginosis (“BV”), yeast infection (Candida), trichomonas, and others
If you have genital itch your skin might look very normal or you may notice changes in color or texture. Skin may be red or white. The skin may feel thickened or it may be thinned and split easily.
To find the cause of your itching, notify your healthcare professional. They can examine your risk and perform testing to see if there is an infection. Usually the test involves placing a cotton swab on your genitals to collect a skin sample. Or, you might be given a urine test. Rarely, a small biopsy is needed, which can be done in the office. In a biopsy, a piece of skin is removed for testing.
Do not self-treat, especially if the itching does not improve after doing the suggestions below. It is possible that things you are buying to try to help yourself may actually make the itching worse. If the itching is worse, you will begin to scratch more for relief. This is called the itch-scratch cycle. This causes skin to become thicker and itch more. With time, it can develop into a type of eczema called, “lichen simplex chronicus.”
Therefore, it is most important to seek care to find the right diagnosis before using treatment. Treatment depends on the cause. If eczema (lichen simplex chronicus) is the cause, then steroid ointments may help with the itch-scratch cycle and improve the abnormal skin. If it is an infection, your provider will give the right antibiotic or anti-fungal medication. Occasionally there might be more than one thing that needs to be treated. You will need to watch your symptoms. If they do not go away or if they return, you should be seen for another exam. You provider can help with a plan of care.
Things You Can Do
- Stop any medications, creams, lotions, or ointments you are putting on your skin until you see a healthcare provider. This includes over-the-counter products or prescriptions.
- To wash this skin, use plain water and your hands. Avoid rubbing with a washcloth, loofah, or using baby wipes. If you need to use soap, find an unscented gel or cream cleanser.
- Itching is not due to lack of good hygiene. Excessive cleaning will make itching worse by removing the natural “good” oils that help protect the skin. Avoid washing more than once daily.
- Avoid any perfumed products or feminine products such as douches. This includes Vagisil.
- Avoid tight clothing and pantyhose and tights. Wear cotton underwear. Avoid harsh detergents when washing your underwear.
- Try to avoid scratching, if possible. You may need to ask for additional medication for relief from your providers. Anti-histamines often used for seasonal allergies (hydroxyzine or diphenhydramine) can help with itching, especially if used at night. Use these with permission of your provider.
The best way to prevent genital itch is to maintain healthy genital skin and prevent the itch-scratch cycle from returning.
Take Home Points
- There are many possible causes of genital itch. These include irritants, infections, and skin diseases. It is important to find the cause of the itch in order to receive the right treatment.
- Seeing a healthcare professional is usually needed to find both the cause of itch and the correct treatment. They can perform testing to see if there is an infection. Usually the test involves placing a cotton swab on your genitals to collect a skin sample. Rarely, a small biopsy is needed, which can be done in the office. Treatments are then given based on the results of testing.
- Do not self-treat, especially if the itching does not improve after doing our suggestions “Things you can do” noted above.
About the Author
Sarah Bradley, MD is a Female Pelvic Medicine & Reconstructive Surgery physician at Western Carolina Women’s Specialty Center in Asheville, NC. She completed a fellowship at MedStar/Georgetown University in Washington, DC and her residency in Obstetrics and Gynecology at the Mountain Area Health Education Center in Asheville, NC. After residency she spent a year training with Dr. Kiran Sigmon, a specialist in vulvovaginal diseases. Her vulvar clinic receives referrals from all of Western North Carolina. She is a member of the International Society for the Study of Vulvovaginal Disease.
No conflicts of interest to report.