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Vulvitis

By

Oluwatosin Goje

, MD, MSCR, Cleveland Clinic, Lerner College of Medicine of Case Western Reserve University

Last full review/revision Sep 2019| Content last modified Sep 2019
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Vulvitis is inflammation of the vulva. When both the vulva and vagina are inflamed, the disorder is called vulvovaginitis.

The vulva is the area surrounding the opening of the vagina and containing the external female genital organs.

External Female Genital Organs

External Female Genital Organs

Causes

Vulvitis may result from

  • Allergic reactions to substances that come in contact with the vulva (such as soaps, bubble bath, fabrics, and perfumes)

  • Skin disorders (such as dermatitis)

  • Infections, including yeast infections and sexually transmitted diseases (such as herpes)

  • Infestation with pubic lice—a disorder called pediculosis pubis

  • Irritation by urine or stool if it remains in contact with the vulva (as may occur in women who have incontinence or are confined to bed)

Contact with urine and stool sometimes causes ongoing (chronic) vulvitis.

In children, infections of the vagina may also affect the vulva. These infections may be due to bacteria from the anus or other bacteria.

Symptoms

Vulvitis causes itching, soreness, and redness. Rarely, the folds of skin around the vaginal and urethral openings (labia) become stuck together. Chronic vulvitis may result in sore, scaly, thickened, or whitish patches on the vulva.

Diagnosis

  • A doctor's evaluation

Doctors examine the vulva to check for redness and changes in the skin and check for a discharge from the vagina. They also ask questions about the discharge (if present), about possible causes of the symptoms, and about hygiene.

To check for other infections, doctors typically do a pelvic examination, and if a discharge is present, they examine it under a microscope. The doctor may also use a swab to take a sample of fluid from the cervix. The sample is tested for sexually transmitted diseases.

Treatment

  • General measures

  • Hydrocortisone or estrogen cream

Various treatments may be tried for vulvitis. They include

  • Avoiding substances that can irritate the vulva

  • Keeping the vulva clean and dry

  • Sitting in a sitz bath containing soothing substances (to help control the itching)

  • Applying hydrocortisone or estrogen cream to the vulva

If chronic vulvitis does not respond to treatment, doctors usually do a biopsy to look for the cause, such as skin disorders of the vulva (vulvar dystrophies, such as lichen sclerosus or squamous cell hyperplasia) or cancer.

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