What is vulvitis?
Vulvitis is an inflammation of the vulva. The vulva is defined as the area outside the vagina between the legs and includes:
- Mons pubis — fatty pads that are covered with pubic hair.
- Labia — Commonly referred to as the "lips of the vagina".
- Labia majora — hair covered fatty mounds referred to as the outer lips.
- Labia minora — thin, wrinkled area referred to as the inner lips.
- Creases where the legs are attached to a woman's body.
What are the causes of vulvitis?
Vulvitis is generally caused by chemical irritation or a breakdown in the skin of the vulva. Several potential causes include:
- Yeast infections.
- Bacterial infections.
- Maceration caused by constant rubbing or scratching of the vulva, which then leads to a breakdown in the skin and irritation.
What are the symptoms?
One of the most common symptoms of vulvitis is intense itching. Chronic vulvitis is a condition that is difficult to treat and requires ongoing therapy over several months to years. Other symptoms include:
- reddened skin
- cracks in the skin
How is vulvitis diagnosed?
You can help to diagnose vulvitis by looking at the vulva in a mirror. If you notice the common symptoms stated above, you may then try to do some treatments at home. Those are listed below. However, if these do not resolve your symptoms, you will need to come to the office for a pelvic exam. A sample of vaginal discharge may also be taken and examined under a microscope to look for the cause of vulvitis.
How can I treat vulvitis at home?
Vulvitis is best treated with local vulvar hygiene. The following are local measures that are important to do to control vulvitis:
- Women should wear cotton underpants.
- Women should wash the cotton underpants in Dreft baby detergent or any detergent that is made for sensitive skin and are free of dyes and perfumes.
- Women who have a severe form of vulvitis should wash their clothes in these detergents for the first 2 or 3 months.
- It is advisable to take short, cool showers to avoid drying out the skin.
- Dove or Ivory unscented soap is also recommended to avoid drying out the skin of the vulva.
- It is important to wash only the hairy areas of the outside of the vagina. Do not wash inside the vagina or part to labia (lips of the vagina), and wash at the entrane of the vagina.
- Women should not douche, except under the advice of the physician. Women should not use feminine deodorant sprays, especially women who have vulvitis.
- Women should not shave the pubic hair, which is a common initial irritant to the skin, causing vulvitis.
- It is advisable not to use any powders on or around the vulva. The only exception would be unscented corn starch in small amounts.
What types of clothing should I wear?
It is advisable to wear loose fitting clothing or dresses. If you are able to, when you are around the house, wearing a dress with no underwear will decrease the moisture around the vulva.
What treatments will my doctor recommend?
- Aveeno sitz baths, twice a day can soothe women who have intense itching.
- It is recommended that all women after showering or sitz bath, thoroughly dry the vulva and the pubic region with a dry towel. Do not rub. Pat gently.
- Dry the vulva thoroughly with a blow dryer on a cool setting. If you do not have a hair dryer with a cool setting, lay down on your bed with you knees bent and your legs drawn up. Separate your legs in the frog position and allow the vulva to completely dry. It would take approximately 15 minutes. You should do this twice a day for the first 2 to 3 months, after which, it can be done on an as needed basis to control vulvitis.
- Lidex is an anti-inflammatory steroid medication. This is very helpful in treating vulvitis and it is a prescription medication.
- Vasoline can be used over top of the steroid cream to help protect the skin from further irritation.
- Vistaril, Atarax, and Benadryl are antihistamines that are also used to treat the itching associated with vulvitis. These are medications that are taken by mouth.
How can I prevent vulvitis?
Because women who are overweight tend to have thighs that rub against each other and also retain moisture in the area on the vulva, it is recommended to lose weight. Other general measures include attempting to identify any chemical or irritant that you may be unknowingly exposing your body to is hard to do. Some commonly overlooked irritants are:
- Scented toilet paper.
- Deodorant pads or other sanitary napkins that may have fibers bleaced with formaldehyde to whiten the pad.
- Urine is also a common cause for chronic vulvitis. If a woman has urine incontinence, unable to control the flow of her urine, this is a potential irritant to the skin of the vulva.