6 reasons why your vaginal area feels itchy and irritated

It’s not always an STD

It started out with an itch. How did it end up like this? It was only an itch… it was only an itch. Now you’re falling asleep, but in between dreams of eating an entire chocolate cake while on a diet (there is a healthier option you can try) and acting out the delightfully unhinged book you just finished, a sudden rush of blood to your hand makes you want to do the thing you’re not supposed to. Scratch at the itchy, burning sensation between your legs. That’s how a lot of vulvar skin conditions begin.

While we refer to it as the vagina, or the vaginal area, what you’re actually talking about is the vulva, which includes the external female genitalia, including the labia, clitoris, urethral opening, and vaginal opening.

Dr Vandana Punjabi says that itching and vulvar skin conditions are common, having observed it in her dermatology practice of more than 25 years. There are many different kinds, some caused by STDs, though many aren’t.

She shares an example of a 40-year-old patient with severe itching in the vulvar area for the past four years. “Due to the constant scratching, the skin had become very dark and thickened. She couldn’t have sexual intercourse because of the itching.” Punjabi, a consultant dermatologist and trichologist practising at Khar and Nanavati Max Superspeciality Hospital, diagnosed her with lichen simplex chronicus, and her patient’s symptoms were relieved in two months. “So many women suffer from vulvar itching, but they are afraid to meet the doctor as they feel these may be sexually transmitted diseases and are scared of being judged.”

“The taboo of sex leads to fear of seeking help even if it’s an STD – which in most cases can be treated and cured. But because of shame, people stay away from doctors (and some doctors don’t make it easy), and the condition may worsen. A UTI can become a kidney infection. There are so many treatable conditions that have nothing to do with sex,” says obstetrician-gynaecologist Rukhsana Hashim.

Six vulvar skin conditions that could be making you itch

Genital psoriasis

Psoriasis is a chronic autoimmune condition that causes the rapid buildup of skin cells, leading to thick, scaly, and inflamed patches on the skin. When it affects the genitals, it is referred to as genital psoriasis.

Genital psoriasis can affect various parts of the genital area, including the vulva, penis, scrotum, and surrounding skin. The skin appears red and scaly with cracks, says Dr Sneha Ghunawat, consultant dermatologist and cosmetologist, director, and co-founder of Meraki Skin Clinic, Gurugram. Genital psoriasis can be accompanied by terrible itching, soreness and immense discomfort and, given the sensitive nature of the affected area, can be challenging to treat,. It affects 2% of people with psoriasis, adds Ghunawat.

Eczema of the vulva

Eczema, or atopic dermatitis, is a chronic skin condition characterised by inflammation, itching, redness, and skin dryness. Eczema, which affects your vulvar area, is also known as vulvar dermatitis and can cause discomfort, itching, burning sensations, and sometimes pain. In addition, the affected skin may appear red, swollen, and dry, and in some cases, there may be oozing, crusting, or thickening of the skin. Scratching the area can further aggravate symptoms and lead to complications.

Various factors can trigger vulvar eczema, including irritants, allergens, hormonal changes, stress, or a compromised skin barrier.

Lichen planus

Lichen planus is a chronic inflammatory condition where the body’s immune system mistakenly attacks its own tissues. Vulvar lichen planus presents various symptoms, including itching, burning sensations, soreness, and tenderness in the affected area. The severity of symptoms can vary among individuals, and Ghunawat says that the lesions tend to be persistent, resolving over months to years.

Certain triggers, such as stress, hormonal changes, or irritants, may exacerbate the condition.

Lichen sclerosis

It is an inflammatory skin condition primarily affecting the genital and anal areas. It most commonly affects women – postmenopausal women are at higher risk – but anyone can develop this condition.

Lichen sclerosus causes thinning, whitening, and tightening of the skin, leading to itching, discomfort, and pain. The skin starts to appear pale and wrinkled. Over time, the condition can cause scarring, adhesions, and changes in the structure of the affected area.

The exact cause of lichen sclerosus is unknown, but it is believed to be an autoimmune response or related to hormonal imbalances. In addition, genetic predisposition, trauma or injury to the area, and certain infections are also considered contributing factors.

Vulvar lichen simplex chronicus (LSC)

Punjabi describes LSC as ‘chronic eczema’. Also known as neurodermatitis or lichen simplex, it’s a chronic skin condition characterised by thickened, leathery, and intensely itchy skin in the vulvar area.

Lichen simplex chronicus typically develops as a response to repeated scratching or rubbing of the vulvar skin, often due to an initial irritant or underlying condition. Persistent scratching can lead to a cycle of itching, scratching, and skin thickening, resulting in the characteristic lichenification (thickened skin) seen in LSC.

The primary symptom of vulvar lichen simplex chronicus is intense itching, accompanied by redness, scaling, and a leathery texture of the affected skin. Unfortunately, the itch-scratch cycle can worsen symptoms and make it feel like you’re stuck in an endless loop of discomfort, but experts have solutions to ease your pain.

Allergic contact dermatitis (ACD)

Ghunawat says allergic reactions can occur due to irritation from applying creams and ointments with harsh chemicals. It causes irritated, red, swollen and itchy skin around the vagina. It can also react to the skin’s contact with certain fabric materials or detergents that contain triggering ingredients, including latex in condoms.

Best hygiene practices for vulvar health

Gentle cleansing: Use warm water and a mild, unscented soap to clean the external genital area. Avoid using harsh soaps, douches, or fragrant products that can disrupt the natural pH balance and irritate the delicate skin.

Proper wiping technique: When using the toilet, always wipe from front to back to prevent the spread of bacteria from the anus to the vulva.

Pat dry gently: After washing, pat the vulva area dry with a clean, soft towel. Avoid rubbing vigorously, as it can cause irritation and microtears in the skin.

Wear breathable underwear: Choose underwear made from breathable fabrics like cotton (we have some options), which allows air circulation and helps prevent moisture buildup. Tight-fitting, synthetic underwear can trap heat and moisture, promoting bad bacterial growth.

Change out of damp or sweaty clothes: Whether it’s post workout or on a hot summer’s day, if you’re hot and sweaty, then change into dry clothes as soon as possible. Wearing damp or sweaty clothing for prolonged periods can create a moist environment that encourages bacterial or fungal growth.

Use unscented sanitary products: When using menstrual products, opt for unscented pads, tampons, or menstrual cups. Scented products can contain ingredients that may cause irritation or allergic reactions.

Avoid unnecessary intimate products: Set aside the scented wipes, vaginal washes, sprays, or powders. They can disrupt the natural pH balance and cause serious irritation. Your vagina is a self-cleaning oven, and does not require any additional scrubbing and washing with soap – unless specified by your healthcare provider.

Pick the right personal lubricants: If needed, use water-based lubricants during sexual activity to reduce friction. Ditch the ones with fragrance or ‘flavours’ if you want to avoid the risk of vulvar skin conditions.

A note of caution: This story is for educational purposes with inputs from trained experts. Please consult your healthcare provider to know what treatment plan suits your needs.