PRURITIS VULVAE

General Information

DEFINITION--An acute or chronic disorder of the skin around the vulva (the vaginal lips). This disorder is characterized by severe itching. It is not contagious. In most instances, it is a symptom of an underlying disorder, and in others, the cause is unknown.

BODY PARTS INVOLVED--Vulva and skin surrounding the vulva and anus.

SEX OR AGE MOST AFFECTED--Female adolescents and adults, especially after menopause.

SIGNS & SYMPTOMS

• Intense itching, sensitivity and irritation in the genital area. The skin may be dry.
• Burning feeling in the genital area.
• Thin, white vaginal discharge (sometimes).
• Discomfort during sexual intercourse.

CAUSES

Skin disease, such as psoriasis or lichen planus. Systemic disease, such as diabetes. Atrophy and dryness caused by estrogen deficiency. > Skin reaction to irritants, such as: toilet tissue; sanitary pads; soap; douches; deodorants; powders; perfume; and fabric.

• Systemic allergies, including food allergies.
• Disorder of the vagina or rectum, such as vaginitis or hemorrhoids.
• Unknown causes in some cases.

RISK INCREASES WITH

• Stress.
• Days prior to menstruation.
• Hot, humid weather.
• Diabetes mellitus.
• Lack of urinary or bowel control.

HOW TO PREVENT

• Wear cotton underpants rather than nylon.
• Avoid contact with irritants listed above.
• Obtain medical treatment for underlying causes.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Diagnostic tests may include laboratory study of vaginal secretions, and if needed, a biopsy (See Glossary) of the vulva.

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment for any underlying cause and more severe symptoms.

POSSIBLE COMPLICATIONS

• Secondary bacterial infection of the inflamed skin.
• Chronic course.

PROBABLE OUTCOME--Home treatment usually provides relief in 4 to 7 days. If medical treatment becomes necessary, allow 2 weeks for recovery.

How To Treat

GENERAL MEASURES--

• Wear cotton underclothes.
• Keep the area as dry and cool as possible. Wear loose clothing.
• Don't scratch the itchy area. Scratching will aggravate soreness and irritation.
• Wash the genital area with water and unscented soap only once a day.
• Use a lubricant, such as K-Y Lubricating Jelly or baby oil, during intercourse.
• After urinating or having a bowel movement, clean the genital area gently with absorbent cotton or antiseptic wipes. Wipe from front to back (vagina to anus).
• During menstruation, use tampons rather than sanitary napkins until the disorder heals.
• Sit in bathtub of warm water several times a day to help relieve itching.

MEDICATION--

• You may use low-potency, non-prescription steroid creams or ointments.
• Your doctor may prescribe: More potent steroid creams or lotions to reduce inflammation. These require 24 to 36 hours to provide relief. Ointments that contain hormones. Medications for any bacterial or fungal infections.

ACTIVITY--Avoid overexertion, heat and excessive sweating.

DIET--

• Avoid foods to which you may be allergic. If you are unsure, try eliminating suspected foods from your diet to see if symptoms get better. Then slowly introduce the foods back into your diet.
• Avoid coffee or other caffeine beverages, tomatoes and peanuts.

Call Your Doctor If

• You have symptoms of pruritis vulvae.
• Symptoms don't improve in 2 weeks, despite treatment.
• Scratching leads to skin infection.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.