Vaginal itching may involve the vagina or the genital area (vulva), which contains the external genital organs. Itching is an unpleasant sensation that seems to require scratching for relief.
Many women occasionally have short episodes of vaginal itching that resolve without treatment. Itching is considered a problem only when it persists, is severe, recurs, or is accompanied by a discharge (see Symptoms of Gynecologic Disorders: Vaginal Discharge).
The most common causes of vaginal itching include the following:
Less common causes include skin disorders such as psoriasis (see Psoriasis and Scaling Disorders: Psoriasis) and lichen sclerosus. Lichen sclerosus is characterized by thin white areas on the vulva around the opening of the vagina. If untreated, lichen sclerosus can cause scarring and may increase the risk of cancer of the vulva.
Doctors can usually determine the cause by asking about symptoms and by examining the genital area and vagina.
There are no warning signs for vaginal itching unless it is accompanied by pain and/or discharge. Then, the warning signs are the same as those for pelvic pain (see Symptoms of Gynecologic Disorders: Warning signs) and/or vaginal discharge (see Symptoms of Gynecologic Disorders: Warning signs).
When to see a doctor:
Women should see a doctor if itching lasts more than a few days or if other symptoms suggesting an infection develop.
What the doctor does:
Doctors first ask the woman questions about her symptoms, particularly whether she has any symptoms of infection, and about her medical history. She is also asked whether she uses any products that may irritate the area. Doctors then do a physical examination, which focuses on the pelvic examination.
If women have a discharge, a sample of the discharge is taken, examined, and analyzed.
The underlying condition is corrected or treated when possible. General measures can help relieve symptoms.
Changing underwear and bathing or showering once a day help keep the vagina and genital area clean. More frequent washing may cause excessive dryness, which can increase itching. Using a cornstarch-based unscented body powder can help keep the genital area dry. Women should not use talc-based powders. A nonallergenic soap should be used. Other products (such as creams, feminine hygiene sprays, or douches) should not be applied to the vaginal area. These general measures may minimize exposure to irritants that cause itching.
If a medical product (such as a prescription cream) or a brand of condom appears to cause irritation and itching, it should not be used. Women should talk to their doctor before they stop using prescription products.
Applying a mild (low-strength) corticosteroid cream such as hydrocortisone to the genital area may provide temporary relief. The cream should not be put into the vagina and should be used for only a short period of time. For severe itching, an antihistamine taken by mouth may help temporarily. Antihistamines also cause drowsiness and may be useful if symptoms interfere with sleep.
Lichen sclerosus is treated with a cream or an ointment containing a high-strength corticosteroid (such as clobetasol), available by prescription.
Last full review/revision May 2012 by David H. Barad, MD, MS