Vulvar itch is incredibly common and very treatable. Here’s what might be behind it.
Contact dermatitis
The vulvar skin is sensitive and easily irritated by everyday products. Soaps, shower gels, laundry detergents, wet wipes, scented pads, and synthetic underwear can all cause redness and itching. Even some creams intended to help can make things worse. Often the solution is straightforward: stop using the trigger and wash only with plain warm water.
Yeast infection (thrush)
One of the most frequent causes of vulvar itch. A yeast infection occurs when Candida, a fungus naturally present in the body, overgrows. Alongside itching, you may notice a thick, white, cottage-cheese-like discharge and burning. Antibiotics, hormonal changes, and a weakened immune system can all trigger it. Antifungal creams or tablets clear it up quickly in most cases.
Bacterial vaginosis (BV)
BV happens when the natural bacterial balance in the vagina is disrupted. It often causes a fishy-smelling, greyish discharge along with itching or irritation. It is not a sexually transmitted infection, but sexual activity can trigger it. Treatment is a course of antibiotics, usually prescribed by your GP.
STIs
Several sexually transmitted infections can cause vulvar itch. Genital herpes can produce itching, tingling, and painful blisters or sores. Trichomoniasis, caused by a tiny parasite, often causes intense itch along with an unpleasant-smelling discharge. Genital warts (caused by certain strains of HPV) can also cause localised itching or irritation. Chlamydia and gonorrhoea sometimes cause vulvar discomfort too, though they are often symptom-free. If you think an STI may be involved, visit your GP or a sexual health clinic. All of these infections are treatable, and testing is straightforward and confidential.
Lichen sclerosus
Lichen sclerosus is a long-term skin condition that causes the vulvar skin to become thin, pale, and fragile. It can be intensely itchy and sometimes painful, particularly during sex. White patches may appear, and the skin can tear or bruise easily. It is more common after menopause but can affect women of any age. It requires treatment, usually a potent steroid cream, to prevent scarring and complications.
Lichen planus
Lichen planus is an inflammatory condition that can affect the vulva and vagina. It may cause painful, raw, or burning areas as well as itch, and can lead to scarring if left untreated. In some women the vaginal lining is also involved, causing discharge or discomfort. It is treated with steroid creams or other anti-inflammatory medications and often needs specialist care.
Lichen simplex
Lichen simplex (also called lichen simplex chronicus) develops from repeated scratching of the vulvar skin, often triggered by another cause initially. The scratching thickens and toughens the skin, which then becomes itchier, creating a hard-to-break itch-scratch cycle. Treatment focuses on breaking that cycle: steroid creams calm the inflammation, and identifying any underlying trigger is key to preventing recurrence.
Genitourinary Syndrome of Menopause
During and after menopause, falling oestrogen levels cause the vulvar and vaginal tissues to become thinner and drier. This is known as genitourinary syndrome of menopause (GSM). Itching, soreness, and discomfort during sex are common. Treatments include vaginal moisturisers, topical oestrogen, or HRT, and they are very effective.
When to see a doctor: If your symptoms are persistent, recurring, or getting worse, book an appointment. Many causes of vulvar itch look similar but need different treatments, so an accurate diagnosis matters. Don’t be embarrassed; your doctor will have seen it many times before.
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