Vulvar itching is a relatively common symptom among women, occurring from childhood to old age, though it is more prevalent in menopausal women. The areas most frequently affected are the clitoris and the inner and outer sides of the labia minora. In severe cases, itching may spread to the entire perineum, labia majora, and even the perianal region. It is often paroxysmal, appearing suddenly and subsiding or diminishing after a short period.
Common causes include:
⑴ Chronic local irritation: Most frequently caused by excessive discharge from vaginitis. Reduced acidity in secretions alters the vaginal bacterial flora, increasing susceptibility to local inflammation.Many individuals also experience thinning of the vulvar skin with loss of subcutaneous fat, leading to atrophic changes. This can extend across the entire vulva and perianal area, manifesting as skin wrinkling, hardening, and whitening, often complicated by vulvar dermatoses.These changes continuously stimulate the nerve endings in the area, causing persistent, unbearable vulvar itching that can be difficult to distinguish from skin conditions such as lichen sclerosus or vulvar leukoplakia.
⑵ Irritation from urine, sweat, and anal secretions.
⑶ Vulvar varicose veins: These cause skin nutritional disorders and altered peripheral nerve excitability, leading to itching. Repeated scratching may result in secondary chronic eczema, simple lichenoid sclerosis, hyperkeratosis, or even progress to vulvar leukoplakia.
(4) Vulvar dermatoses secondary to systemic skin diseases: such as psoriasis, seborrheic dermatitis, chronic eczema, and lichen planus.
⑸ Systemic diseases: Such as vitamin A and B complex deficiencies; jaundice, leukemia, and diabetes. Severe cases may present with localized or generalized itching.
What to do about vulvar itching?
1. Wear loose, breathable 100% cotton underwear. Wash, change, and air-dry frequently to maintain vulvar cleanliness and dryness.
2. Maintain vulvar hygiene using dedicated cleaning tools, adhering to the principle of "one person, one basin, one towel, one water source." Boil a small washcloth in a basin for 15 minutes, then cool before use. Trim nails and wash hands thoroughly before cleansing. Clean and air-dry all tools after use.
4. Maintain menstrual hygiene using certified sanitary pads. Avoid sexual intercourse during treatment; both partners should undergo concurrent treatment if necessary.
5. Use and launder clothing, bedsheets, and pillowcases separately to prevent household transmission. Take special care to protect female infants and young girls from infection.