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’Indelicate’ itching: Causes and cures

To put it mildly, itching of the external female genitals, called the vulva, is an uncomfortable symptom. Fortunately, the conditions that cause it are treatable—and often preventable. What’s behind this type of itching? Possible causes include:

  • Scratch-itch syndrome (pruritus vulvae). The symptoms of this condition are few—itching and burning in the genital area—but the possible causes are many. They include seborrheic dermatitis (a skin disorder), an inadequate supply of estrogen (usually before puberty or after menopause) and exposure to a chemical allergen (the culprit could be anything from baby powder to the dye in toilet paper). Discharge from an infection, especially a vaginal yeast infection, can cause vulvar itching. So can exposure to bacteria-laden urine during a bladder infection.
  • Atrophic vulvovaginitis. The estrogen loss that comes with menopause can make vulvar and vaginal skin dry and thin, which may cause itching and burning in those areas. Usually, estrogen cream applied locally will restore skin to a healthier state.
  • Atrophic vulvar dystrophy. This is another condition that can occur after menopause. Vulvar tissue begins to break down, resulting in patches of thickened, dry, itchy, red skin. Eventually, these patches turn white, glossy and very thin. They may spread to cover all or most of the external genital area. As the skin becomes less elastic, the clitoris and vaginal opening shrink.
  • Your doctor may recommend vulvar biopsy to rule out cancer. Treatment may include cortisone cream to relieve itching and a hormone cream to help prevent further degeneration.

  • Cancer of the vulva. This type of cancer is rare, accounting for a small percentage of all cancers of the female reproductive organs. If caught early, vulvar cancer is almost always curable.

Signs include a small, hard, itchy lump or a bleeding or oozing sore in the skin of the vulva. If a tumor is found, it will be surgically removed, along with some surrounding tissue.

In addition to using any medications your doctor prescribes, you can help vulvar skin heal by keeping the area clean and dry, wearing loose clothing and cotton underpants and avoiding pantyhose.