Persistent itching of the vagina and frequently the surrounding area (vulva).

Many of the conditions that cause vaginal itching are related to irritation of the skin. Avoid the use of synthetic fabrics, perfumes, or other known irritants in the vaginal area.

• A chemical irritant or medication (including detergents and fabric softeners, chemical sprays, ointments, creams, douches, and contraceptive foams)
• Vaginal infection in conjunction with antibiotic use
• Monilial vaginitis (vaginal yeast infection)
• Vaginal discharge caused by other infections such as trichomonas vaginitis and bacterial vaginosis
• Menopause, as a result of decreasing levels of estrogen
• Pruritus vulvae (a noncontagious condition)
• Vulvovaginitis before puberty (children only)
• Pinworms
• Lichen sclerosis
• Certain skin conditions of the vulvar skin (may be precancerous)

To help prevent and treat vaginal yeast infection:

• Keep the genital area clean and dry. Use plain unscented soap.
• Take showers rather than tub baths.
• Wear cotton panties or pantyhose with a cotton crotch. Avoid panties made from synthetic materials. For infants and toddlers, change diapers often.
• Change out of wet clothing, especially wet bathing suits or exercise clothing, as soon as possible after completion of the activity.
• Avoid douches -- they may make the itching worse.
• Ask your health care provider about eating yogurt, sour cream, and buttermilk, or taking acidophilus tablets when taking antibiotics.
• After urination or bowel movements, cleanse by wiping or washing from front to back (vagina to anus).
• If obese, lose weight.
• Avoid broad-spectrum antibiotics unless absolutely necessary.

Avoid scratching -- this will only aggravate the problem. Avoid overexertion, heat, and excessive sweating. Keep the genital area clean and dry. Sexual activity might need to be delayed until symptoms cease.

It may be helpful to use a lubricant, such as K-Y Lubricating Jelly, during intercourse. Low-potency, nonprescription steroid creams or ointments (corticosteroids) may be effective in treating symptoms.

For vaginal itching associated with diabetes mellitus, follow prescribed therapy for treating the underlying disease (mycotic vulvar infection). Adhere strictly to your prescribed treatment program.

For vaginal itching caused by vulvovaginitis before puberty, follow recommendations above for prevention of vaginal yeast infection. In addition, avoid using colored or perfumed toilet tissue, scented soap, and bubble bath.

If antibiotics are prescribed for any reason, yogurt may help reduce the risk of developing vaginal itching by preventing vaginal yeast infections.

Teach children to resist and report any attempted sexual contact by another person. Don't try to remove any foreign object from a child's vagina. Take the child to the health care provider for removal.

• Symptoms worsen or persist longer than 1 week.
• There is unusual vaginal bleeding or swelling.

The medical history will be obtained and a physical examination performed.

Medical history questions documenting the vaginal itching in detail may include:

• Time pattern
  • When did the itching begin?
  • Has it occurred before?
• Quality
  • Is the itching severe?
  • Does it limit activities?
  • Is it getting better or worse?
• Location
  • Is the itching confined to the interior of the vagina?
  • Is the itching on the external vaginal area (vulva)?
• Aggravating factors
  • How often do you bathe?
  • Do you usually shower or use the bathtub?
  • Do you use scented soap, scented or colored toilet paper or bubble bath?
  • Do you frequently swim or participate in water sports?
  • Do you wear cotton panties or synthetic ones?
  • Do you wear tight pants or tight pantyhose?
• Relieving factors
  • What helps?
  • Have over-the-counter creams been tried? What kind?
  • Have douches been tried? What kind? How often?
• Other
  • What other symptoms are present?
  • Is there a family history of diabetes?
  • Is there vaginal bleeding?
  • Is there swelling?
  • Is there a rash?
  • Is there difficulty or pain on urination?
• Additional important information
  • What medications are being taken?
  • What is your menstrual history (complete history)?
  • Do you have any allergies?
  • Are you sexually active?
  • Do you use creams, deodorant sprays, or lubricants?
  • Do you use contraception? What type?

The physical examination may include a pelvic examination.

Diagnostic tests that may be performed include:

• Culture and microscopic exam of vaginal discharge
• Pap smear
• Urine and blood studies (including hormone levels)
• Skin biopsies of the vulvar area

Intervention:
Antifungal drugs may be prescribed for yeast infections. When indicated, steroid creams or lotions may be prescribed to reduce inflammation. Ointments containing hormones may be ordered, and benzodiazepines or antihistamines may be prescribed for nighttime relief.

After seeing your health care provider:
You may want to add a diagnosis related to vaginal itching to your personal medical record.