Vulvitis
Vulvitis is the inflammation of the vulva, the external female genital area. The vulva includes the soft, folded skin surrounding the vagina, comprising the labia majora (outer folds), labia minora (vaginal lips), and the clitoris. Inflammation of the vulva can occur due to various factors, including infections, allergic reactions, or injuries that irritate the skin in this region.
The vulva, being a warm and moist area of the body, is particularly susceptible to irritation and infection.
Vulvitis vs. Vaginitis
Both vulvitis and vaginitis refer to inflammation affecting the female reproductive organs, but they target different areas. Vulvitis pertains to inflammation of the external genitals, specifically the vulva. Vaginitis involves inflammation of the vagina, which is located internally within the body. When inflammation affects both the vulva and the vagina, it is termed vulvovaginitis.
Gynecologists may use these terms interchangeably in clinical practice.
Who is Susceptible to Vulvitis?
Vulvitis can affect anyone with a vulva, but it is more commonly observed in children and individuals who have reached menopause. Prepubescent individuals assigned female at birth have lower estrogen levels compared to menstruating individuals. Postmenopausal individuals also experience reduced estrogen levels, resulting in thinner and drier vulvar tissues. This can increase the risk of injury and inflammation.
Symptoms and Causes
Symptoms of Vulvitis
Vulvitis can manifest with various symptoms, including:
- Itching
- Burning
- Vaginal discharge
- Small cracks on the skin of the vulva
- Blisters on the vulva that may rupture, ooze, and form crusts
- Redness and swelling of the inner labia (vaginal lips) and other parts of the vulva
- Thick, whitish patches of scaly skin on the vulva
These symptoms are common and may resemble those of numerous genital disorders or diseases. Therefore, it is advisable to consult a healthcare provider if any of these symptoms are noticed.
Causes of Vulvitis
Vulvitis can result from various factors, including infections, allergies, irritants, and injuries. Some potential causes of vulvitis include:
- Dyed or scented toilet paper
- Scented or harsh ingredient-containing pads, pantyliners, or tampons
- Bubble baths, soaps, vaginal sprays, and douches containing harsh ingredients
- Prolonged use of a wet bathing suit or sweaty workout clothing
- Irritation from chlorinated swimming pool or hot tub water
- Synthetic underwear that traps moisture and irritates the vulva
- Laundry detergents and fabric softeners that irritate the skin
- Injuries from activities like cycling or horseback riding
- Allergic reactions to spermicides
- Skin conditions such as eczema or dermatitis
- Fungal or bacterial infections, including yeast infections, scabies, and pubic lice
- Viral infections, such as genital herpes
- Vaginal atrophy during menopause
Is Vulvitis Contagious?
Vulvitis itself is not contagious, although some of its underlying causes can be. For instance, many bacteria that cause vaginal infections can be highly contagious. However, vulvitis resulting from allergies or skin irritation is not contagious.
Diagnosis and Tests
How is Vulvitis Diagnosed?
Diagnosing vulvitis involves a comprehensive evaluation by a healthcare provider. The diagnostic process typically includes the following steps:
- Review of Medical History: The healthcare provider will inquire about the patient’s medical history and symptoms, along with their hygiene practices.
- Physical Examination: A physical examination and a complete pelvic exam are conducted to assess the vulva and vaginal area. The healthcare provider will look for any signs of vulvitis, such as redness, blisters, or lesions.
- Fluid Analysis: In some cases, the vaginal fluid may be tested to detect signs of infection.
Additional tests that may be ordered include urine tests, blood tests, STI tests, and pap smears. Since multiple conditions may present with similar symptoms, these tests help the healthcare provider pinpoint the specific cause of vulvitis, whether it is an infection, irritation, or a skin condition. Subsequent treatments are then recommended based on the diagnosis.
Management and Treatment
What is the Treatment for Vulvitis?
The treatment for vulvitis depends on the underlying cause of the inflammation. In many cases, symptom relief can be achieved by protecting the vulva from potential irritants and practicing proper vulvar care. Treatment recommendations may include:
- Avoiding Vulvar Irritants: Discontinuing the use of products like feminine hygiene items, soaps, and detergents that may irritate the vulva. Wearing loose-fitting, breathable, white cotton undergarments is advised to allow for better ventilation and minimize irritation.
- Topical Creams: Healthcare providers may prescribe over-the-counter hydrocortisone ointment to alleviate irritation and itching. In some cases, a topical estrogen cream may be recommended to alleviate itching and other vulvitis symptoms.
- Sitz Baths: Taking regular sitz baths, which are shallow, warm baths, can help relieve itching and burning associated with vulvitis.
If initial treatments do not provide relief, or if the healthcare provider suspects rarer, more serious conditions, such as lichen sclerosus or vulvar cancer, further diagnostic tests and targeted treatments may be necessary.
Treatments to Avoid
Attempting to self-diagnose and self-treat vulvitis is discouraged. While many people may purchase over-the-counter anti-itch products to alleviate symptoms, doing so without proper guidance can worsen the condition and prolong itching and irritation. Seeking guidance from a healthcare provider is essential to receive the correct treatment.
Prevention
Can Vulvitis Be Prevented?
Adopting good vulvar care practices can help prevent vulvitis. These practices include:
- Using mild, unscented soaps and warm water for genital cleaning, or using water alone.
- Avoiding douching and refraining from using fragranced feminine products, such as tampons, pads, and pantyliners.
- Changing into clean, dry clothing promptly after swimming or exercising.
- Wearing breathable, loose-fitting cotton underwear during the day.
Outlook and Prognosis
What is the Prognosis for Vulvitis?
The prognosis for vulvitis is generally positive, as vulvar inflammation is a common issue, and most individuals experience relief once treatment is initiated.
How Long Does Vulvitis Last?
The duration of vulvitis can vary, but with appropriate treatment, itching and other symptoms can usually be relieved within a few weeks, depending on the underlying cause.
Living With Vulvitis
Self-Care Tips
If any symptoms of vulvitis are noticed, it is advisable to consult a healthcare provider promptly. Without treatment, vulvar inflammation may progress to an infection, as the vulvar and vaginal environment is conducive to bacterial growth. A healthcare provider can help prevent complications and infections by prescribing suitable treatments.
Questions to Ask Your Healthcare Provider
When consulting a healthcare provider regarding vulvitis, individuals may consider asking the following questions:
- What tests are necessary to determine the cause of my vulvitis?
- Has the inflammation affected both my vulva and vagina, or is it limited to my vulva?
- What treatments do you recommend?
- How long should it take for my symptoms to resolve?
- What are the best practices for vulvar and vaginal care to prevent inflammation and irritation?
Additional Common Questions
What Does Vulvovaginitis Look Like?
With vulvitis or vulvovaginitis, the genitals may appear red or swollen. The skin may exhibit scaliness, whiteness, and patches, and blisters may be present. In severe cases, the skin can become so irritated that it adheres together. It is crucial to seek an appointment with a healthcare provider if the vulva appears or feels abnormal.
What is a Whiff Test?
A whiff test is conducted when a healthcare provider suspects that inflammation is related to a common vaginal infection known as bacterial vaginosis (BV). Key symptoms of BV include the presence of an off-white or gray discharge and a fishy odor. During a whiff test, the provider assesses the smell of the discharge (referred to as taking a “whiff”) to determine if it has a fishy odor.