Itchy or sore vulval skin: common conditions

The skin of the vulva can feel sore even when it looks much the same as usual. Vulvodynia is long-lasting pain in the vulva. It often causes discomfort without any change you can see. Itching, dryness or white patches can have other causes that need an examination.

The vulva is the area around the outside of the vagina. When you describe symptoms, say where you feel them: on the outer skin, near the opening of the vagina or in a particular patch. You don’t need to know the name of a condition before asking for help.

Irritation and contact dermatitis

Contact dermatitis is a type of eczema caused by something touching the skin. Soaps and detergents are common causes. The skin may feel itchy and become dry, cracked or blistered. It can look red on lighter skin, or brown, purple or grey on darker skin.

Finding and avoiding the trigger can help. A clinician or pharmacist may suggest an emollient (moisturiser) for the skin. For more severe symptoms, they may sometimes prescribe a steroid cream or ointment. Ask which product suits the area.

White patches and lichen sclerosus

Lichen sclerosus can cause itchy white patches that look smooth or crinkled. The skin can be easily damaged, and may bleed or hurt if rubbed. Over time, the affected skin can become scarred or tight. It isn’t caused by poor hygiene, and you can’t pass it on through sex.

A strong prescribed steroid ointment usually eases the symptoms, though there’s no cure. Follow the clinician’s instructions on how to use it. Ask what follow-up is planned and what changes to report between appointments.

Sore patches and lichen planus

Lichen planus can affect the vulva and other parts of the body, including the mouth. You may notice sore red patches on the vulva, and white patches or burning inside the mouth. Mention symptoms in both places rather than assuming they’re not linked.

You can’t catch lichen planus from someone else. A GP can prescribe creams or ointments to control the rash and itching. Ask how to treat the symptoms on the vulva and what to do if the discomfort carries on.

Pain without a clear skin cause

Vulvodynia means pain in the vulva that lasts at least 3 months without a clear cause. It can affect a small area or the whole vulva. The pain may be there all the time or come and go. It can happen with touch, sex or putting in a tampon.

You can get help before then. NHS advice is to see a GP for pain that doesn’t go away, keeps coming back, or makes sex or putting in a tampon hard. A clinician may gently touch the area with a cotton bud and take a swab to check for infection.

Treatment may involve a gynaecologist, physiotherapist or pain specialist. Medicines can include numbing cream or tablets for nerve pain. ACOG also describes physical therapy that relaxes the pelvic floor and eases muscle tension. Your clinician can talk you through the options.

Care while you arrange an appointment

Avoid scented products and cleaning inside the vagina. Ask a pharmacist about an emollient or soap substitute that suits sore skin. Keep clothes and bedding with emollient on them away from smoking and naked flames, because the fabric can catch fire more easily.

Changes to get checked

Book a GP appointment in the UK, or see your doctor or gynaecologist in the US and elsewhere, for itching that won’t go away, pain that keeps coming back, or white patches. You can ask for someone to be with you during the examination.

Book an appointment for a new lump, thicker skin or a sore that doesn’t heal, especially if you have lichen sclerosus. The risk of cancer linked to it is low, but these changes need checking. Ask your clinician how to check your skin between appointments.