GENITAL ITCH IN WOMEN
GENITAL ITCH IN WOMEN
What is it and is it important?
Itch is the feeling on the skin that makes you want to scratch. Genital itch in women refers to itching in the female genital area. Occasional itch is common and may be normal. Persistent itch is not normal and can interfere with daily living; it is important to find the cause so that you can be given the right treatment.
What causes it?
Most women assume that all genital itching is due to yeast/ thrush (Candida) infection. Although itching is a frequent symptom of infections such as yeast/ thrush, there are several other causes:
- Skin disease e.g. eczema/ dermatitis, psoriasis, and other less common skin disorders such as lichen sclerosus
- Irritation from sweat, tight clothing, or personal hygiene products (soaps, detergents, spermicides)
- Genital infections e.g. bacterial vaginosis, trichomoniasis
What do I see?
There may be nothing to see; in other cases, changes in color, surface, or texture may occur, depending on the cause. The skin color may be altered to red, white or brown. The surface may be dry and scaly, or wet and weeping. The texture may thicken. This can be due to prolonged rubbing and scratching, or an underlying skin condition, or both. As it becomes thicker, it itches more, and so an ‘itch-scratch cycle’ is set up. Although you may be able to stop yourself from scratching during the day, you may unknowingly scratch when you are asleep. Continuous scratching could tear the skin and lead to slight bleeding, burning, or soreness.
How do I find the cause of my itch?
It is important to see your health care provider to diagnose the cause of your symptoms and receive the correct treatment. Your health care provider will examine your skin. If an infection is suspected, it can be confirmed by a swab (culture) or a skin scraping (for fungal infection). For some of the less common skin problems, a biopsy may be needed. This is a simple procedure where a tiny piece of skin is removed, so that it can be studied under the microscope to confirm the diagnosis. It can usually be done under local anaesthetic, in your health care provider’s office.
How is it treated?
DO NOT SELF-TREAT.
As with most problems, the treatment depends on the cause. Your health care provider will recommend appropriate treatment. For example, if you have eczema, mild steroid creams or ointments are used; for other types of skin problems, you may need stronger steroid preparations. These are quite safe to use as long as they are monitored by your health care provider. You should follow his/ her advice and finish the course of treatment. If symptoms persist, return to your health care provider. In some skin conditions that cause itching, treatment may be required intermittently. Your health care provider can advise you about a maintenance plan.
What can I do to help myself?
- Stop any creams or topical treatment, including those you have bought over the counter, and see your health care provider.
- Using plain water or saline is the most gentle way to wash the vulva. If a cleanser must be used, try a mild hypoallergenic scent-free product, instead of a scented soap, gel or cream cleanser.
- Avoid excessive washing. Itching is not due to lack of hygiene. Excessive cleaning will remove the protective natural oils on the vulvar skin, and further dry and irritate the skin.
- If the area is dry and irritated, use a thin film of plain petrolatum (but no other products) to seal in moisture and protect the skin, while awaiting advice from your health care provider
- Avoid feminine hygiene sprays and other perfumed products
- Wear cotton underwear, as synthetic clings and may increase heat and sweating.
- Avoid tight clothing & pantyhose
- Use mild unscented hypoallergenic laundry detergents to wash your under wear
- Use ‘all cotton’ sanitary pads or tampons when required.
- Avoid getting too hot at night with heavy blankets or duvets, as itching will be made worse by warmth. Avoid wearing underwear at night that may make you warmer.
What can I do to stop the problem from coming back?
Do Not Scratch! Although you may feel itchy at times, especially at night or at times of stress, and may find yourself involuntarily scratching, this itch-scratch response is potentially harmful, as it can damage the skin, and keep symptoms going for quite some time.
There are several strategies to help to minimize the itch:
First and foremost, the condition needs to be managed properly (this is a job shared by you and your doctor). The second is distraction, which only you can do. For example, if the itch is unbearable, rather than feeling uncomfortable and unable to resist scratching, find something else to occupy your mind and your hands. Soon the tension from the itch will be reduced. It is also best to keep your nails filed down, so that scratching in your sleep will not cause too much damage.
Several medications may provide additional relief. For night time symptoms, a first generation antihistamine, such as hydroxyzine or diphenhydramine, taken before bed, could be very helpful. If anxiety is an issue, an anti-anxiety regimen, such as a selective serotonin reuptake inhibitor, should be considered.
International Society for the Study of Vulvovaginal Disease
Patient Information Committee