Why is it Itchy Down There?

By Caroline Mathis, MSN, ARNP-BC Nurse Practitioner, The Villages Health

Why is it itchy down there? Is it because it’s warm outside, am I using the wrong soap, or could it be my clothing detergent? There are a multitude of factors that can create an itch in the forgotten pelvic organ, the vulva. The vulva is inherently vulnerable to irritation because the barrier function of the vulvar skin is substantially weaker than that of the skin at other sites.

There are many benign cutaneous conditions that affect the vulva, such as yeast infections, bacterial infections, and contact dermatitis.

The importance of routine checks of the vulva can help distinguish if it is caused by a condition such as lichen sclerosuslichen planus, or lichen simplex chronicus. However, for the post-menopausal women, there is the forgotten vaginal dryness vaginal atrophy.

A basic go-to item would be to apply coconut oil when it’s itchy.

The Importance of Basic Care

The vulva needs basic care with things such as sensitive skin soap and clothes detergent without perfumes and dyes. A basic go-to item would be to apply coconut oil when it’s itchy. The vulva is subjected to very caustic practices with the overzealous washing with antibacterial soap, wet wipes, shaving, waxing, and the use of perfumes.

Contact dermatitis can cause vulvar itching, which is subjected to the frequent use of fragrances, chemicals, shaving, and scented panty liners. The removal of the offending irritant, proper skin care practices, and use of low dose potency topical corticosteroid can usually resolve the issue.

Coping with a Yeast Infection 

Yeast infections can occur from dark moist places in folds of skin and commonly in the vulva area. Addressing a low sugar diet in some cases, and/or applying an anti-fungal and low dose corticosteroid topical ointment can help minimize discomfort. Once the area has resolved, apply a talcum-based powder to dried skin with warm, humid weather. 

Treating Bacterial Infections

Bacterial infections can occur from sexual activity and dark moist places. Many women do not know they have symptoms of bacterial vaginitis, which accounts for about fifty percent of infections. The presence of bacterial vaginitis can increase the risk of developing sexually transmitted infections. Some women who develop frequent bacterial infections are advised to use condoms after treatment for three months in severe cases. Bacterial vaginitis is treated with an anti-microbial, or with pills and creams when they are symptomatic.

Bacterial vaginitis is treated with an anti-microbial, or with pills and creams when they are symptomatic.

Lichen sclerosis is a chronic dermatosis that can cause discomfort and morbidity. Although it is mostly seen after menopause, it can be present in women of any age group, on any part of the body. In many cases, the skin loses its pigment and presents with white plaques. Many patients may not experience any symptoms, but other cases there can be intractable burning pruritus. A biopsy is the gold-standard. It can be treated with topical high potency corticosteroid ointment. Most patients are followed up routinely because it can be associated with squamous cell carcinoma.  

At the Forefront of Women’s Health

Vaginal atrophy has entered the forefront lately due to the increasing age of women. There are a multitude of products to use, both over the counter and prescription-based. The overall goal is for women to limit their caustic practices to the forgotten pelvic organ. Always allow the area to breathe by not wearing underwear at night, and limit the use of protective padding and other barriers that can cause irritation to the vulvar area. 

Not all skin is created equal. Therefore, there are many different reasons why it’s itchy down there. Proper standard vulvar skin care is the most important with sensitive skin soap, chemical free detergent, all cotton underwear, and minimal use of wet wipes.

Last updated : 05.25.2018
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Written byCaroline Mathis

Caroline Mathis, MSN, ARNP-BC is a Nurse Practitioner for Gynecology at The Villages Health® Specialty Care Center in The Villages®, Florida. Originally from Boston, Massachusetts, Caroline received her undergraduate degree from Shenandoah University in Winchester, Virginia. From there, she attended graduate school at the University of Cincinnati. Caroline cared for her ill grandmother when she was a young girl, and her passion for women’s health never left. After providing care for her patients, Caroline wants each one to walk away feeling that they were truly heard regarding their health care concerns. She has lived in Florida since 2001 and has been a Nurse Practitioner for women in the Villages since 2012. When she’s not working, Caroline enjoys walking her dogs, playing softball, and running the occasional 5K.

Coach Image

Written by Caroline Mathis

Caroline Mathis, MSN, ARNP-BC is a Nurse Practitioner for Gynecology at The Villages Health® Specialty Care Center in The Villages®, Florida. Originally from Boston, Massachusetts, Caroline received her undergraduate degree from Shenandoah University in Winchester, Virginia. From there, she attended graduate school at the University of Cincinnati. Caroline cared for her ill grandmother when she was a young girl, and her passion for women’s health never left. After providing care for her patients, Caroline wants each one to walk away feeling that they were truly heard regarding their health care concerns. She has lived in Florida since 2001 and has been a Nurse Practitioner for women in the Villages since 2012. When she’s not working, Caroline enjoys walking her dogs, playing softball, and running the occasional 5K.

The Villages, The Villages Health, America’s Healthiest Hometown, and their associated logos are trademarks of Holding Company of The Villages, Inc., and are used with permission.

Disclaimer: This content is for informational purposes only and it is not meant to be relied on as medical advice, diagnosis, or treatment. Consult your physician before starting any exercise or dietary program or taking any other action respecting your health. In case of a medical emergency, call 911.

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