Recurrent Vulvar Itching and Rash: Causes and Solutions

Recurrent itching and rash in the vulvar area?

The frequency of vulvar itching is quite high.
Whenever there is discomfort in the area between the labia majora and labia minora, I apply a cream called Meikang, which usually restores normalcy after one or two applications.
About a year or two ago, while applying the medication, I noticed small bumps between the left clitoris and the labia majora and minora.
These bumps become more pronounced when itchy and flatten out when not itchy, but they can still be felt.
They disappear quite quickly, with noticeable changes in about three to four hours.
The area has not spread and remains unilateral, appearing as pink to white raised lesions arranged in a linear distribution.
I am unsure if they have a pointed beginning or end, as I cannot see them clearly.
There is no pain, and the bumps appear in areas where I tend to scratch due to severe vulvar itching.
I have no sexual experience but do engage in masturbation, and I have a lifestyle that involves prolonged sitting in a humid environment.
Is this some kind of infectious disease, or is it simply inflammation? Is there a way to make it disappear? Thank you for your response.

aa, 20~29 year old female. Ask Date: 2019/06/10

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your symptom description, it is more likely to be inflammation or an allergy.
I recommend that you see a physician for an examination to determine the underlying cause before any medication is prescribed.
In the meantime, please keep the perineal area clean and dry, avoid tight clothing, ensure adequate sleep, maintain a light diet, and minimize stress and prolonged sitting.
You may also soak in a bath to alleviate symptoms.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2019/06/10

More Info

Recurrent vulvar itching and rash can be a frustrating and uncomfortable experience. Understanding the potential causes and solutions is essential for effective management. Based on your description, it seems that you are experiencing localized itching and the presence of small, pink to white raised lesions in the vulvar area, particularly between the clitoris and the labia.

Possible Causes
1. Contact Dermatitis: This is a common cause of vulvar itching and can occur due to irritation from soaps, lotions, or even laundry detergents. If you have recently changed any products that come into contact with your vulvar area, this could be a contributing factor.

2. Infections: Yeast infections (candidiasis) and bacterial vaginosis can lead to itching and rashes. These infections can cause changes in the normal flora of the vagina and vulva, leading to irritation and discomfort. Given that you mentioned the lesions appear to change in size and intensity, this could suggest an inflammatory response to an infection.

3. Lichen Sclerosus or Lichen Planus: These are chronic inflammatory skin conditions that can affect the vulvar area. They can cause white patches, itching, and discomfort. The lesions you describe could potentially fit this pattern, especially if they are persistent and localized.

4. Genital Warts: Caused by the human papillomavirus (HPV), these can appear as small, raised lesions in the genital area. They may not always be painful but can cause itching and discomfort.

5. Hygiene and Moisture: Prolonged sitting and a humid environment can exacerbate irritation and lead to fungal infections. Maintaining proper hygiene and ensuring the area is dry can help alleviate symptoms.

Management and Treatment
1. Topical Treatments: You mentioned using a cream (杏輝的美康乳膏) that provides relief. This may contain ingredients that soothe irritation or reduce inflammation. However, it's essential to ensure that the cream is appropriate for vulvar use and does not contain irritants.

2. Avoid Irritants: Identify and eliminate any potential irritants in your hygiene routine. Use mild, unscented soaps and avoid douching or using perfumed products in the genital area.

3. Maintain Dryness: After bathing or sweating, ensure the vulvar area is dried thoroughly. Wearing breathable cotton underwear can also help reduce moisture buildup.

4. Consult a Healthcare Provider: Since the lesions are persistent and change in size, it’s crucial to consult a healthcare provider for a proper diagnosis. They may perform a physical examination and possibly recommend a biopsy if there’s concern about conditions like lichen sclerosus or warts.

5. Lifestyle Modifications: Consider lifestyle changes such as reducing prolonged sitting, especially in humid environments. If you engage in activities that may irritate the area, such as vigorous exercise, ensure to wear appropriate clothing that allows for airflow.

6. Regular Monitoring: Keep track of any changes in the lesions or symptoms. If they worsen or new symptoms develop, seek medical attention promptly.

Conclusion
While recurrent vulvar itching and rash can stem from various causes, understanding the underlying issue is key to effective management. Given your symptoms, it is advisable to consult a healthcare professional for an accurate diagnosis and tailored treatment plan. Early intervention can prevent complications and improve your quality of life. Remember, maintaining good hygiene and avoiding irritants can significantly help in managing symptoms.

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