Vulvar Itching: Causes, Symptoms, and When to See a Doctor

Genital itching

Vulvar itching sometimes leads to bleeding from scratching! After scratching, there is a sensation of heat.
Hormonal levels are normal, and there is no foul odor.
Since the scratching, the vulva has become darker and has some white patches.
After the bleeding, it seems to scab over with a white appearance, and sometimes there are pimples.
There has been no sexual intercourse or masturbation.
What could be the reason for this? It has been affecting me for two years.
Can a 12-year-old see a gynecologist on their own? If it is a vulvar issue, which specialty within gynecology should I consult? Will the doctor examine the vulva, or do I need to describe my symptoms? If I have difficulty describing, can the doctor perform an examination for confirmation? How much does a consultation typically cost?

Yuan, 10~19 year old female. Ask Date: 2022/10/06

Dr. Huang Yuande reply Obstetrics and Gynecology

It is recommended to consult an obstetrician-gynecologist for evaluation of chronic dermatitis, pubic lice, or folliculitis.
This is not age-related, and usually, a diagnosis can be made at a glance.

Reply Date: 2022/10/06

More Info

Vulvar itching can be a distressing and uncomfortable condition that may arise from various causes. Understanding the underlying reasons for this symptom is crucial for effective management and treatment. In your case, the symptoms you describe—itching, bleeding from scratching, changes in skin color, and the presence of white patches—suggest that a thorough evaluation is necessary.

Causes of Vulvar Itching
1. Infections: One of the most common causes of vulvar itching is infections, including yeast infections (candidiasis), bacterial vaginosis, and sexually transmitted infections (STIs). While you mentioned that there is no foul odor, which is often associated with bacterial vaginosis, it is still essential to rule out other infections.

2. Skin Conditions: Conditions such as eczema, psoriasis, or contact dermatitis can lead to itching and irritation. These conditions may cause changes in skin color and texture, which could explain the darkening and white patches you observe.

3. Allergic Reactions: Allergies to soaps, detergents, or personal care products can cause localized irritation and itching. If you have recently changed any products, this could be a contributing factor.

4. Hormonal Changes: Hormonal fluctuations, particularly during puberty, menstruation, or due to hormonal imbalances, can lead to vulvar itching. However, you mentioned that your endocrine levels are normal, which may reduce the likelihood of this being a primary cause.

5. Hygiene Practices: Over-washing or using harsh soaps in the genital area can disrupt the natural flora and lead to irritation. Conversely, inadequate hygiene can also contribute to itching.

Symptoms to Monitor
- Bleeding: If scratching leads to bleeding, it indicates that the skin is becoming damaged. This can lead to further complications, such as infections.

- Color Changes: The darkening of the vulvar skin and the appearance of white patches may require further investigation to rule out conditions like lichen sclerosus or vitiligo.

- Duration: Since you have experienced these symptoms for two years, it is essential to seek medical advice.

When to See a Doctor
Given the persistence of your symptoms and the fact that they have been ongoing for two years, it is advisable to consult a healthcare provider. In your case, a gynecologist would be the appropriate specialist to evaluate vulvar issues. They can perform a physical examination and may conduct tests to determine the underlying cause of your symptoms.

What to Expect During the Visit
1. Medical History: Be prepared to discuss your symptoms in detail, including when they started, any triggers you have noticed, and any treatments you have tried.

2. Physical Examination: The doctor will likely perform a physical examination of the vulvar area to assess for any visible abnormalities.

3. Tests: Depending on the findings, the doctor may recommend tests such as swabs for infections or skin biopsies if there are concerning lesions.

Self-Description and Communication
If you find it challenging to describe your symptoms, consider writing them down before your appointment. This can help ensure you communicate all relevant information to the doctor. It is perfectly acceptable for the doctor to conduct a physical examination, and they will be able to provide a more accurate diagnosis based on their findings.

Cost of Consultation
The cost of a gynecological consultation can vary widely depending on your location and whether you have insurance. It is advisable to check with the healthcare provider's office regarding the consultation fees and whether they accept your insurance plan.

Conclusion
In summary, vulvar itching can stem from various causes, and given the duration and severity of your symptoms, seeking medical advice is crucial. A gynecologist can provide a thorough evaluation and appropriate treatment options. Remember, it is essential to prioritize your health and well-being, and addressing these symptoms with a professional is a significant step in the right direction.

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