When the skin on or around your vulva becomes dry, flaky, itchy, or scaly, it can be difficult to determine what’s causing this irritation. There are a variety of medical conditions and lifestyle factors that could be the culprit.
But before you panic, know that it is normal to lose skin from any area of the body.
Eczema
While it is easy to think of “itchy vaginal skin” as a yeast infection, it can be a symptom of other conditions. The vulva has very sensitive skin, especially due to the drop in estrogen that occurs during menopause. This makes the area more susceptible to itching and dryness caused by environmental irritants, like soap, perfume, or personal lubricants. Many women are hesitant to see their physician because of the embarrassment of talking about their itchy vulva, but they should. The condition could be a more serious problem than a simple yeast infection and the treatment may require more than an over-the-counter ointment.
If the itching is accompanied by a red rash, dry skin, bumps or fissures, it could be contact dermatitis of the vulva. This is a type of rash that develops when the skin comes into contact with an irritant or allergen, including many household products such as soap, laundry detergent, talcum powder, fragrances, and personal lubricants.
This type of dermatitis typically affects the arms and legs, but can also appear on the hands, face and inside the genital area, causing itching and peeling of the skin in those areas as well. If you suspect you have eczema, your doctor will examine your vulva and ask about your past symptoms, including what triggers the itching and rash. He or she may use a magnifying scope and insert a speculum to inspect the folds of the skin. The doctor will prescribe medications to treat the underlying condition, which may include an anti-itch lotion or cream, oral steroids and/or antibiotics.
Psoriasis
Psoriasis is an autoimmune condition that causes thick, itchy, red patches of scales on the skin. It occurs when white blood cells in your immune system mistakenly speed up the growth of skin cells, causing them to grow and flake away at a faster rate. It can also cause a form of arthritis called psoriatic arthritis. You can develop psoriasis anywhere on the body, but it most commonly affects the elbows, knees, scalp, and hands.
If you have psoriasis and experience vaginal dryness or itching, you may also have patches of scaly, flaky skin in your labia or vulva. Symptoms of genital psoriasis can be similar to those of eczema, so it is important to talk with your doctor about the severity and duration of your symptoms.
You can reduce the frequency of psoriasis outbreaks by using gentle cleansers, avoiding harsh soaps, and wearing breathable fabrics such as cotton. You can also soak in a warm bath with colloidal oatmeal to help soothe the itchy and dry skin. It is important to moisturize often with a fragrance-free, unscented lotion or cream. You can also use a personal lubricant that is free of alcohol and colorants.
If your scaly, flaky, peeling skin is caused by psoriasis, your doctor will prescribe a medicated ointment or gel to treat it. It is important to follow the instructions for your medication to prevent itching, burning, and irritation.
Candida or Vaginal Yeast Infection
Yeast infections (also called Candidiasis) occur when the yeast that normally lives in the mouth, digestive tract and vagina grows out of control. Itching and a thick, clumpy discharge are common symptoms. Yeast infections can happen in women and men of all ages.
Several things can cause Candida overgrowth in the vulva, including pregnancy, taking antibiotics, and illness that suppresses the immune system. Women also can get a yeast infection more often if they wear tight-fitting or lacey underwear, if they use feminine hygiene products with scented sprays or ingredients like talcum powder, and if they wear latex condoms for sex.
The fungus that causes candida overgrowth may be found in the skin of the armpits, the groin, the spaces between fingers and toes, on uncircumcised penises or in the vulva. These areas are warm and moist, and they can become irritated by soaps, detergents, bubble baths, perfumes, douches, lubricants and personal hygiene sprays.
A doctor can diagnose a yeast infection by visually assessing the genital area and asking questions about symptoms. They will probably take a swab from the vulva and send it for a culture. They may also prescribe a short course of over-the-counter antifungal medicine. If they suspect a different condition is causing the infection, such as lichen planus or lichen sclerosis, they will order a blood test and other tests to check for these conditions.
Lichen Planus
Lichen planus (LIE-kun PLAY-nus) is a disease that causes itchy, flat bumps on your skin. It can also cause sores in your mouth and genitals and can make sex painful. It can be mild and not need treatment, or it can be severe and need prescription medicine. The condition is thought to be caused by your immune system mistakenly attacking your skin and mucous membranes. It can affect people of any age, but it usually appears in middle-aged adults. It is more common in women than men.
Your doctor will look at your genital area and ask you about your symptoms. They will check for other health problems and may do blood tests. They will also want to know what supplements, vitamins, and medications you take.
If you have vulvar or vaginal lichen planus, your doctor may use a thin blade (scalpel) to remove a small sample of your rash. They will then send it to the lab to test for the rash. They might also do an allergy test to see if you have an allergy that’s causing your rash to flare up.
For oral lichen planus, your doctor may prescribe a cortisone cream or ointment. They might also give you pills called prednisolone or methotrexate to help relieve your rash. They will also advise you to avoid rubbing the affected areas and to wear loose clothing.
