What’s Causing My Vulval Rash? The 101 On Rashes ‘Down Below’.

Vulva Itching and rashes 101Do you find you’re not able to sit still, pee without the skin stinging, have sex comfortably, or are constantly looking for something to calm the vulval area?   Read on. That’s what we’re going to look at in this article.

What are the symptoms of vulval rashes?

The vulva is the area shown in the picture here.Intimate vulval rashes 101

The best way to look for a vulval rash is (perhaps obviously) with a mirror and a good light. Natural light is best but a flashlight or lamp shone onto the skin from a distance will work too. Put one foot on a chair or side of the bath so that you can see the area clearly.

Rashes anywhere on the body cause the skin to become sensitive and perhaps painful. It looks red and a little swollen and there may be visible pink spots, or just red and patchy.

Scratching this sensitive skin will damage it and can cause an itch-scratch cycle. The itch-scratch cycle is caused by histamines released in the skin by scratching, which then cause the skin to become more itchy, and so on.

What causes vulval rashes?

There are many causes and some rashes all look the same. Treatment (see below) will depend on the cause. Your medical professional will have a trained eye and be able to advise.

  1. Sensitivity to soaps, sprays, douching, perfumes etc.

This is perhaps one of commonest and easiest problems to fix. If your rash is a recent problem, review your washing habits to see if you are using anything new that may have triggered it:

  • A change of soap/shower wash
  • Different clothes wash or fabric softener
  • Spermicide products or condom brands.

Douching and using vaginal/vulval sprays or talc is never recommended as they reduce the vagina’s own balance of natural cleansing agents. This can happen in the short or long term.

Treat by:

  • Using unscented soaps or baby wash on the vulval area.
  • Not douching.
  • Not scratching.
  • Using laundry soaps and fabric conditioners for sensitive skin.
  • Use a hot or cool compress on the skin to relieve the irritation – eg run a washcloth under a hot or cold tap, squeeze out and apply to the skin. The skin will repair itself given a little time.
  1. Thrush/vaginal candidiasis/yeast infection.

The vagina does its own natural cleaning and its normal mucous discharge shouldn’t smell bad. It changes in consistency – how thick or runny it is – throughout the menstrual cycle and towards the menopause.

However when the balance of good bacteria and yeasts is upset, this can cause a discharge that is often thicker than normal, looks like curds and may be itchy. The discharge can also irritate the skin, and so can scratching the skin.

Treat by:

  • Using an over the counter thrush treatment – ask the pharmacist.
  • Don’t wash more than usual, and gently pat the skin dry.
  • If you don’t want to use pharmaceuticals then you can use hot or cold compresses to relieve the discomfort. The yeast balance should correct itself within a few days.

There’s more information about yeast infections here.

  1. Lichen planus.

Lichen planus (say ‘lye-ken play-nuss’) is a skin condition that causes as purple, itchy, bumps with flat tops to them. They come on over several weeks and can affect the skin, hair, nails and mucous membranes (eg mouth, vagina). In the mouth and vagina they appear as white patches or ulcers and are often painful.

It’s caused by the immune system misfiring, attacking its own cells by mistake. It’s not contagious and can be part of another problem, eg Hepatitis C infection, or a reaction to some painkilling drugs and some heart/blood pressure drugs.

Treat by:

  • Your doctor will give you some steroid cream or ointment to reduce the inflammation.
  • Use antihistamines to reduce the itch.
  • Immune response meds may be needed.
  • Light therapy may be needed. This will be prescribed by your doctor and administered by a specialist.
  • Soak in a bath colloidal oatmeal – eg Aveeno, Oak Soak – and use a colloidal oatmeal moisturising lotion.
  • Use a hot or cool compress on the skin to relieve the irritation – eg run a washcloth under a hot or cold tap, squeeze out and apply to the skin.
  • Not scratching.
  • Using 1% hydrocortisone cream, which you can buy over the counter, if you’re not using prescribed steroid cream.
  1. Vaginitis.

Vaginitis is simply an inflammation of the vagina and can affect the vulval are too. It commonly causes itching, and the itch-scratch cycle (see above) causes the rash.

Vaginitis can be caused by scratching, which can be caused by bacterial vaginosis (BV), yeast infection, vaginal atrophy or trichomoniasis. See the links for more about these problems.

It can also be caused by irritation from douches, sprays, a change in spermicide or condom products.

What tests will the doctor do for vulval rashes?

The most important test is for the doctor to simply look at the rash and listen to your medical history. Some rashes and vaginal discharged look different to others.

  • She may ask about your use of douches, perfumes, soaps etc.
  • She may take a vaginal swab to see if infection is the cause or an irritating vaginal discharge.
  • Arrange for a vulval biopsy if she suspects lichen planus.
  • Take blood tests.

Vulval rashes are common and in most cases can be easily treated once the cause is found.

This Mayo Clinic article will tell you more about vulval rashes and problems down below.

If you’re worried about your symptoms or medical problem but don’t want to seek professional help because you feel embarrassed, silly or that it’s your fault in some way, read this page now: How to talk to a doctor about an embarrassing problem

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