From the Guidelines
Itchy vulvar lesions should be initially managed with a thin layer of 1% hydrocortisone cream applied to the affected area twice daily for up to 7 days, while avoiding internal application, as recommended by general medical guidelines and supported by studies such as 1 and 1.
Causes of Itchy Vulvar Lesions
Itchy vulvar lesions can be caused by various conditions including:
- Contact dermatitis
- Lichen sclerosus, as discussed in 1
- Lichen simplex chronicus
- Yeast infections, such as those caused by Candida species, as outlined in 1 and 1
- Sexually transmitted infections
Initial Management
For immediate relief, the following measures can be taken:
- Apply a thin layer of 1% hydrocortisone cream to the affected area twice daily for up to 7 days, avoiding internal application
- Use cold compresses and sitz baths with colloidal oatmeal to help reduce itching
- Avoid potential irritants like scented soaps, douches, and tight synthetic clothing
Medical Evaluation
If symptoms persist beyond a week, worsen, or are accompanied by discharge, pain, or bleeding, medical evaluation is necessary. A healthcare provider may prescribe:
- Stronger corticosteroids
- Antifungal medications like clotrimazole or fluconazole, as recommended in 1 and 1
- Antibiotics depending on the diagnosis They might also recommend maintenance treatments for chronic conditions.
Pathophysiology
The itching occurs because irritants, allergens, or infections trigger inflammatory responses in the sensitive vulvar skin, releasing histamine and other chemicals that stimulate nerve endings and cause the itching sensation.
Importance of Recent Guidelines
Recent guidelines, such as those from 1 and 1, emphasize the importance of proper diagnosis and treatment of vulvar lesions, including those caused by cancer. However, for itchy vulvar lesions, the initial approach remains focused on symptom management and identification of common causes such as infections or dermatitis, as supported by the most recent and highest quality studies like 1.
From the Research
Causes of Itchy Vulvar Lesions
- Vulvar lichen sclerosus is a common skin disease that can cause itchy vulvar lesions, especially in women over 50 2
- Vulvar pruritus, or itchy vulva, can be caused by various factors, including vulvo-vaginal candidiasis, chronic dermatoses, and invasive or preinvasive lesions such as squamous epithelial dysplasia 3
- Other causes of itchy vulvar lesions include lichen simplex chronicus, lichen planus, and psoriasis 4, 5
Symptoms and Diagnosis
- Symptoms of itchy vulvar lesions include vulvar itching, irritation, burning, and pain, which can be chronic or recurrent 4
- Diagnosis of itchy vulvar lesions requires a thorough evaluation, including a physical examination and medical history, to rule out other conditions such as vaginal infections 4
- Vulvar skin disorders, including itchy vulvar lesions, can be diagnosed and managed by healthcare providers, including obstetricians and gynecologists 6
Treatment and Management
- Treatment of itchy vulvar lesions depends on the underlying cause, but may include topical or oral antimycotic drugs, high-potency glucocorticoids, and basic moisturizing care 3
- Early intervention with topical corticosteroids can help prevent serious complications, such as scarring and deformity, in cases of vulvar lichen sclerosus 2
- Education and guidelines for vulvar care and hygiene are important for preventing and managing itchy vulvar lesions 4