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Last updated: October 21, 2025View editorial policy

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Differential Diagnosis for Vaginal Irritation

Single Most Likely Diagnosis

  • Vulvovaginal Candidiasis (Yeast Infection): This is the most common cause of vaginal irritation, characterized by itching, burning, and a white, clumpy discharge. It's often associated with antibiotic use, diabetes, or immunosuppression.

Other Likely Diagnoses

  • Bacterial Vaginosis (BV): A bacterial infection that causes an imbalance in the natural vaginal flora, leading to symptoms like fishy odor, thin discharge, and irritation.
  • Trichomoniasis: A sexually transmitted infection caused by a parasite, resulting in symptoms such as itching, burning, redness, and a frothy discharge.
  • Atrophic Vaginitis: Common in postmenopausal women due to decreased estrogen levels, leading to vaginal dryness, itching, and irritation.
  • Contact Dermatitis: An allergic reaction or irritation from soaps, douches, or other products, causing redness, itching, and burning.

Do Not Miss Diagnoses

  • Herpes Simplex Virus (HSV): A sexually transmitted infection that can cause severe vaginal irritation, along with painful blisters or ulcers.
  • Syphilis: Another sexually transmitted infection with various stages, including a primary stage that can present with a painless sore, which might be missed if not properly examined.
  • Cervical Cancer: Although rare, it can cause vaginal irritation among other symptoms like abnormal vaginal bleeding. Early detection is crucial for effective treatment.

Rare Diagnoses

  • Lichen Sclerosus: A chronic skin condition that can affect the vulva, causing itching, pain, and scarring if left untreated.
  • Lichen Planus: An autoimmune condition that can affect the mucous membranes, including the vagina, leading to irritation and discomfort.
  • Desquamative Inflammatory Vaginitis (DIV): A rare condition characterized by severe vaginal inflammation and a purulent discharge, often resistant to standard treatments.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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