What is irritant dermatitis of the vulva?
Irritant dermatitis of the vulva is a skin condition that is caused by exposure to allergens and irritants which produce vulvar and/or vaginal itching and burning when there is no infection.
What is the cause of irritant dermatitis of the vulva?
The skin of the vulva can be very sensitive to products called contact irritants. Contact irritants are products that cause irritation on the vulvar skin. This occurs when the vulvar skin becomes very sensitive to products such as laundry detergent, fabric softeners, body soaps, deodorized tampons or pads, and feminine hygiene products. Regular use of these products over a period of time causes irritation, burning and itching.
What are the signs and symptoms of irritant dermatitis?
- Mild to severe itching and/or burning of the vulva
- Vulvar redness and swelling
- Skin thickening
- A raw feeling due to irritation
- A damp feeling
This feeling of dampness is from the outer vulvar skin surface which "weeps" due to chronic irritation. The dampness may be mistaken for discharge coming from the inside of the vagina, and may be believed to be the cause of symptoms.
- Vulvar pain, in more advanced cases, with insertion of a tampon, speculum, or with intercourse.
How is irritant dermatitis of the vulva diagnosed?
The diagnosis is made by examining the vulva and vagina.
- The skin of the vulva, vagina and anal area are examined to look for common skin changes associated with this condition.
- During vaginal examination, a sample of the cells of the vaginal wall (done with a Q-tip) will look for changes in the cells and rule out signs of infection.
What is the treatment for irritant dermatitis of the vulva?
- Remove the irritant. Avoid contact with the irritants listed below. Follow the "Guidelines for Vulvar Skin Care" instruction sheet.
- Apply steroid ointment if prescribed. This will decrease redness, swelling, itching and burning. Caution: Use only as prescribed by your physician or nurse practitioner. Overuse may result in thinning of the skin which will make your problem worse. The steroid ointment may tingle or burn when initially applied. This should not last a long time and will usually disappear with repeated use.
- Soak in a luke-warm bath with 4-5 tablespoons of baking soda to help soothe vulvar itching and burning. Soak 2-3 times a day for 10-15 minutes. If unable to soak, splash down with cool water after using the bathroom.
- A&D Ointment or Crisco may be applied liberally between applications of steroid ointment.
Symptoms should resolve gradually with these suggestions. If the symptoms persist, or if they intensify, further evaluation and treatment may be needed.
What contact irritants should be avoided?
- laundry detergents containing enzymes
- fabric softeners and dryer sheets
- bath soaps, gels, lotions
- bubble bath, oils, bath salts, skin softeners
- feminine hygiene sprays, perfumes and powders, vaginal moisturizers and douches
- adult and baby wipes or towelettes
- deodorant tampons and pads, minipads Always
- contraceptive creams, jellies, foams, and sponges, KY Jelly, Nonoxonyl-9
- condoms prepackaged with lubricant or spermicides
- colored, perfumed toilet paper
- synthetics such as nylon underwear or pantyhose
- nail polish
- newsprint
Written by M.V. Weitz, MSN, CRNP
Reviewed by P. Nyirjesy, MD, 7/06
Sections courtesy of R. Galask, MD, University of Iowa
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