Thank you for consulting with us at Doctor spring. I understand that you are significantly distressed by the vulval itching you have been having for quite some time. This is also called Pruritis vulvae. Vulvar irritation is not the same as pruritis, but it is a painful condition associated with burning. Lets us restrict our discussion to Pruritis vulvae. It is an itching sensation with a desire to stratch. This ultimately leads to vulval irritation due to scratching and abrasions.

There are several causes of Pruritis vulvae:

1. Systemic: Diabetes, Jaundice, Uraemia due to renal failure, Liver cirrhosis. These conditions cause itching of the whole body which also includes the vulva and vagina.

2. Generalised dermatitis: Like psoriasis or eczema.

3. Allergy: To drugs, detergents, bathing soap, lotions and moisturizing creams, deodorants, talcum powder, improperly rinsed underclothes, wearing tight synthetic undergarments, condoms, diaphragm or spermicidal agents.

4. Cervical causes: Infection of the cervix (the entrance to the womb) can cause it to secrete a lot of mucus and thus itching in the vulva.

5. Vaginal discharge: One of the most common causes of Pruritis vulvae is Trichomonas (a sexually transmitted parasitic infection) infection of the vagina or fungal infection of the vagina which is commonly due to Candida. There may be only minimal vaginal discharge but even this can lead to intense itching of the vulva.

6. Parasitic infection of the vulva: Pediculosis (infection with body louse or pubic louse), Scabies.

7. Threadworm infestation of the anus leads to a crawling sensation in the around the anus especially at night. This may also spread to the vulva.

8. Psychological: This may develop due to stress. The itching may develop due to sexual frustration, too much masturbation or other sexual practices.

9. Chronic Vulval dystrophies

I’d like you to consider each of these causes, especially the ones due to allergy. Think about any new cream or brand of detergent you started using. Rinse your undergarments separately using body soap to wash them too. You could take an Antihistamine like Cetrizine meanwhile. If your problem persists, I suggest that you visit your doctor who will perform a detailed examination and rule out the various causes and be able to come to a diagnosis.

General treatment measures opted for Pruritis vulvae are Antihistamines to reduce itch and mild sedation to help you sleep at night. A steroid cream prescribed for local application may also be of considerable use. Antibiotics and antifungal agents may have to be prescribed for infections.

Hope this information was of use to you.