Ask the Doc

Ask the Doc

Nicole Williams, MD Your embarrassing questions answered!

By Nicole E. Williams, MD

Q: Why is my vagina so itchy?

A: Vaginal itching is more common than a cold, and it usually means nothing. While most of the time an itchy vagina is transient and not necessarily anything to worry about, some conditions warrant extra attention.

I tell my patients that all their vagina needs is soap, water, and sunshine. By sunshine, I mean your vagina needs to breathe, and the perfect time to air her out is while you are sleeping. 

Some of the main culprits for itchiness are using scented soaps or wipes, bubble baths, and douches. But there are other reasons your vagina might be itching. If you think you have one of the conditions below, see your gynecologist.

Eczema. Eczema is quite common, especially if you have asthma or other allergies. While not dangerous, it can be bothersome. In light skin, it may appear as a red, dry, and itchy rash. In darker skin, eczema can look dark brown, purple, or ashy gray. Make sure to see a gynecologist for a diagnosis.

Contact dermatitis. Using smelly soaps, oils, or other products may cause an allergic reaction to the sometimes-sensitive vaginal skin. Use plain soap like Dove or Ivory, and avoid scrubbers like loofahs. Also, so your vagina has a chance to air out, don’t wear underwear to bed unless you’re menstruating.

Pubic lice. A sexually transmitted condition, pubic lice are tiny organisms that live on pubic skin and hair. Pubic lice are actually easy to eradicate, and it’s important to do so, or else the lice will lay eggs and multiply. You can eliminate them with over-the-counter medication containing pyrethrins or permethrin lotion 1%.

Herpes simplex. If you see anything that looks like a scratch or even a sore paired with itching and perhaps pain, it could be genital herpes. Caused by the herpes simplex virus, the rash — often with sores — comes and goes over a lifetime. Your doctor can make the diagnosis with a blood test or a culture. Herpes is easily treatable with medication.

Lichen sclerosus. This condition affects mostly adult women after menopause and causes itching and white patches of thinned skin usually in the genital area. The most common treatment to minimize discomfort is to apply a steroid cream or ointment. 

Vulvar cancer. Vulvar cancer is relatively rare, typically occurring in women over age 60. Look for discoloration, growths, or any other new changes in your skin. Your gynecologist can perform a biopsy to make the diagnosis. Luckily, doctors usually catch this condition early and cure it with surgery.

Waxing or shaving. Just don’t do it! Waxing is not worth the trouble on your skin. Just keep the hair trimmed short like that of a military recruit. You will avoid annoying folliculitis or hair bumps and maintain the helpful glands in your skin that keep your vagina soft and well lubricated.

Overall, please know that any vaginal itchiness you experience isn’t only happening to you. Everyone experiences an itchy vagina at some point. Occasional itching that goes away is nothing to worry about. Itching that lasts more than a few days or that wakes you from sleep could be a problem. 

If your itchy vagina doesn’t improve after you eliminate common culprits, or if you see color changes,swelling, or have pain or severe burning, see a practitioner for further investigation.

Nicole E. Williams, MD, is an obstetrician/gynecologist, founder of the Gynecology Institute of Chicago, and author of the book This is How You Vagina: All About Your Vajayjay and Why You Probably Shouldn’t Call It That. 

Originally published in the Spring/Summer 2022 print issue.