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Vulval itching is a common but often distressing symptom that affects women of all ages. While it’s usually linked to minor issues such as thrush or skin irritation, persistent vulval itching should never be ignored. In some cases, it can point to conditions such as lichen sclerosus or even vulval cancer.
This guide explains the most common causes of vulval itching, what to look out for, and when to seek medical advice.
Common Causes of Vulval Itching
Most women will experience vulval itching at some point, and in many cases the cause is simple and treatable. Common culprits include:
- Thrush (candida infection): causes itching, soreness, and a thick white discharge.
- Bacterial vaginosis: can cause irritation, often with a fishy odour.
- Irritant reactions: perfumed soaps, bubble baths, laundry detergents, sanitary pads (especially perfumed ones), urinary leaking, or tight clothing can all trigger itching.
- Dryness and thinning: especially after menopause (called genitourinary syndrome of the menopause), when falling oestrogen levels make the vulval skin more fragile.
- Contraception: progestogen only contraception can cause dryness which can cause itching
- Breastfeeding: can also cause itching and dryness of the vulva
- Skin conditions: eczema, psoriasis, or lichen planus may affect the vulval area.
While these causes are common, any ongoing or worsening vulval itching deserves professional assessment.
Lichen Sclerosus and Vulval Itching
One important cause of long-term vulval itching is lichen sclerosus.
What is lichen sclerosus?
Lichen sclerosus is a chronic inflammatory skin condition that most often affects the vulva. It leads to thinning, fragility, and scarring of the skin. It’s most common in prepubescent girls and post-menopausal women, though it can occur at any age.
Symptoms of lichen sclerosus
- Severe or persistent vulval itching (often worse at night)
- Soreness, burning or pain during sex
- White, thin or shiny patches of skin
- Cracks, bleeding or pain with urination
- wrinkling of the skin
- Changes to vulval shape, such as shrinking of the labia
Why lichen sclerosus matters
If untreated, lichen sclerosus can cause permanent scarring and narrowing of the vaginal opening. It also carries a small increased risk of vulval cancer (around 4–5% of women with the condition).
Treatment for lichen sclerosus
- Topical strong steroid ointments to control inflammation and itching
- Moisturising ointment emollients to protect the skin
- Regular medical follow-up to monitor for changes and reduce cancer risk
With proper care, symptoms can usually be well-managed and long-term complications prevented.
Vulval Cancer: A Rare but Serious Cause
Although rare, vulval cancer is an important condition to consider in women with ongoing vulval itching.
Risk factors for vulval cancer
- Age over 65 (but can happen at any age)
- Long-term lichen sclerosus that isn’t treated properly or at all
- Persistent HPV infection
- Smoking
Warning signs of vulval cancer
- Vulval itching that doesn’t improve with treatment
- A persistent lump, ulcer, or thickened skin patch
- Changes in colour or texture of the vulva
- Pain, burning, or soreness
- Bleeding or unusual discharge not linked to periods
Diagnosis and treatment
If vulval cancer is suspected, your doctor will perform a careful examination and may take a biopsy. Treatment usually involves surgery, and sometimes radiotherapy or chemotherapy. Early diagnosis leads to better outcomes.
When to Seek Medical Advice
See a GP or women’s health specialist if you notice:
- Vulval itching lasting more than a few weeks
- Visible changes to vulval skin colour, texture, or shape
- Pain, bleeding, or discharge without clear cause
- Recurrent symptoms despite treatment
Remember: doctors see vulval conditions frequently, don’t feel embarrassed about getting checked.
Self-Care Tips for Vulval Health
Alongside medical care, small changes can help protect vulval skin:
- Avoid perfumed wipes, bubble baths, and scented products
- Wear cotton underwear and loose clothing (white/light-coloured undies are best)
- Moisturise AND WASH with plain emollients if skin feels dry
- Check your vulva regularly so you can spot changes early
Key Takeaways
- Most vulval itching is due to simple, treatable causes.
- Lichen sclerosus is a chronic condition that requires monitoring and carries a small cancer risk.
- Vulval cancer is rare, but early detection is vital.
- Persistent itching or changes to vulval skin should always be assessed by a healthcare professional.
👉 Concerned about vulval itching? At The Female Health Doctor Clinic in Milton Keynes, we offer discreet, expert assessment and treatment. Book your consultation today and get the reassurance you deserve.
References and useful links
- NHS – Vulval problems and vulval cancer overview
https://www.nhs.uk/conditions/vulval-cancer - British Society for the Study of Vulval Disease (BSSVD) – Guidance on lichen sclerosus
https://bssvd.org/patient-information/lichen-sclerosus - Cancer Research UK – Vulval cancer symptoms and risks
https://www.cancerresearchuk.org/about-cancer/vulval-cancer - FSRH (Faculty of Sexual and Reproductive Healthcare) – Clinical standards and resources
https://www.fsrh.org - British Association of Dermatologists – Patient information on lichen sclerosus
https://www.bad.org.uk/pils/lichen-sclerosus - The Lowdown – Women’s health patient experiences and contraception side effects
https://thelowdown.com - Jo’s Cervical Cancer Trust – HPV and cervical screening
https://www.jostrust.org.uk
