II. Definition

  1. Vulvar Itching

V. Causes: Post-menopausal women

  1. Includes causes seen in young women
  2. Atrophic Vaginitis
  3. Lichen Sclerosus
  4. Paget's Disease of the vulva
  5. Vulvar Cancer (Squamous Cell Carcinoma)

VI. Evaluation

  1. Biopsy atypical vulvar lesions (rule-out cancer)

VII. Management: Prevention

  1. Treat specific causes
  2. Use loose fitting cotton (100%) underpants
    1. Consider not wearing underwear overnight
  3. Use only unscented (hypoallergenic) soaps and lotions
  4. Use unscented laundry detergent without dyes
  5. Avoid fabric softeners
  6. Wipe front to back after urinating or defecating
  7. Use white, unscented toilet paper
  8. Urinate with knees spread apart
  9. Maintain Ideal Weight
  10. Manage Incontinence
  11. Consider sitz bath for 10 minutes daily (girls)
  12. Pruritus Management with Sedating Antihistamine
    1. Hydroxyzine (Atarax) 50 mg PO at bedtime (adult dose)
  13. Wear cotton-liner gloves at night
  14. Use Vaginal Lubricants liberally before intercourse
    1. Use K-Y liquid instead of K-Y Jelly
    2. Astroglide
  15. Dry vulvar area gently after bath
    1. Pat dry or use hair dryer and
    2. Apply Skin Lubricant to vulva
      1. Vaseline
      2. Eucerin
      3. Crisco shortening (very effective)
  16. Avoid exacerbating factors
    1. Avoid scrubbing vulva
    2. Avoid douching
    3. Avoid panty liners or pads (use tampons instead)
    4. Avoid contraceptive foams
    5. Avoid Alcohol wipes
    6. Avoid bubble baths or prolonged soap exposures
      1. Use only Mild Soap or no soap on vulva
      2. Avoid hard water for bathing
    7. Avoid prolonged wearing of wet bathing suits
    8. Avoid tight restrictive clothing that causes sweating
    9. Avoid nylon tights or underwear
    10. Avoid frequent shaving of pubic hair (Folliculitis)

VIII. References

  1. Goroll (2000) Primary Care, Lippincott, p. 693-95
  2. Noble (2001) Primary Care, Mosby, p. 282
  3. Paek (2001) J Am Acad Dermatol 44:795-802 [PubMed]

Images: Related links to external sites (from Bing)

Related Studies