Chronic Pruritus in the female intimate area has many causes
Recurring pruritus (itching), pain, redness, soreness, and burning in the female intimate area often lead women to suspect a vaginal yeast infection. This suspicion may persist even when the symptoms stubbornly remain despite antifungal treatments. Unfortunately, this can result in ineffective or even harmful self-treatments (e.g. vaginal douching), leading to an unnecessarily prolonged suffering and, in some cases, serious consequences—such as when Lichen sclerosus is diagnosed too late.
When pruritus (itching) and its accompanying symptoms are persistent, they usually originate from the vulva (not the vagina) and are often not caused by infections (like fungi, bacteria, viruses, or parasites). During and after menopause, hormone deficiency alone can trigger these exhausting intimate discomforts. Additionally, there are numerous chronic conditions that can lead to pruritus, soreness, burning, and pain in the female intimate area—some examples are listed below. Common to all of them, as well as to menopausal symptoms, is that they require gynecological (and sometimes dermatological) treatment.
Lichen Sclerosus – Pruritus of the vulva is the main symptom
Lichen sclerosus is an autoimmune disease. It primarily affects the vulva and anogenital area, and less commonly other parts of the body. In 90% of affected women (less so in men), intense pruritus (itching) is the predominant symptom. In addition to pruritus, the vulva and anogenital area may exhibit slight redness and swelling, whitish patches and nodules, and even small tears (fissures). If not recognized and treated early, the condition can lead to serious consequences: tissue atrophy of the labia minora, scarring, and hardening (sclerosis) of the intimate skin, which may result in pain during sexual intercourse and/or when urinating or defecating.
Vulvodynia – Pain, burning, and pruritus without a known cause
Vulvodynia is accompanied by pruritus (itching), burning, and a feeling of dryness or soreness of the vulva. Additionally, there may be sharp pains that can occur without any apparent reason or during normal activities: such as sitting, cycling, inserting a tampon, or during sexual intercourse. By the time a woman receives a diagnosis of vulvodynia, she has often endured years of despair. This is because the condition is still poorly understood. The physical and other causes of pruritus, pain, and other symptoms remain unknown, making the diagnosis one of exclusion—complicated and time-consuming.
Psoriasis: Silvery-White scales and pruritus
Psoriasis, another autoimmune disease, typically presents in flare-ups. The skin develops round, sharply defined, and intensely red patches. These are covered by large, silvery-white scales, which are caused by an abnormally rapid renewal of the epidermis. The patches often itch intensely. When psoriasis occurs in the genital area, it can affect the vulva, mons pubis, and adjacent groin area. However, it manifests atypically on the vulva: the strongly reddened, sharply defined areas rarely scale, but they often weep and cause intense pruritus. Incidentally, the term “psoriasis” is derived from Greek and refers to itching: “psao = I scratch.”
Atopic dermatitis – Extreme pruritus, recurring eczema
Atopic dermatitis (also known as eczema) usually appears in early childhood. It is characterized by pruritus (itching), intensely itchy eczemas that flare up periodically, and generally dry, sensitive skin. The condition often improves during puberty or adulthood, but the skin remains dry, sensitive, and prone to allergies and pruritus throughout life—even in the intimate area. The causes of atopic dermatitis are not fully understood. However, it is known that genetic predisposition, immune system overreactions, and a deficiency of fats and moisture in the epidermis play a role.
The Itch-Scratch Cycle
Pruritus leads to scratching (including rubbing or scrubbing), which provides only temporary relief. Scratching damages the skin barrier and stimulates inflammatory processes, which in turn exacerbates the pruritus. If the “pruritus-scratch cycle” is not interrupted, it can severely affect the quality of life. Additionally, scratched intimate skin (damaged skin barrier) offers numerous small entry points for pathogens (fungi and bacteria).
Breaking the vicious cycle
Medical treatment of the underlying condition responsible for pruritus (and other intimate complaints) is essential. As a supplementary measure, diligent but not excessive intimate hygiene is recommended. This can significantly help to regenerate the scratched intimate skin, make it more resilient, and ultimately relieve the distressing pruritus. Deumavan Cleansing Lotion and Deumavan Protective Ointment are recommended for this purpose. Both products are dermatologically tested and specially formulated for the delicate, sensitive skin in the intimate area.
