An itchy vagina might rank as the absolute worst. I mean, it’s not exactly easy to scratch down there.
But what’s even more frustrating than doing the crotch-itch dance in public is not knowing why your vagina’s itchy in the first place (is it a yeast infection? Or…crabs?).
And if the temptation to scratch becomes even more unbearable at night, you’re not alone. But it isn’t because your vagina is itchier at night. Because you aren’t distracted with work, phone calls, and all that other daytime stuff, you can become hyper-aware of an itchy vagina (or any part of the body) at night, says Carroll Medeiros, MD, an ob-gyn in Rhode Island. In rarer cases, more itching at night in that area can be the result of pinworms, adds Dr. Medeiros, small parasites that can live in the colon or rectum, but the itching is usually closer to the rectum than the vagina in that case.
Truthfully, there are *tons* of (totally normal and treatable) reasons why it feels like a wool sweater is permanently attached to your vagina region. Here are a few things that might be causing the itch—and how to take care of it for good.
1. Bacterial vaginosis
Bacterial vaginosis (BV) is a pretty common condition caused by bacterial overgrowth and a pH imbalance in the vagina. Though it can affect all women, higher rates of BV are particularly prevalent among Black women, though experts don’t know why, says Dr. Medeiros. It may be related to a genetic predisposition, found one 2016 study in the American Journal of Reproductive Immunology.
But the itching isn’t the primary symptom—the hallmarks are typically a loose discharge, strong odor, and general irritation (though it definitely can make you itchy too), says Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University.
According to Dr. Minkin, to treat it, you can try an OTC medication like RepHresh to help up the acidity of your vagina. Acidity in the vagina is a good thing, as it kills off harmful bacteria, she says. If that doesn’t work, your doc might prescribe antibiotics.
2. Eczema or psoriasis
“Skin conditions like eczema and psoriasis can occur due to an allergy or autoimmune issue,” says Natasha Chinn, MD, FACOG, an ob-gyn with Brescia and Migliaccio Women’s Health in New Jersey. Eczema often appears in the crevices of arms, folds, groin area, and labia, she explains. Psoriasis can also present on the skin around the vagina, she adds.
Most people with eczema and psoriasis are well-versed in the appearance (and treatment) of these red, patchy rashes. But if you’ve never had the symptoms before, make an appointment with your doctor. Both conditions can be managed if they’re flaring up, and Dr. Chinn says that psoriasis can sometimes warrant a prescription for an oral pill or a topical cream.
3. Contact dermatitis
Ever try a new moisturizing cream and wind up with dried out, flaky skin or a full-blown rash a few days later? Well, guess what: The same thing can happen to the skin around the vagina. “Soaps, detergents, and bubble baths, a new kind of underwear—any new products at all that come in contact with your vagina [can cause itching],” explains Dr. Minkin.
If your vagina feels itchy and irritated, but you don’t have any other symptoms, it’s worth thinking about whether you’ve recently started using any new products. Pads and tampons, condoms and lubricants, shaving products, and even toilet paper can all be to blame (basically anything with added perfumes or chemicals, so stick with hypoallergenic stuff if you’re sensitive).
In the meantime, stop using whatever you think is bugging you, treat the itch with an Epsom salt bath or an OTC hydrocortisone cream applied externally, and wait a few days to see if the irritation resolves. If not, see your doctor.
4. Yeast infections
Vaginal yeast infections, which occur when there is an overgrowth of the fungus Candida, are probably the first thing people think of when they feel that telltale itching down there. “A cottage cheese-like discharge, redness around the labia and vulva, and itching are all classic signs of a yeast infection,” Dr. Minkin says.
But she also notes that only about one-third of women who experience itching and irritation genuinely do have a yeast infection. The easiest way to tell which category you fall into is to use an OTC treatment like Monistat. Dr. Minkin says that if you do have a yeast infection, it should do the trick; if it doesn’t, check in with your provider.
5. Sexually transmitted diseases (STDs)
Itching isn’t a classic symptom of most STDs, though it can sometimes be a first sign that something is up, says Dr. Minkin. From there, symptoms may progress to burning, painful urination, smelly discharge, sores on your genitals, or painful intercourse, at which point you should head to your ob-gyn for a vaginal culture.
The STDs below are most commonly associated with itchiness down there, among other symptoms. Here’s what to look out for:
- Genital warts. Genital wars are small, flat, flesh-colored bumps or tiny, cauliflower-like bumps that appear on the skin, resulting from exposure to the human papillomavirus. “This type of STD can shift the pH in the vagina, which then causes dryness and itching,” says Dr. Chinn.
- Herpes. Genital herpes causes clusters of red, blistery bumps on the vulva, which come and go as outbreaks. You may experience itching in the areas the sores appear in even before they show up.
- Chlamydia. Chlamydial infections will usually not show any symptoms. But in rarer cases, chlamydia can lead to itching and irritation of the genital area, discomfort when urinating, and an unusual discharge.
- Gonorrhea. Gonorrhea is an infection of the genitals, rectum, or throat. Symptoms can include itching, increased vaginal discharge, and a painful or burning sensation when peeing.
- Trichomoniasis. An infection causes this STD from a protozoan parasite called Trichomonas vaginalis. Only about 30 percent of people with the infection show symptoms, but they can include itching, burning, redness, or the genitals’ soreness.
6. Pubic lice
No one wants to think about bugs crawling around on any part of their body, but especially not down there. Unfortunately, that’s precisely what pubic lice (a.k.a. crabs) is: an easily transmittable infestation of little bugs in your genital area that makes you itch like crazy.