What Does Vulvovaginitis Look Like?

Symptoms cause redness and swelling on your vulva

Medically reviewed by Anju Goel, MD

Vulvovaginitis is a condition that affects the vulva (the skin around the opening of the vagina) and vagina. It causes swelling, redness, irritation, and discharge. Vulvovaginitis can have several different causes: infection, hormone changes, or irritation from external sources. Treatment will be guided by the underlying cause and is aimed at relieving symptoms and eliminating the source of the condition.

How Vulvovaginitis Looks

Vulvovaginitis will look different from person to person based on the underlying cause and symptoms. Below are the different characteristics seen when someone has vulvovaginitis.

Atrophy

Someone with vulvovaginitis may have atrophy of the vulva. The vulva will look pale and thin with narrowing of the introitus, the entrance to the vaginal canal. The skin will not be elastic and can easily bleed.

Redness

Vulvovaginitis typically looks red. The vulva skin will be redder than the surrounding skin. It can be swollen as well.

Sores

Sore or open areas on the skin occur from the irritation or scratching caused by vulvovaginitis. They can be painful, burn, or itch.

Swelling

The vulva can be swollen. The skin will appear red and can look larger than normal.

Discharge

An abnormal vaginal discharge can be a symptom of vulvovaginitis. The discharge appearance will vary based on the underlying cause. They can include:

• Yeast infection: thick, white cottage cheese-like discharge

• Bacterial vaginosis: thin, milky or heavy gray discharge that can smell fishy

• Trichomoniasis: greenish-yellow discharge that is frothy and musty-smelling
  

How Vulvovaginitis Feels

Vulvovaginitis will feel differently based on what's causing it and the severity of the symptoms. Below are the various ways vulvovaginitis can feel.

Itching

A common feeling associated with vulvovaginitis is itching. Itching is one of the primary symptoms of vulvovaginitis caused by a yeast infection. However, itching does not mean that the underlying cause is always yeast and other causes should be ruled out.

Burning/Stinging

Another common feeling related to vulvovaginitis is burning or stinging. The irritation caused by the source, along with any scratching can cause burning and stinging. While this can be felt at any time with vulvovaginitis, it is not uncommon to feel it when urine touches the vulva.

Self-Care and Symptom Treatment at Home

Based on the underlying cause, some cases of vulvovaginitis can be managed at home with simple lifestyle changes and home treatments. Below are ways to treat vulvovaginitis symptoms and tips for properly caring for the vulva and vagina.

It's important to properly care for the vulva and skin around the genitals. This skin is sensitive and prone to irritation. Only was the exterior genital skin and do not douche. Just use warm water to clean the area and pat dry.

A sitz bath in warm (not hot) water for 10 to 15 per day can help to relieve vulvovaginitis symptoms. When finished pat the skin completely dry. Other self-care and symptom treatments include:

• Wear cotton underwear and loose-fitting clothing

• Avoid bubble baths or scented soap

• Avoid laundry detergents with perfumes and colors

• Do not wear wet bathing suits for a long time

• Urinate with legs spread far apart

• Wipe with toilet paper from front to back
  

What Conditions Cause Vulvovaginitis?

Vulvovaginitis can be caused by an infection, hormone changes, or most commonly for no known reason. Below each cause is explained.

Infection

Bacterial vaginosis (BV) is a common vaginal infection. It is caused when unwanted bacteria outgrows the desirable types of bacteria. This generates an unhealthy bacterial infection causing inflammation, redness, and a thin, gray discharge with a fishy odor.

Yeast infections, also called vulvovaginal candidiasis are the most common cause of vulvovaginitis. There is normally a small amount of yeast in the vagina. When something disrupts the normal microbial balance, yeast can overgrow. A common example of this is when someone takes antibiotics for an infection. The antibiotics also kill the normal bacteria that grow in the vagina which then allows yeast to overgrow causing a yeast infection.

Trichomoniasis is a sexually transmitted infection (STI) that is caused by a parasite. Approximately 70% of people who have trichomoniasis do not have symptoms. Those who do have symptoms may experience itching, burning, and redness of the genitals. They may also have pain when urinating and increased vaginal discharge with a fishy odor.

Hormone Changes

After menopause, women have lower estrogen levels. These hormone changes cause vaginal dryness and thinning of the vulva and vaginal skin creating many of the vulvovaginitis symptoms. This condition is called genitourinary syndrome of menopause (GSM), previously termed atrophic vaginitis.

Unknown Causes

Many times the exact cause of vulvovaginitis cannot be determined. This is called nonspecific vulvovaginitis. It is often linked to stool bacteria and may be due to poor hygiene or wiping from back to front. Nonspecific vulvovaginitis can happen to anyone but is more common in younger people before puberty.

Vulvovaginitis: Which Age is Most Susceptible?

Vulvovaginitis can happen at any age. In females who have not yet reached puberty, the skin that lines the vulva and vagina is very thin, making vulvovaginitis more common in females during this time. However, infectious vulvovaginitis like BV and yeast infections do not typically happen until a female reaches puberty.

Prescriptions for Vulvovaginitis Discomfort

Prescriptions for vulvovaginitis are typically reserved for infections. A healthcare provider will perform an examination to determine the underlying cause and if a prescription is necessary.

Yeast infections will need an antifungal cream or suppository. These can be prescription or found over-the-counter.

Trichomoniasis is treated with an antibiotic. It is usually one dose of metronidazole or tinidazole. If the initial treatment is not effective follow-up antibiotics will be prescribed.

BV is also treated with an oral or topical antibiotic like metronidazole, clindamycin, or tinidazole.

Steroid creams or antihistamine pills are also used to relieve general vulvovaginitis discomfort.

Managing Cyclic Vulvovaginitis

Cyclic vulvovaginitis is when someone has recurring vulva or vaginal itching and burning during the same phase of their menstrual cycle.

Cyclic vulvovaginitis can be caused by yeast. Antifungals are used to treat symptoms.

Those who have cytolytic vaginosis, an overgrowth of lactobacilli bacteria should not use antifugals but a sitz bath to find relief.

A healthcare provider can help determine the exact cause of cyclic vulvovaginitis and suggest a treatment plan for the specific cause.

Summary

Vulvovaginitis is a condition that causes pain, swelling, and itching of the vulva and vagina. It is seen in females of all ages. Females who are prepubescent are prone to vulvovaginitis due to the thinner skin that surrounds the vagina. Females who have reached puberty are more prone to infectious vulvovaginitis causes. A healthcare provider should be seen to determine the cause and guide treatment.

Read the original article on Verywell Health.