Causes of vaginal itching : 

Pruritus associated with vaginal discharge : 

1. Trichomonas vaginalis.
2. Candida albicans.

Pruritus without vaginal discharge : 

1. Local skin lesions : Psoriasis, Seborrhoeic dermatitis, Intertigo.
2. Infections of the vulva : Candida, Herpes genitalis, scabies, Gonorrhoea, Trichomoniasis, Pediculosis, genital warts.
3. Allergic or contact dermatitis : Use of Nylon under – garments.
4. Non – Neoplastic epithelial disorders of vulva : Squamous hyperplasia, Lichen sclerosis.
5. Neoplastic epithelial disorders of vulva : VIN, Pagets disease.
6. systemic disease : Example

• Glycosuria
• Thyroid disorders
• Chronic liver disease
• contact dermatitis
• Drug allergy
• Deficiency of iron
• Deficiency of folic acid
• Deficiency of vitamin B12
• Mental anxiety
• Sexual frustration.

Management of  a young women with itching vulva : 

Diagnosis : 

Detailed History :

1. Age of onset of pruritus
2. Intensity of itching
3. Duration of itching
4. Associated vaginal discharge
5. Contraceptive practice
6. Relation with psychological upset or neurosis.
7. Allergy to nylon, soap or particular detergents.

General examination :

• Through systemic examination is needed.
• Examination of DM, liver & thyroid disorders, haematological diseases are to be made.

Local examination : To see the extent of lesion.

Investigations of Vaginal itching :

1. Microscopic examination of vaginal discharge.
2. Vulvar scraping to detect Candid or Trichomonas vaginalis.
3. Urine for sugar, protein & pus cells .
4. Liver function tests
5. Renal functions tests
6. Stool Look for ova, parasites & cyst.
7. Blood:

• CBC
• Postprandial glucose
• Detailed haematological work up (polycythemia, leukaemia)
• Thyroid profile.

Treatment of Vaginal itching :

1. Proper explanation and reassurance.
2. Appropriate local hygiene is to be maintained.
3. To wear loose fitting cotton underclothes & keeping of the vulva well aerated by day & night.
4. Regular physical exercise and rest.
5. Correction of anaemia by iron and vitamins.
6. Vulvo-vaginal douching is to be avoided.
7. To prevent the itching-oral antihistamine.
8. To prevent the vicious cycle of “itch-scratch”:

• Local application of antibiotics or clobesterol propionate 0.05%.
• If the skin is atrophic, estrogen or testosterone cream.

Specific treatment of Vaginal itching : According to cause.

Surgery  of Vaginal itching : Surgery may be needed when biopsy confirms the features of neoplasia (VIN or invasion).