Bedell SL, Lawson AA, Griffith WF, Werner CL (2018) Vulvar Pruritus: Variability of Clinical Evaluation and Management. Int J Womens Health Wellness 4:084.


© 2018 Bedell SL, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ORIGINAL ARTICLE | OPEN ACCESSDOI: 10.23937/2474-1353/1510084

Vulvar Pruritus: Variability of Clinical Evaluation and Management

Sarah L Bedell, Ashli A Lawson, William F Griffith and Claudia L Werner*

Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, USA



We characterize the evaluation and initial management of patients with vulvar pruritus, including elements of history-taking, physical examination, laboratory testing, and treatments. We propose an algorithm for approaching this common clinical problem in a systematic way.


A retrospective chart review of patients with vulvar pruritus who presented to Gynecology or Vulvology Clinic at Parkland Health and Hospital System in 2012 informed this descriptive study.


A total of 46 patients aged 19 to 70 years presented with a primary symptom of vulvar itching, of which 41% had additional irritative vulvar complaints. The average duration of symptoms was 24 months; 67% had used at least one self-treatment unsuccessfully prior to their visit. Only 13% of patients received a non-genital skin examination; 46% received a vaginal culture, and 20% underwent vulvar biopsy. The most common diagnoses were "nonspecific" (39%), and "dermatitis" (22%). The most common treatment prescribed was a topical steroid (78%). Vulvar skin care counseling was documented for 67% of patients. At 18 months, 46% were lost to follow up and of those who returned, 48% reported resolution of initial vulvar symptoms.


The assessment and treatment of vulvar pruritus is variable. An algorithm for the evaluation of this common clinical complaint is proposed.