Aunt Vadge: strange vulvar itch for six weeks

TL;DR

Persistent vulvar itch can be frustrating, especially when common treatments fail to provide relief. This article explores the possibility that the cause might not be fungal, but rather a bacterial infection or an issue related to environmental factors such as wearing a wetsuit. It highlights the importance of proper testing and considering all potential sources of the problem, including the materials of clothing worn during activities like surfing.

Hi Aunt Vadge,

I have had extremely annoying itching for over 6 weeks. It first started after I shaved a little “farther in” my bikini line than normal. I then went surfing.

The nurse practitioner at GYN office thought it was fungal, but RX antifungal topicals did nothing. I did a month-long candida cleanse, have been taking antifungals to kill Candida, no positive results.

I have been using yeast arrest suppositories for 2 weeks, if I have a yeast infection normally these knock it out immediately.

My naturopath took a culture 3 days ago, it came back negative for everything – Candida, bacteria, etc. She said it’s possible because of topical treatments I’ve been trying (coconut oil, tea tree oil, clove oil) it didn’t get bacteria on culture. She did not swab inside of the vagina or break skin to take culture, just very light scraping of surface of labia.

I finally asked to try an oral antibiotic as I am at my wit’s end and I feel absolutely sure if it was fungal I would have cured it by now.

Please, please help! I’m desperate to stop this itching it’s taking over my life. It’s causing anxiety and depression, and I have two young children to care for.

Yours,
S

Age: 35
Country: United States

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Hi there S,

Your itching sounds very uncomfortable! I’m not clear where exactly the itching is located – inside your vagina or just on your labia where you shaved? Regardless, it seems as though shaving + surfing = persistent vulvovaginal/vulvar itch.

It seems true that if it was fungal, it would have responded to your treatments, but this isn’t always the case. Yeast can be treatment-resistant.

Also, it may not be yeast, but rather a fungal or bacterial infection you’ve picked up in your freshly-shaved open/unprotected follicles from your wetsuit or swimsuit.

Bacteria and mould find the normal insulating materials (neoprene or polychloroprene, or synthetic rubber or variations) good support substrates that retain moisture/water and offer a food source. Food and a safe place allow undesirables to flourish, which can then easily enter your hair follicles or attach to your skin when pressed close during surfing.

It would be worth getting a swab taken and tested when your vagina/vulva and system is clear of any treatments. You mention requesting an oral antibiotic, but don’t say if you got it or not.

Depending on your test results or desire to experiment, a local antibiotic cream, rather than oral antibiotics, may be worth exploring. Oral antibiotics for a local problem may be overkill in this instance.

You need to be properly tested for bacteria, fungus and yeast – a false negative isn’t enough, and you shouldn’t be treating yourself with antifungals or antibiotics when you don’t have a clear test result.

Presumably, you are still surfing regularly wearing the same wetsuit/swimsuit, which will keep the problem reappearing. I’m not completely across the best way to deal with possible fungal or bacterial overgrowth on wetsuits, but it seems entirely possible that a colony may have embedded with biofilms and be incredibly difficult to get rid of.

While you’re trying to treat whatever it is, it seems wise to avoid wearing any wetsuit/swimsuit – using a fresh suit will possibly transfer whatever you have to the new suit. Depending on the outcome of testing, consider your options for deep cleaning/replacing your wetsuit.

I realise a change of suit is inconvenient and expensive, but the problem will keep coming back if you have a reservoir of microbe in your suit. It’s difficult to know whether this is true or not, but it seems reasonable based on what you’ve told me.

In the meantime, you could try an oat bath to soothe your skin or apply an ice pack (covered in fabric).

I’d love to know the outcome when you finally get to the bottom of it, so if you get a minute feel free to write back!

Best,
Aunt Vadge



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