Vaginal Itching (White Discharge)

 Vaginal Infection and Treatments

Dr. KS Prasanna, Director, Institute of Applied Dermatology, Kasaragod, Kerala

Vaginal itching is a common and distressing condition that affects nearly all women at some point in their life. The problem can be in children, teenagers, adults, or aged ladies. But the cause could be different. As some patients and parents come and say” Doctor, I have itching in an area which nobody can see. Because of this itching, I am not able to go to the public. How can I itch in front of people? Please doctor treat and give me relief, I will not forget your help”. Yes, it is a problem causing mental agony to ladies.

Vaginal discharge is a normal physiological process. Normal vaginal discharge is white, non-homogenous, and flocculus. Normal vaginal PH is acidic. Around 10-14 days after menstruation, there is often sticky, thick, and white discharge which is not itchy. This thick white discharge is a normal process, and it indicates ovulation. This vaginal discharge contains a bacteria called lactobacillus. This bacillus protects the vaginal epithelium from any other infection. Lactobacillus, which is a healthy vaginal flora, inhibits the growth of other organisms by maintaining a low PH 4.5

Vulvovaginitis is the inflammation of vulva and vagina. It is due to infective and non-infective causes. Infective causes are Fungal(candidiasis), trichomonas, or bacterial vaginosis. Non-infective reasons are due to trauma, allergic (soap, detergent, etc.), or due to skin diseases like lichen planus and thinning and wrinkling of the skin (called in medical term as Lichen sclerosus et atrophicus). Vaginal infection in Prepubertal girls has many reasons. Could be due to behavioral, anatomic, and physiologic factor. Behavioral factors include wearing tight, non-absorbent clothing, poor hygiene, particularly when young girls start their hygiene practice. Girls may be drying water after ablution from back to front or wiping inadequately. The use of too many chemicals like scented soaps can cause vaginal irritation. Pinworm infection also causes vaginal irritation in children. Even respiratory pathogens following respiratory tract infection in premenarchal girls can cause vaginitis by the oral digital route.

When the vaginal discharge becomes itchy, frothy, yellowish-green, or foul-smelling, then it indicates vaginal infection either by candida, trichomonas, or bacteria.  Burning dryness and painful coitus after menopause are due to hormone estrogen deficiency. This condition is known as atrophic vaginitis. Also, patients who have diabetes, on long term immunosuppressive drugs, oral contraceptive pill, and antibiotics are more vulnerable to vaginal infection.

Whenever a lady develops a vaginal infection, consult Doctor. And get the blood test done for diabetes, anemia, and urine test to see any underlying urinary tract infection. The management of chronic vulvovaginal symptoms is a challenge, and it requires an organized approach. Vulvovaginal diseases are multifactorial. And these components need to be addressed simultaneously. You have to tell every detail to your Doctor, allow a full examination with adequate light and get done blood and urine tests. This approach will give a cure in most of the cases.