What are the causes and management measures for vulvar itching that becomes particularly severe at night?

Itching of the vulva, especially severe at night, may be caused by physiological factors that generally do not require special treatment; it could also result from pathological conditions such as leukoplakia of the vulva or vulvovaginal candidiasis. In such cases, targeted medication under medical guidance is necessary.

I. Physiological Factors

Poor personal hygiene over a long period or frequent wearing of non-breathable underwear can lead to irritation of the vulva by sebum, sweat, vaginal secretions, etc., resulting in redness and itching. This is considered a physiological phenomenon. Maintaining good personal hygiene and wearing comfortable clothing usually allows symptoms to resolve on their own.

II. Pathological Factors

1. Leukoplakia of the Vulva

Leukoplakia causes pigment loss in the vulvar skin. At night, increased smooth muscle tone and higher blood flow resistance may lead to accumulation of secretions in the vulvar area, causing irritation and worsening swelling and itching. Patients may consult a doctor for treatment with medications such as triamcinolone acetonide-econazole cream, betamethasone propionate cream, or neomycin fluocinolone acetonide cream. Sexual activity should be avoided during treatment.

2. Vulvovaginal Candidiasis

This condition results from a Candida infection of the vulva and vagina, causing irritation that leads to symptoms such as itching, burning, and swelling. As it progresses, abnormal vaginal discharge and painful urination may occur. It is recommended to follow medical advice and use medications such as fluconazole capsules, itraconazole capsules, or miconazole nitrate cream. Appropriate medication helps promote recovery of vulvar health.

Other possible causes include trichomoniasis vaginitis. During illness, maintain good hygiene habits and wear comfortable underwear.