Sore vulva? How washes, tight clothes and pads cause irritation, and how to calm it

Hormones often get the blame for a dry vulva. Low oestrogen is a common cause. But irritation plays a big part too. And it's often something you can change. Many of us say our vagina feels sore or itchy. Often it's actually the vulva, the skin on the outside.

Vulval skin works hard. It folds and stretches. It copes with sweat, heat and movement all day. And it does all this with a thin, delicate barrier. When that barrier gets worn down or inflamed, dryness usually follows.

What causes vulval irritation?

Usually it's ordinary things adding up. Walking. Cycling. Sweat. Hot weather. Tight leggings. And anything that foams.

Washes and soaps. Many intimate washes use the same foaming agents as eco washing-up liquid. Look for glucosides and betaines on the label. They're gentler than soap. But they're still made to lift oil, and your vulva needs its natural oils. Some people react to them too. Add perfume, and the wash strips the skin and leaves fragrance behind. UK dermatologists say don't use soap, shower gel or bubble bath on the vulva. They also say avoid wipes and panty liners.

Tight clothes. Synthetic fabrics and shapewear trap heat and moisture. That leaves the skin warm, damp and airless. A tight fit adds friction with every step. So even one day in leggings or shapewear can leave you sore and dry.

Pads. Pads trap heat and moisture too, especially if you leak urine. Urine breaks down into ammonia on the skin. It also makes the skin less acidic. Both can irritate thin skin. The longer the skin stays damp, the worse it gets. So pads worn every day, or not changed often enough, can cause trouble.

What does a sore, irritated vulva feel like?

Dry vulval skin doesn't always look cracked or flaky. Often you feel it before you see it. When you can see it, the lips may look red or a little swollen. It may burn in hot weather. It may feel sore after a day in fitted clothes. Some women feel a sting when they start to wee.

Sex can hurt. The stretch can turn into a pinch, or a sharp pain that seems out of proportion. These feelings usually build up slowly. They're a sign the skin's barrier is struggling.

Why does irritation make the vulva dry?

Vulval skin is thin and sensitive. It isn't built for detergent, perfume, hot showers or the constant damp of tight clothes and pads. Even mild foaming products can strip away its natural oils.

Then a cycle starts. Irritation causes inflammation. Inflamed skin holds less moisture. Dry skin rubs more. More rubbing means more irritation. Once that cycle is going, soreness and dryness can hang around for a long time.

Irritation isn't the only cause of a dry vulva. Low oestrogen plays a part too, especially after menopause. See Low oestrogen symptoms: why your vulva and vagina get dry.

What helps a sore vulva?

Start with a gentler routine. Wash once a day at most, with water or an emollient instead of soap. Skip anything that foams or smells of perfume. For how to wash, and which cream or ointment to use, see Dry vulva: what cream to use, and can you use Vaseline?

Then cut down the heat, sweat and friction. Choose loose cotton underwear over synthetics and shapewear. Change out of sweaty or damp clothes quickly. Sleep without underwear, and give the skin some air in the day if you can.

If you use pads, change them often. Try not to wear them all day, every day, if you can avoid it.

What should you put on a sore vulva? A plain, unscented ointment. It protects the skin while it recovers.

How long does it take to heal?

Improvement is usually steady rather than sudden. A week or two of gentle care can start to break the cycle. If irritation has built up over months, the skin often needs longer to settle.

When should I see a doctor?

See your GP or a sexual health clinic if soreness doesn't settle after a few weeks of gentler care, or if sex stays painful. Go sooner if you notice white or shiny patches, splits, sores or lumps. For other causes of dryness and soreness, see Why is my vulva dry, itchy or sore?

In short

Your vulva isn't built for perfume, foam or tight synthetic clothes. It does best with a gentle routine and fewer products.

References

British Association of Dermatologists, "Vulval skincare," patient information leaflet (May 2023) https://www.skinhealthinfo.org.uk/wp-content/uploads/2018/11/Vulval-skincare-PIL-May-2023.pdf

Wounds UK, "Incontinence-associated dermatitis" https://wounds-uk.com/wp-content/uploads/2023/02/content_10008.pdf