DISCLAIMER-this list is not to make you afraid of the things listed here, it is not meant to make you throw away all of the products in your home that may have a chemical from this list, or to make you afraid to try a new product; however this list IS meant to help you be more aware that there is more than 250 things that we commonly use, come into contact with that initiate a histamine response, or health issues that can be eliciting an immune and/or inflammatory response in your vulvovaginal tissues, and that coming into contact with/experiencing them on a regular basis, even minorly, can cause a chronic low level immune or inflammation response that ends up causing significant vulvovaginal health issues. Even though you think you have made all the changes, and got rid of all the products that the doctor has recommended, and you’ve taken all the advice you’ve received on the internet, you’ve tried taking probiotics and using boric acid but you’re still itching! You are still itching despite having no sex, and despite using antibiotics and/or anti-yeast infection medications on a constant rotating basis because the drs. simply don’t know what else to do, it just doesn’t stop. So, as I said, this article isn’t meant to make you afraid of chemicals or certain products but it is to provide you with additional knowledge you can hopefully use in your fight against what may be causing your unexplained, never ending, itch.
I wrote an article about seasonal vulvovaginitis and how seasonal allergies can impact the vulvovaginal complex and I was very glad to hear that the info I provided was a big help to so many who were not aware that such a condition existed. But so many women are still struggling with unexplained, undiagnosed, and untreated vulvovaginal itch, burning, unusual discharge, stinging, micro-tears, pain, irritation, rawness, erythema(redness), chronic positive yeast infections, OR constant negative test results for infections despite having symptoms.
For instance, you could have a pelvic floor muscle or nerve issue. Many pelvic floor issues go undiagnosed because we are not taught or aware that the pelvic floor muscles and nerves can cause a large amount of the same type of symptoms that vulvovaginal infections do, including chronic itching, but with no other symptoms to see on a visual exam which is how a pelvic floor issue commonly gets missed. But the pelvic floor is a very large subject so I mention it here in the list but I won’t be getting into detail about the different pelvic floor conditions specifically. This is best left for pelvic floor specialists. Try an internet search for one in your area, or a wonderful woman known as the Pelvic Guru (www.pelvicguru.com) has a tremendous amount of evidence based info and resources on this subject as well as a provider directory.
UPDATE: There are medical professionals called Vulvar dermatologists, they are familiar with discovering what may be your culprit/culprits. If you are still having issues after going through this list and trying out eliminations call around or internet search to find a Vulvar Dermatologist.
Part of the problem with discovering what is causing your unexplained or undiagnosed itch is that many times an allergen or irritant doesn’t necessarily cause an instant reaction, it can take 48-72 hours in most cases! Many times our exposure is low or our body doesn’t have a strong reaction and so it can take time for the allergen/irritant to build up in the uterine/vaginal tissues before it hits a threshold and triggers a response. By that time you’ve used something long enough you can’t easily track what the offender is. Another sneaky way you may be unknowingly causing exposure is that allergens are also excreted in your urine and fecal matter after your body has processed what you’ve eaten or taken/used such as medication or drugs and can spark a histamine or mast cell reaction in the vulva and perineum areas. Other times you can use a product for years with no problem but then for one reason or another you need to use a steroid, or you contract any one of the herpes virus variants (there are so many types besides genital herpes such as Epstein Barr for example), or you develop an autoimmune disorder, or simply due to aging, and now your immune system has changed and become a more alert and sensitive system and one of the products you’ve been using for years is no longer innocuous.
When it comes to the allergens and irritants listed it would first be very beneficial for you to understand that the vulvovaginal complex can be reactive to these allergens and irritants without the rest of the body responding as many times the allergen affects a distant organ instead of the part of the body that came into direct contact, and a skin prick test, or a saliva test, or even a blood antigen test will not tell you if your vulvovaginal complex will have a reaction-the recommended testing to be done directly on the area and followed by a colposcopic examination of the epithelium.
Many skin patch tests only test for a very limited number of allergens and many times the concentration of the product creating the allergic reaction may be lower in the testing mechanism than what the real life exposure is. Versus other skin on your body, the vulvar skin, vestibular and vaginal mucosa are particularly susceptible to allergens and irritants due to multiple factors such as counter-current flow (explained below) and the vulvovaginal complex’s propensity towards hyper-reactivity.
“It is a common diagnosis in (the female) population, with estimates suggesting an underlying irritant or allergic contact dermatitis may be present in up to
54%
of patients presenting to vulvar clinics.( https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1440-0960.1996.tb00988.x ) And while this linked paper is from 1996, the % remains high today.
There is something called the counter-current flow. The mechanisms which allow for the vaginal mucosa to be repeatedly exposed and sensitized to airborne allergens are not fully delineated or known. The existence of a countercurrent blood flow in the female genital tract, which allows inhaled and ingested compounds to selectively accumulate in the vaginal wall has provided an anatomic and physiologic basis for the airborne allergy-chronic vaginitis association but, obviously, further studying is needed. (https://link-springer-com.ezp1.lib.umn.edu/article/10.1007/s00404-016-4081-2 ; https://pubmed-ncbi-nlm-nih-gov.ezp1.lib.umn.edu/512996/ ; https://pubmed-ncbi-nlm-nih-gov.ezp1.lib.umn.edu/2104967/ )
So super simplistically- anything inhaled, or ingested or absorbed via the skin or mucus membranes can then be transported via the vascular system and ultimately makes it’s way to the vagina, as all blood in your cardiovascular system does. The uterine and vulvovaginal tissues are highly sensitive to this counter-current mechanism and so due to how counter-current flow functions the allergens and irritants are accumulating in higher concentration in the uterine and vaginal tissues and not getting circulated back out as fast as they are getting circulated in. There are many instances where we have seen drug and other allergen levels continue to rise in uterine/vagina tissues and vaginal and/or cervical discharge DAYS after the drug use/allergen exposure has stopped like penicillin and nicotine for example. I link a couple of good articles published on this at the end.
I also want to make you aware that the use of antihistamines are not always helpful in this situation, it is UNCOMMON for them to not be helpful but there is a portion of the population that do not receive relief for their symptoms with the use of antihistamines even though it is an allergen or irritant causing the problem but if you are someone who is not getting any relief from using an antihistamine this should prompt you to further investigate what the underlying cause of your itch is as it may be due to a pelvic floor nerve or that you need a stronger or different antihistamine.
You should also understand how the vulvar skin, vestibular and vaginal mucus membranes moisture plays a role in our immune response. Irritants and allergens are more of a problem for this area because, simply put, not only does the vulvar skin contain a higher concentration of antigen-presenting cells (a type of immunity cell) compared with skin at other body sites (https://pubmed.ncbi.nlm.nih.gov/17762422/ ) but the vulvovaginal epithelium has a higher rate of trans-epidermal water loss and water loss leads to atrophy allowing in more of what you don’t want to get in as the main barrier functionality of the vulvovaginal skin is comprised of moisture.
Moisture losses or estrogen deficiency leads to tissue atrophy and decreased elasticity thus impairing the skin’s ability to act as a barrier to external exposures allowing for greater permeability. A drop in estrogen (whether from menopause, POI, birth control, cancer treatments, etc.) leads to a rise in pH and a decrease in production of lipids (think fats/oils)- 2 factors that normally contribute to the skin’s protective function, as a result the vulva and vaginal tissue become increasingly sensitive to injury, have a slower recovery rate after injury and thus an increased susceptibility to microbial colonization and infection.
Here is a general visualization of what happens when the dermal layers are experiencing moisture loss or a barrier dysfunction, whether it’s the outside skin or the inside mucus membranes-the principle is the same. A broken barrier allows for permeation of things in places we don’t want them to be.
Increased hydration isn’t a good thing either, however. Many are aware that frequently causing a moist environment such as that with daily pad or liner use, or swimwear, or workout clothing can cause dermatitis or yeast infections however consistent moisture can also cause mechanical trauma which leads to broken dermal barriers, and too much moisture allows for greater permeability of hydrophilic agents (molecules that like and play well with water’s polarity).
The use of what’s termed occlusive fibers such as polyester and nylon or any of the fiber types used in athletic clothing/tight leggings/yoga pants, or athletic underwear can be an issue in that “while initially these occlusive fibers promote retention of moisture, their removal in low humidity conditions results in rapid evaporation of moisture from the skin. Pre-existing epidermal barrier dysfunction in patients with atopic dermatitis allows the quick change in humidity to cause fissuring of the skin. Rapid removal of occlusion also upregulated inflammatory cytokines. As a result, it is helpful to wear fibers such as cotton or lyocell which wick moisture, by absorbing liquid away from the skin, under (any) occlusive materials.” ( https://link.springer.com/article/10.1007/s11882-015-0518-0 )
The take away here is to wear cotton underwear if you wear synthetic or stretchy materials so you don’t rip away your moisture barrier when stripping off the stretchy/athletic clothing! The synthetic materials rip your needed moisture along with it when you take those types of clothing, having on cotton underwear allows the cotton to wick the excess moisture as you go about your day/activity.
Now for a cool sciency side note:
A number of studies have shown that vaginal immune response causes some cases of recurrent vaginitis. IgE antibodies to C. Albicans, seminal fluid components, pollen, and contraceptive spermicides have been identified in vaginal fluids of women with recurrent vaginitis. Exposure to allergen in the vaginal lumen is followed by the transport of this allergen through the interepithelial channels and its interaction with mast cell-bound specific IgE. This induces mast cells degranulation and the release of histamine and other inflammatory mediators, causing symptoms of allergic vaginitis. In addition, histamine is a potent inducer of prostaglandin E2 from macrophages which suppresses cell-mediated immune response. Protection against yeast is dependent on the cellular immune system (the cell-mediated immune response). The resulting symptomatic candidal vaginitis would be a secondary consequence to a primary allergic vaginitis. If you have the chance to read this whole article and not just the abstract, do! It is phenomenal. (https://pubmed.ncbi.nlm.nih.gov/11061467/ )
It’s basically saying that your body may be experiencing recurrent or chronic yeast infections because there is an allergen and/or immune response you are not treating and inflammation is causing a break down in the vaginal protections. Candida is an opportunistic organism so it will take over in any chance and environment it can, it can happen in low pH OR high pH vaginal environments. There are studies that have proven it can also happen in vaginal microbiomes with normal, healthy levels of beneficial bacteria. It’s the immune system that is the primary problem and figuring out how to get yours under control may be what finally breaks the cycle you’re in.
Another part of the equation is progesterone causes immunosuppression and thus enhanced susceptibility to infections and allergic reactions so you may also notice a rise in occurrence in the late luteal phase of the menstrual cycle which is just before your period. The immunosuppression effects were also seen in vaginal fluids collected during peri-ovulation, it is believed to be a necessary mechanism to create an environment compatible with sperm. This is one of the ways that women can experience monthly yeast infections around the same time every month.
I know that was a lot to learn and take in and you really want to just get to the list but I was serious when I said there was 250+ things making your “vag” itch so you can’t say I didn’t warn you.…..
Now for the list:
Personal, beauty, cosmetic products (The items listed here are usually an issue due to cross contact, direct contact or counter-current flow)
1. Inhaled latex: latex products, especially gloves, release latex particles which you can breathe when they become airborne
2. Shaving creams or depilatories: for those of you, or partners, who prefer a more “manicured” look to the vulva
3. Shaving: the actual act with a razor blade causes moderate inflammation to the dermis even if there isn’t razor burn, shaving acne or ingrown hairs
4. Aftershave lotions/splashes/ect.: on a male’s face from face shaving and then he performs oral sex causing cross contact
5. Nail polish: nail polish contains many irritants, particularly Formaldehyde and there is a high rate of using the bathroom after painting nails (home or professional) causing cross contact
6. Same with nail polish remover: that stuff is actually very penetrative and sticky to your skin, don’t believe me? Wash your hands after using nail polish and see how you feel about putting your fingers in your mouth or eye-I’ve done it, it did not end well!
7. Perfumes/colognes
253. Toilet paper: Did you chance toilet paper brands or types around the time the itch started? Many vulva owners report that they are unable to tolerate certain brands, however this is different for each person. One brand may cause an issue for one person but not another
8. KY Jelly
9. Hygiene sprays and deodorants: not only can the product ingredients themselves cause a problem but the propellant used to provide the aerosol spray mechanism can as well
10. Any soap, body wash/gels: Sodium Lauryl sulfate is the ingredient we don’t typically think about with soaps, we tend to think about the fragrance or dye component. SLS is a surfactant that makes things foam, it is alkaline, and will dry out mucus membranes which is what the inner labia consists of, so bad news bears!
11. Lotions: due to possible cross contact or any fragrance used, especially if applied to the inner thighs and then the thighs come into contact with the vulva
12. Sanitary napkins/pads: due to possible fragrances used, but also the plastics themselves and the glues used for stick. The ones with wings have been reported to be even bigger problem causer due the proximity you are to the glue on the wing as your leg/vulva crease is in direct contact with it.
13. Laundry soap residue: laundry soaps are alkaline and also have formaldehyde and enzymes, so if the clothing isn’t rinsed well or you use more soap thinking it will get things cleaner there may be soap residues left behind
14. Bacillus Licheniformis Protease (Alcalase, and/or Maxatase): present in the household detergents, typically those with “stain removers”, or actual stain removing products
15. Coal tar: used in dandruff or lice shampoo, paints
16. Colophony: used in adhesives such as adherent bandages, topical medications, personal and beauty products, you come into contact with this if you’re a violinist
17. Spermicides
18. Foreign body: possible tampon left inside does still happen
19. Colored soaps
20. Douches: somehow these are still on the market and being used
21. Fabric softener: while many of you reading this article have already stopped using fabric softener on your underwear, if you are still using it on pj’s or other pants then the fabric softener is still coming into contact with your vulva or vulvar/thigh crease
22. Nickel (usually also contains cobalt): if it’s turning your skin green or even just making the area where it’s being worn itch then it’s causing a histamine and inflammatory reaction in your body. Nickel can also be found in some recycled toilet papers.
23. Needlework/crafting tools: usually a cross contact concern
24. Balsam of Peru: used as a fragrance
25. Gold
26. Lanolin
27. Pert plus shampoo: contains Linalool and hydrogen peroxide
28. Essential oils: many products have come to the market lately for feminine use that have called themselves natural, organic, plant based, essential oils….THIS DOES NOT MEAN IT IS SAFE FOR VULVOVAGINAL USE DESPITE WHAT THE PACKAGING SAYS
29. Insect repellant: mainly the hydroxycitronellal, citriodiol. We use the product and then don’t wash thorough enough and go to the bathroom, etc.
30. Benzyl salicylate: an acne product, mainly comes into contact with the vulva if products are used in the shower and the water then runs down passed the vulvar area
31. Methychloroisothiazolinone or Methylisothiazolinone: are widely used preservatives found in liquid cosmetic and personal care products
32. 2-phenoxyethanol: a preservative in cosmetics
33. Parabens
34. Iothiazolinones, octylisothiazolinone, benzisothiazolinone: antimicrobials used in a wide variety of products
35. Home use UV curing nail polish
36. Rubber: Neoprene-used for waterproof clothing, or can be used in things like shin pads if you play those sports, or orthopedic braces
37. Anti-hemorrhoidal creams/wipes: these are clearly in very close proximity to the vulva
38. Benzocaine and other topical anesthetics: these ingredients are in yeast infection anti-itch medications or things like Vagisil anti-itch creams and others
39. Hair dyes: the ingredients in hair dyes are known to make you more susceptible to developing allergies to things you otherwise would not have been had you not exposed yourself to hair dye. Even natural ones as they contain Acid Violet
40. Wet wipes/feminine wipes/moist toilet paper wipes: whether a cleaner or botanical/essential oil based, these products are highly irritating to the vulva
41. Octocrylene in UV filters and sunscreens
42. Contact lens solution (polyhexamethylen biquanide): usually a cross contact issue
43. Tea tree oil- (ahem) Let me say that again for those in the back, Tea tree oil is not the cure all and causes a reaction in many who try it. This stuff can cause significant dermatitis and allergic responses in a large portion of the population, please try this product with extreme caution!
44. Arbutin-A skin whitening cream, cross contact or by being used on the genitals to lighten that skin
45. Cetearyl isononanoate: an emoliant in a variety of person care products and cosmetics
46. 2-Amino-4-hydroxyethylaminoanisole sulfate: found in hair dyes
47. Cocamide diethanolamine, or Cocoamphoproprionate, or Cocamidopropylamine oxide: used in personal cleansing products
48. 3-o-Ethyl-L-ascorbic acid: or EAC for short is an “etherified derivative of ascorbic acid” that consists of vitamin C and an ethyl group bound to the third carbon position. Used in most notably anti-aging products however the Vit C has been changed to be more stable for use. There is a delayed reaction so many don’t attribute skin issues to this products start. While this product isn’t meant for direct use on the vulva that doesn’t mean that zero products contain it especially body lotions and then there’s the chance for cross contact.
49. Ethylhexylglycerin: preservative and skin conditioning agent
50. Glycyrrhiza inflata extract (licorice root extract): used as a skin conditioning agent and also in some lubes
51. Fragrance mix I & II
52. Masking fragrance: many times a product is labelled as scent free but the product actually contains what’s called a masking fragrance
53. Hydroxypropyl tetrahydropyrantriol: used in anti-aging products
54. Liquorice flavonoids: act as antioxidant and anti- inflammatory agents.
55. Magnolia Offininalis bark extract: traditional natural herb used for anti-inflammatory and a source of pain relief, and has been used to help alleviate joint and muscle pain, as well as headache and menstrual cramps
56. Panthenyl ethyl ether: hair conditioner and antistatic
57. Pantaerythrityltetracaprylate/tetracaprate: usually found in skin conditioners/lotions/etc.
58. 5PEG-22/dodecyl glycol copolymer: used as an emulsifier in personal products and cosmetics
59. Phenylethyl resorcinol: A whitening and brightening ingredient used in skin and hair products, is a synthetic compound that is partially derived from natural lightening compounds found in Scotch pine bark.
60. Quarternium-15: aka Benzalkonium chloride, benzethonium chloride, quaternium-15, centrimonium bromide, polyquaternium. Found in Hair conditioners, hair styling products, creams, lotions, cleansers, shaving products, eye drops contact solutions and household cleaning products.
61. Vagisil/Summers Eve products: any of them
62. Scutellaria baicalensis extract: aka skullcap, an herb
63. Steareth-10: an emulsifier. A polyethylene glycol ethers of stearic acid. They are waxy compounds. In cosmetics and personal care products, Steareth ingredients are used in the formulation of personal cleanliness products and deodorants, as well as suntan, fragrance, skin, eye and hair products.
64. Thioctic acid: aka lipoic acid, an antioxidant
65. Vitamin K1 oxide: Vitamin K1 oxide is intended to replace the use of vitamin K1, which has recently been banned for use in cosmetic products as the allergenic potential was considered to pose a risk in the light of its therapeutic use. There has been a public call for data on Vitamin K1 oxide.
66. Lavender oil
67. “Botanical” products- chamomile aloe vera, calendula, etc.
68. Peppermint oil
69. Resolve: ingredients are irritating
70. Acylates or Methacrylates: plastics in pads, acrylic nails, nicotine pouches
71. Phenols: an acidic aromatic compound used in many products
72. Diaphragms: such as used for birth control
73. Arousal stimulants
74. A&D ointment: due to an allergy to lanolin
75. Sex toys: many sex toys are not made with ingredients that are safe for genital use and even if they are the ingredients may be one you aren’t able to tolerate. It isn’t always a proper washing/sanitizing issue but the toy itself
76. Condoms: due to a latex or lubricant allergy
77. Bleach: many women will try and sanitize their underwear to kill off any BV or yeast that they think is still on them and the bleach is used in too high of concentration and/or not rinsed well enough, or by cross contamination, or when cleaning
78. Lye
79. Antiseptic mouthwashes: usually due to the user then putting their mouth on your genitals/vulva
80. Toluene sulfonamide formaldehyde resin in nail polish
81. Fluorinated hydrocarbon propellants
82. Gyno exam lube
83. Esters
84. Polymyxin
85. Sulfonamides
86. Chlorhexidine
87. Gentian violet
88. Phenylmercuric salts: Antifungal and antiseptic sometimes used in ophthalmic products
89. Eyelash glue
90. Oil of Eucalyptus
91. Oxyquinoline: antiseptic, disinfectant, and pesticide properties. It is used as a stabilizer for hydrogen peroxide, where it is sometimes added in cosmetic products.
92. Thymol
93. Glycerin
94. Jojoba oil
95. Diazolidinyl urea, Imidazolidinyl urea: antimicrobial preservative in cosmetics
96. Kathon: an antibacterial
97. Thiurams: associated with natural rubber latex
98. Oxyquinoline sulfate: used in hair dye and some anti-infective agents
99. Stearyl alcohol: a fatty acid used in a variety of cosmetics, lubricants, perfumes, and personal products
Health conditions and biological sources
100. Semen: the proteins in the semen itself
101. Luteal phase vaginal discharge: the dryer, thicker discharge that’s typical during the luteal phase seriously can irritate some vulvas
102. C. Albicans: yes you can be having an allergy to the teensiest amount of candida which in the average person might get fought off but in someone who has developed a candida allergy even a tiny amount can cause an allergic reaction, this thus then causes an hyper immune and histamine response which then lowers the vaginal immunity and then the candida (an opportunistic organism) can flourish. See paragraph just above the start of the list
103. Male ejaculatory delayers/male genital desensitizers: the ingredients in these are horrible for your vulva and vagina to come into contact with
104. Saliva: yours or someone else’s. Someone’s saliva could contain proteins that you could be sensitive to or food components hours after the food has been eaten, same as your saliva-there’s the potential for cross contact
105. Atopic Dermatitis: Different from eczema, which can be happening to your vulva but happens anywhere on your body and can make the vulva more susceptible to other allergens and irritants
106. Urticaria: aka Hives, usually happening on other areas of the body but the same mechanism as listed above causes a heightened histamine and immune reaction which can make your vulva itch but you may not put the two together
107. Dermographism: same mechanism as above
108. Partner sweat: usually male partner sweat can contain proteins that your vulva reacts to especially since the groin is a more consistently sweat producing area of the body
109. Microscopic abrasions: from sex or any vaginal penetration can make you itch, ever have a papercut? That shit itches after its done with the initial pain!
110. Immunosuppressive activity of semen: besides the proteins, semen needs to cause immunosuppression in the vagina and reproductive tract so that your body doesn’t kill off the sperm before it reaches the egg
111. Any change to vaginal pH can be irritating to the delicate mucus membranes and cause itch
112. Psychological symptoms: there is a frequent association between tension and pruritis. Many studies have shown that stress and tension can cause eczema and other pruritic conditions but it’s difficult to determine which issue came first
113. Trichomonas
114. Gardnerella
115. Mycoplasma
251: Ureaplasma-reports of this affecting the surrounding vulva and mons
252: Urealyticum-reports of this affecting the surrounding vulva and mons
116. Chlamydia
117. Herpes
118. HPV
119. Aerobic AND anaerobic bacteria lol
120. Staph
121. AIDS
122. Gonorrhea
123. Psoriasis-can totally happen in the groin area
124. Any one of the Lichen complexes: there are multiple and not all have plaques
125. Lupus
126. Pellagra: a disease caused by a lack of the vitamin niacin (vitamin B3). Symptoms include inflamed skin, diarrhea, dementia, and sores in the mouth. Areas of the skin exposed to either sunlight or friction are typically affected first.
127. Bechet’s syndrome: A rare disorder causing inflammation in blood vessels. The cause of Bechet’s disease is unknown, but it may be the body’s immune system attacking healthy cells (autoimmune disorder). Symptoms include mouth and genital sores, inflamed eyes, and rashes.
128. Vulvar cancer: of any kind
129. Parasites
130. Pelvic floor dysfunction-this is a huge topic that I won’t get into here but this is a biggy, pelvic floor muscle or nerve issues are usually significantly undiagnosed because most people and drs. alike are not aware of how the pelvic floor plays a huge role in genital health and any issue in this area can make you have a vulvovaginal itch that won’t go away
131. Idiopathic: this one sucks but sometimes current medical technology just cannot find an answer to what caused a health issue, it doesn’t mean there isn’t an answer it just means you haven’t found it yet.
132. Lactose: seriously, even if you aren’t technically lactose intolerant that does not mean that lactose isn’t still causing inflammation inside your body. There has been some recent debate whether dairy causes inflammation in the body but if you are someone who experiences symptoms after consuming dairy, those symptoms are from inflammation in your digestive tract and that inflammation can trigger mast cell proliferation in the groin area if you are consistently exposed to the offending dairy products especially if you are experiencing intestinal cramping and diarrhea-these things are known triggers to those who have dealt with vulvovaginal conditions for a long time
133. Eczema: just eczema in the groin area can make you itchy but having eczema elsewhere on your body can predispose you to being more sensitive to other allergens or irritants
134. Epstein Barr virus
135. Seborrheic dermatitis
136. Mechanical friction: clothing, wash cloths, towel drying, sponges, sexual stimuli, anything that causes friction on the genitals
137. Neuroproliferation: hyperinnervation
139. Estrogen deficiency or anything that would cause a decrease in estrogen or testosterone or attenuation of the HPO axis such as THC, hormonal birth control, POI, PCOS, being over the age of 30, excessive exercise, stress, some others
140. Vulvodynia
141. Vestibulodynia
142. Vestibulitis
143. Genital warts
144. Diarrhea
145. Urine: the acidity irritates the flesh
146. Vaginal atrophy
147. Personal/family history of atopy
148. Plasma cell vulvitis
149. Desquamative Inflammatory vaginitis
150. Bone Marrow Transplant: can cause vulvar and vaginal graft versus host disease (VVGvHD) as the mucosa becomes altered and sclerotic changes in the female external genital organs (can) occur (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412147/ )
151. Vitamin D deficiency
Medications
152. Topical meds: many people do not wash their hands thorough enough after using a topical medication or ANY product for that matter and then use the bathroom or go to do any activity where you and up touching your vulva and now there is cross contact
153. Drug eruption (which means an adverse skin reaction): phenolphthalein, analgesics/antipyretics, barbiturates, penicillin’s, sulfonamides or other sulfa drugs, NSAIDs, chemotherapy agents, anticonvulsants, psychotropic drugs, tetracycline, minocycline, antimicrobial agents, and more
154. Bacitracin: a topical antibiotic ointment/cream
155. Neomycin sulfate: Neosporin ointment/cream
156. Cocamidopropyl betaine: used in most personal and beauty products and cosmetics
157. Versa Base- due to it having MCI/MI in it
158. Miconazole, Clotrimazole, Terconazole: antifungal creams
159. Paraderm Plus: a first aid cream containing chlorhexidine, lidocaine, and bufexamac-all possible allergens
160. Mycolog
161. Bronopol: antimicrobial and preservative in pharmaceuticals
162. Hexylresorcinol: aka Sucrets throat lozenges
163. Quinine hydrochloride: an antimalarial drug
164. Pevaryl: aka Econazole, an antifungal
165. Ovestin: a brand name for an estriol cream-the allergy comes from it’s other ingredients
166. Nystatin: or any of it’s brand names- an antifungal. Many people have reported a reaction to Nystatin and unfortunately it gets prescribed for use on the vulva and usually just makes things worse
167. Hydraderm cream: issue lies with one of the ingredients-glycerol, liquid paraffin, soft white paraffin, cetostearyl alcohol, propylene glycol, cetomacrogol 1000, silicon dioxide and chlorocresol.
168. Fluorouracil: a chemotherapy drug
169. Imiquimod: an immunosuppressant drug
170. Podophyllin: a resin made from the American mandrake root used to treat warts
171. Cantharidin: aka Spanish fly, also used to treat warts
172. Anti-itch creams: are actually notorious for causing itch and allergy problems when applied to the vulva
173. Bichloroacetic acid: a therapeutic agent to treat lactic acidosis, diabetes, and familial hyperlipidemia in humans
174. Corticosteroids: there’s many and while you may not have a reaction to the corticosteroid itself. Hydrocortisone is a common one but prescription types can as well. Corticosteroids can make you more susceptible to other allergies and irritants due to the medicines method of action on other tissues
175. Benzalkonium chloride: used in a good portion of the hand sanitizers, vulvar issues are usually due to cross contact
176. Maleic acid: The name malic is from the Latin for apple, malum. Malic acid is found in other fruits such as grapes, watermelons, cherries, and in vegetables such as carrots and broccoli. This acid is mainly used in food applications including candy and beverages.
177. Streptomycin, Kanamycin, Gentamicin, Tobramycin: aminoglycoside antibiotics
178. Sulfa drugs
179. Thiazide diuretics
180. Numbing agents: Bupivacaine, lidocaine, dibucaine, mepivacaine, prilocaine, pramoxine, there are others-please google yours + side effects to see what comes up for yours specifically
181. Hydroxyzine: an antihistamine, issue typically due to Ethylenediamine hydrochloride also aminophylline
182. Crotamiton: an antiparasitic cream
183. Diphenhydramine: antihistamine, normally to relieve an allergy but can cause the opposite reaction in a small portion of the population
184. Mercuric chloride: a disinfectant
185. Povidone iodine
186. Thimerosal: an antiseptic and antifungal, widely used as a preservative in a number of biological and drug products, including many vaccines, to help prevent potentially life threatening contamination with harmful microbes
187. Benzethonium chloride: has surfactant, antiseptic, and anti-infective properties, and it is used as a topical antimicrobial agent in first aid antiseptics.
188. Methyl salicylate: used to treat minor aches and pains of the muscles/joints (such as arthritis, backache, sprains), works by causing the skin to feel cool and then warm
Environmental, home, pets
189. House dust mites
190. Seasonal allergies
191. Animal allergies: due to counter current flow you may not notice you are having a tough time with the pet you have but there’s a chance those allergen responses are building up in the vaginal epithelium. ALSO, many times we pet the furry friend and then use the bathroom, masturbate, give the vulva a scratch, etc. and now we have transferred the pet dander directly to the vulva
192. Dry winter air: when the skin and mucus membranes are dry the defense systems are down, if your skin is dry and needs lotion your vulva is dry, drink more water, apply a little coconut oil, build up that moisture barrier
193. Lack of air flow: such as with wearing jeans, occlusion due to weight, etc.
194. Hot water: strips away the natural moisture barrier
195. Vigorous drying or using a hot hair dryer
196. Stool residue
197. Poor nutrition status
198. Any chemical or food residue on hands that then touch the vulva or penis that then touches the vulva/vagina
199. Sodium bicarbonate and sodium borate: these are alkali and can cause irritant contact reactions. Baking soda sitz baths are helpful to a lot of women but sometimes it’s not what is needed and can cause more irritation instead of helping to relieve.
200. Scratch-itch cycle: the more you scratch the more things itch and the more you create microtears and weaken the skin barrier
201. Heat: can increase histamine
202. Plants: obviously any plant can cause you an issue but exposure to poison ivy/sumac/oak, urushiol, can cause a significant systemic reaction that can linger longer than body symptoms which can make you mistake how your vulva became itchy, most cases are due to cross contact
Clothing
203. Disperse Blue 124 and Disperse Blue 106: which is used on black, synthetic, stretchy materials such as leggings and work out clothing, jeans, body suits, aerobic outfits, and underwear transferred from normal body sweat
204. Azo dyes: textile dye, however use is becoming seldom due to a known increase in allergy incidence
205. Rayon
206. Acetate
207. Nylon
208. Polyester
209. Acrylic: just get your nails done? Don’t put those hands anywhere near your bits for like a day girl! But this is also used in clothing
210. Spandex
211. Lycra
212. Textile dyes: most commonly Disperse Yellow3, Disperse Red1 and just like the Disperse Blue I mentioned before the issue here besides any direct contact allergy, what is believed to be happening is that plain ol’ minor body sweat plays a role in the transfer of dye to the skin
213. Tight clothing: especially nylon or lycra underwear
214. Elastane: aka spandex, lycra
215. Sodium metabisulfite: from dying and bleaching jeans
216. Wool
Misc
217. Propylene glycol: is found in just about everything we use and eat
218. Newsprint
219. Aluminum- usually due to cross contact or antiperspirant
220. Trichloroacetic acid: TCA is a noninvasive skin treatment used to treat skin discolorations, scarring, and wrinkles, usually a cross contact problem
221. Exaggerated personal hygiene: excessive or rough or even “thorough” cleaning of vulva with or without soaps, simply the rubbing can cause a breakdown in the natural defenses
222. Chromium: usual places of contact can include- cosmetics or tattoo inks of yellow or green coloring
223. Titanium: particularly if it’s in tattoos
224. Vanadium: a corrosion resistant alloy used in surgical implants
225. Amalgam components: mainly mercury then copper sulfate
226. Ultrasound gel
227. Newly painted rooms off gassing an then you sit an breathe that in for days
228. Spruce needles: you may see a big uptick in itching around Christmas time if you handle a real Christmas tree
229. Sawdust
230. Worse at night: anti-inflammatory hormone cortisol are naturally lower at night and the immune system kicks into higher gear at night when you are normally sleeping which makes it the best time for the immune system to go and fight
231. Polyurethane: which is also an ingredient in the Invisalign braces but most contact comes from foam like mattresses, pillows, and other furniture
232. Phenylmercuric acetate and butyrate: a white to yellow powder found in fungicides, herbicides, and used to help control mildew in paints….painting the house or treating a garden?
233. Mercaptobenzothiazole: most likely to contact mercaptobenzothiazole when using, wearing, or handling natural or synthetic rubber products at work or at home. Work shoes and athletic shoes are often made with rubber components that contain mercaptobenzothiazole or related substances. Usually a cross contact issue
Food
234. Fruit and Fruit skins as well as bananas, nuts
235. Acrylamide: found in french fries and potato chips, crackers, bread, and cookies, breakfast cereals, canned black olives, prune juice, and coffee, tobacco products and tobacco free nicotine pouches
236. Farinaceous foods: foods rich in starch
237. Flavorants
238. Turmeric-usually from cross contact from handling the herb
239. Nutmeg powder
240. Coriander powder
241. Curry mix powder
242. Onion Powder
243. Food particles: can linger in a person’s mouth for hours and then their mouth gets put on your vulva
244. Food contact via partner: the chemicals in the food you are allergic to are also found in semen-seriously!
245. Cinnamic alcohol, cinnamic aldehyde
246. Eugenol, Isoeugenol: clove oil
247. Chicken: Some people are allergic to chicken and it can take several hours to show symptoms
248: Alpha-galactose (alpha-gal): Some people are allergic to red meat but the issue isn’t the red meat, it’s the alpha-gal in the red meat.
249. Various foods due to cross reactivity: If you are allergic to latex you could have an allergy to one or many of these foods-Between 30 and 50% of individuals with a natural rubber latex allergy are sensitized to other foods, especially fruit. It’s most common to see cross-reactivity with avocado, banana, cassava, chestnut, kiwi, mango, papaya, passion fruit, tomato, turnip, zucchini, bell pepper, celery, potato, and custard apple. However, sensitivity to various other foods has been recorded. (https://www.verywellhealth.com/rare-but-real-food-allergies-1323994 )
250: Gelatin
That was a lot, I know, but if you’ve gotten this far there’s probably a reason such as your desperate need to be well again, or at the very least a thirst for knowledge. If you skipped over the first part of this article please make sure you go back and read it, it contains a lot of info about how this list can play a role in your vulvovaginal health, how your “vag” can itch but not the rest of your body, and how it’s not meant to make you afraid of what’s listed but to make you more aware of what could be causing your “vag” to itch!
https://pubmed.ncbi.nlm.nih.gov/3364502/
https://pubmed.ncbi.nlm.nih.gov/11511847/
https://pubmed.ncbi.nlm.nih.gov/30179968/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857673/
https://pubmed.ncbi.nlm.nih.gov/2104967/
https://pubmed.ncbi.nlm.nih.gov/20883913/
https://link.springer.com/article/10.1007/s11882-015-0518-0
https://ir.uiowa.edu/cgi/viewcontent.cgi?article=1255&context=pog
https://pubmed.ncbi.nlm.nih.gov/11061467/
https://www.contactdermatitisinstitute.com/disperse-blue-mix-124-106.php#:~:text=Disperse%20blue%20124%2F106%20is,color%20polyester%20fabrics%20and%20blends.
https://pubmed.ncbi.nlm.nih.gov/10644021/
https://pubmed.ncbi.nlm.nih.gov/30663079/
https://pubmed.ncbi.nlm.nih.gov/26455062/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025382/
https://escholarship.org/uc/item/4053p27c
Healthy Hooha 
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