While truly unbearable at times, vaginal burning can be a helpful sign from the body that something is wrong. "Vaginal or vulvar burning is a very common symptom people can feel when the skin on or around the vulva and clitoral region, or at the opening or inside of the vagina, is exposed to infections, bacteria, irritants, or allergens," says Arizona-based ob-gyn Erica Montes, MD, FACOG. Vaginal skin is extremely delicate and sensitive, which makes it more susceptible to irritation and inflammation. Meanwhile, the vulva (or external skin) is most vulnerable to irritants and allergens, such as scented lubricants and soaps.
Jill Krapf, MD, a board-certified ob-gyn at the Centre For Vulvovaginal Disorders in Washington, DC, explains that most burning specifically occurs at the vaginal opening, known medically as the vulvar vestibule. "The vestibule contains many nerve endings, so if someone is experiencing burning, it is usually detected in this small ring-like area through a test or screening," Dr. Krapf tells POPSUGAR. "It's also the site of the urethra, as well as the glands that produce natural lubrication, both of which can become irritated, and consequently lead to burning."
Vaginal burning that isn't caused by an irritant or allergen is usually related to an infection. "This is why a doctor will often test for vaginal or bladder infections, including sexually transmitted infections," Dr. Krapf says. So, unless you can link your symptoms directly to a product you've used recently, it's best to see a doctor for testing and treatment. Keep reading to learn more about the most common causes of vaginal burning and when experts recommend scheduling an appointment.
Irritants and Allergens
Contact with irritants and allergens is the most common cause of vulvar or vaginal burning, Dr. Krapf says. Just like other parts of your skin can develop rashes or hives when exposed to an allergen, the vulva can become itchy and inflamed as a result of certain ingredients found in products that go in or near the vagina, such as condoms, lubricants, soaps, creams, and fragrances.
With products that simply irritate the vulva, symptoms of burning and redness usually start immediately, Dr. Krapf explains. However, in the case of an allergic skin reaction, redness, hives, itching, and burning can take anywhere from a few minutes to a few hours to develop. And, while an irritation will quickly resolve on its own, an allergic reaction could take up to a few days to fully heal. Dr. Krapf recommends reaching out to your doctor if symptoms don't begin clearing up within three to four days. Monitoring the ingredients listed on products and steering clear of anything scented, especially if you have sensitive skin, can help prevent future irritation.
Urinary Tract Infection
When there's an overgrowth of bacteria in the bladder, a urinary tract infection (UTI) can form and consequently, irritate the inside lining of the bladder and urethra. A burning sensation near the urethra, painful urination, and an urge to pee more frequently — a constellation of symptoms known as "dysuria" — are the most classic clinical signs of a UTI, Dr. Montes tells POPSUGAR.
Although common and very treatable, a UTI can spread like wildfire if you delay getting treatment. "It's important to seek immediate professional care if you start to experience UTI-like symptoms because there is a risk of the infection moving up the urinary tract to the kidneys," Dr. Montes explains. With oral antibiotics, symptoms typically start improving within two to three days — but you still need to take all the prescribed doses to fully extinguish the infection.
A yeast infection is a fungal infection that occurs when there's an overgrowth of Candida, a yeast that's naturally present in the vagina (and typically not harmful), Dr. Krapf explains. In addition to vaginal burning, yeast infections can cause itching, irritation, thick and lumpy discharge, and dysuria. "Urination may be more irritating due to inflammation of the tissue at the vaginal opening, where the urine exits the body through the urethra," Dr. Krapf says. While uncomfortable, yeast infections are extremely common and can be easily treated with an over-the-counter antifungal cream. If you don't feel relief within two to three days — or if your symptoms worsen — book an appointment. Your doctor can conduct a proper yeast infection test and prescribe treatment if necessary.
Bacterial Vaginosis or Mixed Bacterial Vaginitis
Bacterial vaginosis (BV) is an imbalance of "good" and "harmful" bacteria inside the vagina, which can cause green or milky-white vaginal discharge, along with a fishy odour. According to Dr. Montes, vaginal burning, inflammation, itching, and dysuria may also be present with BV — but more often, these symptoms point to something else. "BV alone typically doesn't produce all of these symptoms. Rather, it could suggest mixed bacterial vaginitis, which is when two separate infections occur at the same time inside the vagina," Dr. Montes explains.
In either case, it's best to get examined by your doctor as soon as possible so you can get started on an oral or vaginal antibiotic. "Similar to a UTI, symptoms should improve within a few days of treatment. But again, it's important to complete all prescribed doses to properly fight off the infection," Dr. Montes says.
Genital herpes often resembles small blisters or sores, but before those symptoms appear, you may feel a tingling sensation around the vulva, Dr. Krapf explains. That sensation can give way to severe vaginal burning and painful urination as the blisters grow more uncomfortable. Symptoms aren't always present with genital herpes, but when they are, they typically appear two to 12 days after exposure. Dr. Krapf adds that people may also experience flu-like symptoms with the first outbreak.
Although genital herpes can't be cured, your doctor can prescribe an antiviral medication to help shorten the length and severity of your symptoms. Schedule a visit with your provider as soon as you notice anything unusual, especially if you're sexually active. Dr. Montes says you can also ask for prescription topical lidocaine to apply to the affected areas, which may help ease any discomfort.
Other Sexually Transmitted Infections
Genital herpes isn't the only STI that can cause vaginal burning. Trichomoniasis typically produces thin vaginal discharge with a foul odour, Dr. Montes explains, but it can also be accompanied by vaginal burning, lower abdominal pain, and itching. Other common STIs include gonorrhea and chlamydia, both of which can cause vaginal burning and abnormal discharge. Genital symptoms of these STIs can develop within two to 10 days after exposure.
Because STIs are very common and can be asymptomatic, you should be tested for them at least annually. "It's important to screen for these infections because they may not always show symptoms and can cause a pelvic infection if left untreated," Dr. Krapf says. "In the event of an STI, you should also talk with all partners, as these infections are transmissible, and avoid sexual contact until everyone is fully treated." Your doctor can prescribe antibiotics for trichomoniasis, gonorrhea, and chlamydia. Symptoms usually go away within a week of proper treatment.