Is It Vulval Eczema or Thrush? Key Differences Explained

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Vulval eczema and thrush can look and feel similar, but they are very different conditions.
Thrush is a fungal infection caused by Candida. Vulval eczema is an inflammatory skin condition affecting the external vulval skin. Thrush often causes discharge and intense internal itching, while vulval eczema usually causes dry, sore, itchy, or burning skin without discharge. Using antifungal treatments on eczema will not help and may worsen irritation.

If symptoms persist, recur, or worsen, a GP or sexual health clinic can confirm the diagnosis.

You can learn more about symptoms, triggers, and gentle care in our full female genital eczema guide.

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Why vulval eczema is often mistaken for thrush

This confusion happens because:

• Both can cause itching and soreness
• Both affect a very sensitive area
• Many women are first told “it’s probably thrush”
• Over-the-counter antifungal creams are often tried first

When thrush treatments don’t work, it’s often because the cause isn’t fungal at all.

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Vulval eczema vs thrush: key differences at a glance

Feature	Vulval Eczema	Thrush (Yeast Infection)
Cause	Skin barrier inflammation	Fungal overgrowth (Candida)
Location	External vulval skin only	Internal vagina + vulva
Itching	Persistent, dry, sore itch	Intense, often sudden itching
Skin changes	Dryness, redness, flaking, cracking	Redness, swelling
Discharge	❌ None	✅ Thick, white (cottage-cheese-like)
Burning	Common, especially with friction	Common during urination or sex
Response to antifungal creams	❌ No improvement	✅ Usually improves
Recurrence	Linked to irritants & flare-ups	Often linked to antibiotics, hormones

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Symptoms more typical of vulval eczema

You’re more likely dealing with vulval eczema if you notice:

• Dry, tight, or cracked skin
• Red or inflamed patches on the vulva
• Burning or stinging rather than deep itching
• Worsening after washing or sweating
• No unusual vaginal discharge
• A history of eczema, allergies, or sensitive skin

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Symptoms more typical of thrush

Thrush is more likely if you have:

• Thick white vaginal discharge
• Sudden intense itching
• Swelling around the vaginal opening
• Pain during sex or urination
• Recent antibiotic use
• Symptoms that improve with antifungal treatment

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Why thrush treatments may not work for vulval eczema

Antifungal creams are designed to kill yeast.
When used on eczema-affected skin, they can:

• Dry the skin further
• Disrupt the skin barrier
• Increase stinging or burning
• Prolong flare-ups

This often leads to a frustrating cycle of repeated treatments with no relief.

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What helps vulval eczema instead

Managing vulval eczema focuses on soothing and protecting the skin, not killing fungi.

Gentle care principles:

• Use fragrance-free, soap-free cleansers
• Apply a bland, barrier-supporting moisturiser
• Wear loose, breathable underwear
• Avoid scented wipes, pads, and intimate washes
• Pat dry gently — never rub

⚠️ Products should be used externally only unless advised by a healthcare professional.

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How vulval eczema affects daily life

Living with vulval eczema can impact more than just the skin:

• Sleep – itching and soreness can disturb rest
• Exercise – friction and sweat may trigger flares
• Intimacy – discomfort can cause anxiety or avoidance
• Mental wellbeing – persistent symptoms can be distressing

These effects are real and valid — and often improve once the correct diagnosis is made.

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When to see a GP or sexual health clinic

Seek medical advice if:

• Symptoms don’t improve after 1–2 weeks
• Antifungal treatments haven’t helped
• Skin becomes painful, oozing, or cracked
• Symptoms keep returning
• You’re unsure what’s causing the irritation

A simple examination can usually rule out infection and confirm whether eczema is present.

If you would like further information on the topic please visit the HSE website here.

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Further information can be found here:

• Vulval eczema
• Genital eczema hub
• Contact dermatitis (irritant vs allergic)
• Rash cream for sensitive areas

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Frequently Asked Questions

Is it vulval eczema or thrush?

Vulval eczema usually affects the external vulval skin and causes dryness, soreness, itching, or burning without unusual vaginal discharge. Thrush often causes thick white discharge, intense itching, and may involve internal vaginal symptoms. If antifungal treatments don’t help, eczema may be more likely.

Can vulval eczema itch without discharge?

Yes. Vulval eczema commonly causes itching, soreness, and burning without any vaginal discharge. Discharge is more typical of infections such as thrush.

Why don’t thrush treatments help?

Thrush treatments target yeast infections. If symptoms are caused by vulval eczema instead, antifungal products can dry or irritate the skin, making discomfort worse rather than better.

Is vulval eczema contagious?

No. Vulval eczema is not contagious and not a sexually transmitted infection (STI). It cannot be passed through sexual contact.

What helps soothe vulval eczema?

Gentle care helps soothe vulval eczema. This includes using fragrance-free, soap-free cleansers, avoiding irritants, and applying a bland moisturiser designed for sensitive skin. Products should only be used on the external vulval skin, unless advised by a healthcare professional.

When should I see a GP?

You should see a GP or sexual health clinic if symptoms persist, keep returning, become painful or oozing, or if you’re unsure whether symptoms are eczema or an infection. A simple examination can usually clarify the diagnosis.

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