Extreme itching at the perineum may be related to pubic lice, perineal eczema and fungal vaginitis. 1. Pubic lice: patients often have a history of unclean sexual contact, and pubic lice are usually attached to the surface of the skin or the roots of pubic hair. After lice bite, their toxins and excretions can cause itching, eczema-like changes and folliculitis. 2. Perineal eczema: due to skin barrier dysfunction and abnormal immune function based on a variety of internal and external factors. It leads to direct invasion of microorganisms or induces immune response causing eczema. The affected area has clear boundaries, infiltration and thickening, often due to itching and scratching, vesicular scratches can be seen. 3. Fungal vaginitis: mostly infected by Candida albicans, when the immune function of the whole body or the vagina decreases, it invades the tissues around the vagina and causes symptoms. The main manifestations are obvious vulvar itching and increased vaginal discharge. When extreme itching occurs at the perineum, you should consult a doctor in time, follow the doctor’s instructions for further examination, clarify the cause with the doctor’s help, and carry out targeted treatment or therapy.