If a woman has a very itchy vulva, but there is no disease in the leukorrhea, the cause of the vulvar skin itself should be considered. In a small number of women, it may also be caused by the growth of pubic lice in the pubic hair. If the vulva is itchy and there are also changes in the pigmentation of the vulva, it is considered to be caused by vulvar dystrophy, which can only be determined by a local biopsy of the hypopigmentation because there is no way to confirm the diagnosis with ordinary tests. If vulvovaginal dystrophy is considered, progesterone ointment or fluorescein ointment can be considered for topical application to stop itching. For women with particularly severe itching symptoms, local injection of tretinoin solution into the vulva may also be required to significantly stop the itching.