Eczema is an inflammatory skin condition with many causes and varying manifestations. It is synonymous with “dermatitis.” In the acute phase, direct contact with an endogenous or exogenous irritant or allergen results in a vesicular eruption with associated erythema and localized edema. Irritants are more common exposures than allergens, but the vulva is particularly susceptible to either. The barrier function of the vulvar skin is often challenged by the local environment. The main therapeutic intervention is identification and discontinuation or elimination of the offending agent, although this may be challenging. Thereafter, treatment involves control of pruritus and scratching as well as recognition and prompt treatment of any secondary infections. Care of the vulvar skin should be specifically counseled.