Guidelines for Vulvar Skin Care
The vulva includes all of the female external genital structures, including the labia majora and minora, the tissue surrounding the clitoris, urethra, and vaginal opening and the perineum (refer to picture on page 2). These tissues are naturally moist and tend to be very sensitive to external substances. Proper vulvar skin care is very important to reduce the development of vulvitis.
What is vulvitis?
Vulvitis is simply defined as an inflammation of the vulva. There are a variety of causes including infections, diseases, injuries, allergies, and external irritants. Stress, illness, hygiene practices, insufficient rest, and inadequate diet can contribute to a woman’s susceptibility to vulvitis.
What are the symptoms?
Vulvitis symptoms may include redness, swelling, itching, and burning of the genitalia. Blisters or crusting can occur. Chronic irritation can cause thickening of the skin.
How is the condition evaluated?
A clinician should be consulted when symptoms do not respond to self-help measures, reoccur frequently or are accompanied by pain. At this visit the clinician will review your medical history and discuss the current symptoms. Part of this review may include a discussion regarding personal hygiene, clothing worn, and use of fragrances, soaps, detergents, and sanitary supplies. The exam usually involves a thorough inspection of the external genitalia, a pelvic exam, sampling of vaginal secretions, and possibly screening for sexually transmitted diseases. Occasionally a specialized exam called colposcopy (a visual exam using magnification) is recommended if symptoms persist.
What can be done for vulvitis?
When symptoms are significant, medication may be needed to provide some immediate relief. If an infection is identified, medication would be prescribed accordingly. However, since the symptoms are frequently related to the use of external agents such as perfumed soaps, detergents, scented fabric softeners etc., it is important to identify products that may be contributing to the irritation. Look closely at the products used for bathing, laundry, and personal hygiene. Listed below are some suggestions to implement at home to reduce irritation.
- Use a perfume and dye-free detergent on any clothing that may come in contact with the vulva. Using 1/3-1/2 of the recommended amount per wash load will still get the clothing clean, but will reduce the amount of residue.
- If a stain removal product has been used on underwear or towels, soak and rinse in clear water, then wash in the regular wash cycle. This assists in removing any product residue.
- Avoid use of fabric softeners and dryer sheets for clothing that may be in contact with the vulva.
- Wear white, all-cotton underwear.
- Avoid pantyhose. If you must wear them, cut the crotch out along the inset panel leaving about ¼ to ½ inch of fabric from the seam to prevent running.
- Avoid tight clothing and synthetic fabrics. Wet bathing suits and exercise clothing should be removed as soon as possible. Cornstarch or an unscented cornstarch-based powder may be applied to the vulva and groin to absorb moisture.
Bathing and Hygiene
- Use mild, unscented soaps or body wash. Avoid feminine hygiene sprays and douches.
- Avoid bubble baths, bath salts or scented oils.
- Do not scrub the vulva with a wash cloth. Washing with your hands is gentler and less irritating.
- Pat dry with a towel or use a hair dryer on a cool setting.
- Soaking in a tub of tepid water with a colloidal oatmeal preparation (such as Aveeno) or 4-5 Tbsp. of baking soda can be soothing. A cool compress with these solutions can also be used.
- Use unscented, deodorant-free pads or tampons. Avoid wearing panty liners except during your menses. Tampon absorbency should be consistent with the amount of menstrual flow.
- Do not shave the hair in the genital area. This may cause irritation and lead to skin infections.
- Use white, unscented toilet paper. Pat dry.
- Drink plenty of fluids (8-12 eight-ounce glasses each day) to keep the urine and vaginal secretions dilute. If burning occurs when urine comes in contact with the skin, pour warm water over the genital area while urinating.
- Limit intense exercise that creates friction to the vulvar area.
- Don’t swim in highly chlorinated pools.
- Avoid the use of hot tubs.
- Use a foam rubber donut for prolonged periods of sitting.
- Biking with a seat that doesn’t sit properly or isn’t well cushioned can cause trauma.
- Vaginal dryness during intercourse may be reduced by use of a water-based or silicone lubricant. Many different brands are now available in drug stores. Avoid petroleum-based lubricants such as Vaseline, baby oil, etc.
- Contraceptive gels, creams, or sponges may cause itching and burning. Changing brands may be helpful.
- Avoid genital sexual activity when having symptoms.
References“Guidelines for vulvar skin care” (2006). Drexel University College of Medicine.
“Self help tips for vulvar skin care" (2007). National Vulvodynia Association.