Vulva Skin Care – Your Guide to A Happy, Healthy labia

Learn about the best vulva skin care tips and and how to maintain a happy, healthy labia and vulva. This includes how to reduce dryness, irritation, and burning; prevent itching and labia infections; and promoting healthy vulval skin.

Vulva and Vagina Health

The vulva is the outer part of the female genitalia, and includes the labia majora, labia minora and clitoris. It is the area of skin that surrounds the urethra and vaginal opening.

The skin of the vulva is sensitive. The vulva skin can be irritated by a sexually transmitted infection (STI), non STI infection, other skin conditions, and chemical and physical causes. If your have burning, itching a rash or ulcers on your vulva it is important to see a health professional to help work out the best treatment for you.

Sexually Transmitted Infections

Herpes and syphilis can cause itch and soreness of the vulva. Chlamydia, gonorrhea and trichomonas can also cause irritation of the vulva skin and also burning or pain with urination.

Non-STI Infections

Vaginal infections such as candida (thrush) or tinea infections can cause the vulval skin to itch. Bacterial vaginosis can cause vulval itchiness, irritation and pain with urination (Klebanoff 2004).

Skin conditions affecting the vulva

Dermatitis or eczema, psoriasis, and lichen planus, lichen sclerosus can all cause the skin of the vulva to become dry, itchy and cracked. Often there can be skin discoloration, either red and inflamed skin or whitened skin.

Hormonal Causes of Vulva irritation

If you are peri-menopause, post-menopause, breast feeding or on the oral contraceptive (birth control), you may experience vaginal and vulva dryness, irritation, burning with urination, pain with sex and increased urinary tract infections.

Chemical causes of vulva irritation

Spermicides, detergents, bath soaps, shampoos, bubble bath and perfumed products can irritate the vulval skin.

Physical causes of vulva irritation

Wiping from back to front after going to the toilet can transfer bacteria from the anus to the vulva. This can cause irritation, itching and inflammation. Period pads and panty liners can irritate as well as underwear that is not breathable as it enhances the retaining of moisture.

Vaginal Discharge

Vaginal discharge is normal and it has a normal variation through the menstrual cycle. Typically the most vaginal discharge is produced during the mid-cycle, around ovulation.

The discharge can become watery and white or sticky and yellow. If you have any concerns about your discharge, speak to your health professional.

Sensitive Vulva Skin: How can I heal the skin on my vulva?

Maybe you are wondering why am I so sensitive down there? Vulva skin is sensitive at the best of times, so it is important to know how to clean the vulva without causing additional irritation. The key to happy, health vulva skin includes:

1. avoiding irritants on the vulva
2. avoiding scratching or rubbing the vulval skin and
3. keep the vulva dry.
4. Correct Hormonal issues

1. Avoid Potential vulva skin irritants

Many cleansers and skincare products are potential vulva skin irritants. If your vulva is dry, sore or irritated take care to avoid the following products which may aggravate your condition:

• soaps, shower gels and bubble baths, and cleansing wipes (for example, baby wipes) have a pH higher than vulval skin so this can irritate.
• pH adjusted vulval skin cleanser – although these cleansers are pH adjusted, they can still contain chemicals that those who are sensitive will react to.
• feminine hygiene products such as period pads are bleached and contain other chemicals that can irritate vulval skin. Also they can cause friction with movement that can irritate the vulval skin. Better alternatives may include non-bleached tampons, a period cup or period underwear.
• daily use of panty liners; limit use of pads and panty liners to periods
• perfumed products, fragranced products and scented oils
• tea tree oil and other disinfectants – these can be really strong for sensitive skin
• medicated topical treatments, unless prescribed by your healthcare professional
• fabric softeners
• douches
• black underwear, some people may have a dye allergy

How to wash your vulva: Vulva skin care guidelines

The vagina and vulva are self cleaning. They do not need soaps and additional cleansers which can contribute towards vaginal/vulva dysbiosis- an imbalance in the vaginal/vulva microflora that usually happily inhabits the vulva and vagina.

As the vulva skin and perineal skin (skin between the vulva and anus) is very sensitive you should limit washing these areas to once a day.

Wash your vulval skin with:

• warm water or
• a pH adjusted wash for sensitive skin.

pH adjusted wash for sensitive vulva skin

Many brands of pH adjusted washes for sensitive skin are available such as Cetaphil® and Aveeno®. Aim for scores on your cleansing products that rank low on the Environmental Working Group (EWG) hazard rating for chemicals that cause allergy/toxicity/endocrine disruption. A few examples of good cleansers include:

• Cetaphil® Gentle Skin Cleanser (EWG rating 1) or
• Aveeno® Daily Moisturizing Facial Cleanser (EWG rating 1).

Low allergenic wash for very sensitive vulva skin

For very delicate skin, aim for products that do not contain any allergy/toxicity/endocrine disruption chemicals according to the Environmental Working Group (EWG) hazard rating. The following products are examples of cleansers which have been verified free from these chemicals:

• Conscious Skincare® Pure Organic Wash Face Hands Body (EWG VERIFIED™)
• ATTITUDE® Super Leaves Shower Gel, Nourishing Olive Leaves (EWG VERIFIED™)
• Lowen’s Natural Skin Care® You Sure Clean Up Nice! Face & Body Cleanser (EWG VERIFIED™)

What can I use to moisturize my vulva?

Often prescription unperfumed moisturizer are recommended as a soap substitute, such as sorbolene (EWG 4) or aqueous cream (EWG 4). These products can also be used during the time of your cycle when the vaginal discharge is low and the vulval skin feels dry.

For those with sensitive vulva or body skin, they may still react to these products.

Anyone with very sensitive skin or vulva skin may wish to use a moisturizer that is EWG VERIFIED™ as not containing allergy/toxicity promoting chemicals such as:

• Just the Goods® vegan hand + body lotion, unscented
• ATTITUDE® Little Leaves Body Lotion, Mango
• Silk Therapeutics® Nurture Silk + E Matte Hydration.

Avoid irritants in the vulva cleanser you choose

Read the ingredients of the cleanser or moisturizer you choose to clean your vulva skin. The more ingredients a product contains, the more likely one or more of these will cause vulval irritation. Anything that lathers will remove healthy oils from the skin and alter the vulval skin pH.

2. How to Keep the Vulva Dry

The vulva skin is suited to being dry, or lightly moist from the discharge made in the cervix and the greater vestibular glands.

It is more comfortable for the vulva skin to avoid situations where the vulva is wet for long periods of time with water, sweat or urine as this irritates the skin. Irritated skin is uncomfortable and increases the risk of dermatitis and infection.

Choose cotton fabrics to promote healthy vulva skin

To help keep the vulva skin dry try the following clothing tips:

• remove wet swim wear or gym clothes as soon as possible
• carry spare underwear to change into if your underwear becomes damp
• avoid underwear made from synthetic fabrics such as polyester, lycra, spandex or nylon underwear
• wear cotton underwear, and choose cotton fabrics and other breathable material for pants so they are less likely to retain moisture.

Incontinence can cause vulva irritation

• For women and people who experience urine leakage or fecal incontinence or regular diarrhea, it is important to use a barrier ointment to protect the skin.
• Change continence pads regularly so urine does not sit against the skin and irritate it.
• See your health provider or a pelvic physio who can help you with exercises and other treatments for incontinence.
• If incontinence is a regular problem, using an ointments can help protect the vulval skin. Ointments, unlike creams do not contain preservatives, so they are better tolerated. Zinc and castor oil has a low EWG rating – 2.

3. Reduce friction, rubbing and scratching

Try not to scratch or rub at irritated skin. When washing, never scrub vulva skin as this skin can easily become broken.

The vulva skin is damaged by friction, and damaged skin is more easily infected by common skin bacteria and yeast infections. Chronic scratching can also lead to thickening of the skin and nerve fibers.

What should you avoid when caring for your vulva?

Strategies to help reduce itching include:

• avoid rubbing the genital skin with a washcloth or paper
• don’t scratch
• if your skin is irritated or itching give shaving and waxing the pubic hair a break so the skin can heal.
• avoid tight clothing, non-breathable clothing, pads and liners as they can chafe the skin.

What can you do at home to care for your vulva?

• keep your nails short and wear loose underwear to bed.
• keeping the skin cool, avoiding hot showers and baths can reduce the itch, and ice-packs can be distracting.
• relaxation techniques can be helpful to reduce the urge to scratch.
• pat the vulva skin dry rather than rubbing with a towel

4. Vulvar dryness and hormones

If you are experiencing vaginal and vulva dryness, irritation or pain and you are peri-menopause, post-menopause, breast feeding or on the oral contraceptive (birth control), you may benefit from a topical estrogen cream to increase the elasticity and integrity of the vulva skin.

Sexual activity and vulva skin care

The type of birth control can affect vulva health. If you have a latex allergy use non-latex condoms. Some women develop vaginal and vulva dryness when using birth control tablets.

Talk to your partner about your vulva discomfort. Sometimes taking a break from sex is needed for a short time while the skin heals.

If you want to continue having sex, or your problem is chronic try the following strategies during sex to reduce irritation and pain and enhance your sexual pleasure.

Water based lubricants are recommended with condoms as oil based lubricants can increase the risk of condom breakage. However water based lubricants can dry to an irritating powder. After sex, it is a good idea to rinse any lubricant residue off the with water and moisturize the vulva skin.

Experiment with various brands of water based lubricants, many contain ingredients that are allergenic and therefore irritating to sensitive vulva skin.

If condoms are not needed, edible oils can be used as a lubricant and are much less irritating and often lubricate for longer. Suitable edible vegetable oils include:

• Almond oil,
• Extra virgin olive oil,
• Coconut oil.

Almond is the lighter oils so if you are prone to blocked pores then use this one.

Reduce stressors, enjoy foreplay, and ensure you are well aroused with adequate lubricant before attempting penetrative sex or using a sex toy.

Vulva first aid

If the skin of the vulva is split, red or inflamed try the following vulva first aid soaks. Both salt water soaks or potassium permanganate can help with healing, soothe the vulva skin and reduce the risk of infection.

Salt water baths

• 1 fistful of salt to a shallow bath and soak or
• mix 1 teaspoon of salt into 1 liter of cool water, soak a washcloth and apply to genital skin for 5-10 minutes pat genital skin dry repeat daily for 3-5 days

Potassium permanganate solution

• Potassium permanganate crystals are dissolved in water aiming for a dilution of 1-in-8,000 solution.
• Apply soaked cotton balls to the affected skin for 5-10 minutes. Potassium permanganate soaks are not suitable for dry skin conditions such as eczema.
• Potassium permanganate can leave a temporary brown stain on skin and nails as well as the container holding the solution.

Vulva pain with urination or bowel motions

• If the vulva stings or hurts when urinating or having a bowel motion make sure you drink plenty of water to keep urine dilute and avoid constipation.
• Consider applying a barrier cream such as zinc and castor oil, coconut oil or a local anesthetic gel to the skin 10 minutes before toileting.
• Lean forward when urinating to avoid urine flowing onto inflamed skin.
• For painful ulcers, try urinating in a bath of water or in the shower.

Frequently asked questions

How do you know if you have a healthy vulva?

Your vulva is healthy if you have clear, or whitish discharge. There should be no fishy odor. The skin of your vulva should also feel soft and elastic and not be inflamed, red, white or raw. You should see a doctor if you have itchiness, ulcers, painful urination, or pain during sex

Can I use Vaseline on my vulva?

Yes you can, but it contains petroleum. It does work as an excellent barrier ointment.

How long does it take for vulva skin to heal?

It depends on the cause, but you should see improvements after a few days and healing may take up to 2 weeks. If after removing the irritant, your vulva skin remains sore or inflamed you should see a health professional.

Hopefully this has guide to vulva skin care will help you with your vulvovaginal health.

References

Melbourne Sexual Health Centre. Genital skin care fact sheet. https://www.mshc.org.au/sexual-health/sexual-health-fact-sheets/genital-skin-care-fact-sheet. Accessed 8/29/22.

Environmental Working Group (EWG) website. Accessed 8/29/22.

Klebanoff MA, Schwebke JR, Zhang J, Nansel TR, Yu KF, Andrews WW. Vulvovaginal symptoms in women with bacterial vaginosis. Obstet Gynecol. 2004;104(2):267-272.