Women don’t often want to talk about it, but no surprise, the questions are there. “Why does my vaginal skin look dark?” or “When is vaginal itching a problem?” or “What is that smell down there?” Most of the time, women spend time and money trying to solve skin issues down there and their first stop for answers is Google, TikTok or their best friend. Unfortunately, women are often embarrassed or too ashamed to talk about their vaginal skin. But it’s skin like anywhere else and knowing what’s fact versus fiction is important.
Myth: The vagina needs to be cleansed. One of the most common questions I get is what type of soaps or cleansers should be used to clean the vagina. The reality is the vagina is self-cleaning and doesn’t need any specially designed cleansers. The vagina is teeming with its own cocktail of bacteria, yeast and viruses, what we call normal flora. Cleaning methods like douching, can lead to a disruption in the normal flora and cause infection. Only the outer skin (also called the vulva) needs cleansing and a gentle, fragrance-free cleanser is recommended. I often recommend Dove Sensitive Unscented or Vanicream Gentle Body wash.
Myth: My vagina’s scent is abnormal.Not necessarily true. The vaginal area does have a healthy, baseline odor, which you can thank that normal flora for. Vaginal odor is completely normal and it doesn’t have to be masked or fixed. If you personally don’t like your baseline odor, there are things you can safely do to neutralize it, like using a whole-body deodorant and applying it along the inner thigh. Now when the normal flora is off or an infection is present, there can be a change in the scent, which is a helpful signal sometimes that something is wrong. Your vaginal odor can also change throughout your menstrual cycle, during pregnancy, after intercourse or due to heat, sweat and moisture. What’s important to know is your baseline and if you think something is off or you have other symptoms, like vaginal discharge or itching, to talk with your doctor.
Myth: There is a normal or typical look to a vulva. Believe it or not, but vulvas are quite diverse. They can vary in size, thickness, color and shape. The labia minora (inner lips) can stick out more in some women as well. The melanocytes (pigment producing cells) in vulvar skin are more active than other areas of the body and is often darker. This can be accentuated in melanin rich skin. Similar changes can also be seen around the anus. Some people can also have benign pigmented areas called labial melanosis. You can also have benign growths like moles, angiokeratomas (vascular growths) or even cysts on vulvar skin. As we age, hormonal changes can also lead to dryness or even atrophy, where the vulvar and vaginal skin does not maintain moisture and becomes thinner as well.
Myth: Removing pubic hair is cleaner for vaginal skin. If getting a Brazilian was on your radar to improve the health of your vulvar skin, well, think again. Removing pubic hair is more of a personal choice and not necessary for vaginal health. In fact, hair removal in the vaginal area can lead to other health issues like ingrown hairs, irritation and folliculitis. There are some instances where hair removal might help skin conditions, like hidradenitis suppurativa, but in general, hair removal in the vaginal area is more of a cosmetic endeavor.
Myth: If I have itching in the vaginal area, it must be a yeast infection. This is probably the most common thing I hear from patients. And often they will request treatment but refuse an exam. However, itching down there can also be from problems with vulvar or vaginal skin that are not infections. Itching can be caused by allergies to laundry detergent, synthetic underwear, feminine hygiene products, hormonal changes (menopause/postpartum), or skin conditions like eczema or lichen sclerosis. If you experience vaginal itching, it’s a good idea to have a vaginal exam so that the cause can be identified and treatment started appropriately. Trotter’s Take: Vulvar and vaginal skin issues should not be stigmatized and deserve time and attention from both patients and providers.
Feeling like the stigma is gone or you want to know your vaginal skin more? Then you need to listen to Dr. Emily Murphy, an expert in vulvar/vaginal skin, who sets the record straight.
