Vulval hygiene

The routine that keeps vulval skin healthy is shorter than most people expect. Most of the improvement in a dermatology clinic comes from removing things rather than adding them.

The routine

Once a day, wash the external vulva with warm water. Use fingers rather than a flannel or sponge, both of which are abrasive and hold bacteria. Separate the folds gently and rinse, because the small amount of white material that collects there is simply shed skin cells and secretions.

If water alone leaves the skin feeling uncomfortable, use an unperfumed emollient as a soap substitute. Emollients clean by lifting oils rather than by stripping them with detergent, and for anyone with dry, sensitive or inflamed skin they are far better tolerated than any wash.

Pat dry rather than rubbing. Leave the skin to air for a minute where that is practical.

That is the entire routine. Twice daily washing is not better and, for irritated skin, is usually worse.

Never inside

The vagina maintains its own environment through bacteria that keep the pH low. Douching, meaning flushing water or a solution inside, removes those bacteria and raises the pH, which is exactly the condition in which bacterial vaginosis develops. Douching is associated in research with higher rates of bacterial vaginosis, pelvic inflammatory disease and other problems, and no major health body recommends it. The same applies to any wash, spray or deodorising product intended for internal use.

If there is a smell that is genuinely abnormal, a strong or fishy smell in particular, it needs diagnosis rather than masking. See thrush and bacterial vaginosis.

Products that commonly cause trouble

• Soap, shower gel and bubble bath. All are detergents, all strip the skin barrier, and all are frequent culprits.
• Anything fragranced, including washes marketed specifically for this area. Fragrance is the leading cause of contact dermatitis on the vulva.
• Wipes. Convenient and frequently irritant, because of preservatives as well as fragrance.
• Panty liners worn daily. They trap moisture and heat, and the adhesive and fragrance both cause reactions in some people.
• Antiseptic products, which have no routine role and disturb normal flora.
• Talc, which has no benefit here.
• Detergent residues left in underwear after washing, which cause a surprising number of unexplained cases.
• Products claiming to tighten, brighten, deodorise or rejuvenate. None of these addresses a genuine health need and several actively damage the skin.

Where irritation has appeared with no obvious cause, the most efficient test is to remove everything except water for two weeks. If symptoms improve, the culprit is in the list above.

The narrow group of products that has a role

Some things applied to this area are functional rather than cosmetic. An unperfumed emollient used as a soap substitute and as a barrier is the main one, and it is part of the treatment for several skin conditions. Barrier preparations protect skin that is repeatedly wet, for example where there is urinary leaking. Lubricant reduces friction during sex, which matters a great deal for dry or fragile tissue.

Retailers that separate unperfumed daily care items from cosmetic ranges, such as inWonderstate, make that distinction easier to see than a general shelf does, but the decision still comes down to the ingredient list: the shorter it is, and the less fragrance it contains, the less likely it is to cause a reaction.

Everyday practicalities

• Wipe from front to back after using the lavatory, which reduces the transfer of bowel bacteria towards the urethra.
• Cotton underwear, and none at night if that is comfortable. Tight synthetic clothing worn all day traps heat and moisture.
• Change out of wet swimwear and damp exercise clothing rather than sitting in it.
• Pubic hair is not unhygienic and removing it has no health benefit. Any method that breaks the skin carries a small infection risk, and hair removal on skin affected by a condition such as lichen sclerosus tends to provoke flares.
• During a period, change products regularly and avoid the temptation to wash more often; the same routine applies.
• After sex, passing urine is a reasonable habit for anyone prone to urinary infections. Washing internally is not.

Skin conditions hide behind hygiene advice

There is a limit to what a routine can fix, and it is important to know where it is. If itching persists for more than a couple of weeks despite removing every product, if there are white or thickened patches, if the skin splits, if there is a lump or ulcer, or if there is pain with sex that does not settle, that is a skin condition or another diagnosis until proved otherwise. Treating it as a hygiene problem is the reason lichen sclerosus is so often identified years late. See lichen sclerosus and vulvodynia.

Knowing what normal looks like

Looking at the vulva with a mirror occasionally, in good light, is a sensible habit for the same reason that knowing the normal appearance of the skin anywhere else is sensible: it makes change noticeable. Colour, the size and shape of the labia, and asymmetry all vary enormously between people, and none of that variation is abnormal.

Last reviewed: September 2026