Guidelines for Vulvar Skin Care
NOTE: The goal is to promote healthy vulvar skin. This is done by decreasing and/or removing any chemicals, moisture, or rubbing (friction). Any products listed below have been suggested for use because of their past success in helping to decrease or relieve vulvar/vaginal itching and burning.
- Use a detergent free of dyes, enzymes and perfumes (such as ALL-Free and Clear or Earth-Rite) on any clothing that comes in contact with your vulva such as your underwear, exercise clothes, towels, or pajama bottoms. Use 1/3 to 1/2 the suggested amount per load. Other clothing may be washed in the laundry soap of your choice.
- Do not use a fabric softener in the washer or dryer on these articles of clothing. If you do use dryer sheets with the rest of your clothes, for any loads, you must hang dry your underwear, towels, and any other clothing that comes in contact with your vulva.
- Stain Removing Products. Soak and rinse in clear water all underwear and towels on which you have used a stain removing product. Then wash in your regular washing cycle. This removes as much of the product as possible.
- Wear white all cotton underwear, not nylon with a cotton crotch. Cotton allows air in and moisture out.
- Avoid pantyhose. If you must wear them, either cut out the diamond crotch (if you cut out the crotch be sure to leave about 1/4 to 1/2 inch of fabric from the seam to prevent running) or wear thigh high hose. Many stores now carry thigh high nylons.
- Avoid tight clothing, especially clothing made of synthetic fabrics. Remove wet bathing and exercise clothing as soon as you can.
BATHING AND HYGIENE
- Avoid bath soaps, lotions, gels, etc. which contain perfumes. These may smell nice but can be irritating. This includes many baby products and feminine hygiene products marked "gentle" or "mild". We suggest any of the following soaps: Dove-Hypoallergenic, Neutrogena, Basis, or Pears. Do not use soap directly on the vulvar skin just warm water and your hand will keep the vulvar area clean without irritating the skin.
- Avoid all bubble baths, bath salts and scented oils.
- Do not scrub vulvar skin with a washcloth, washing with your hand is adequate for good cleaning.
- Do not use hot water while bathing or showering. Only luke-warm water should only be used.
- Pat dry rather than rubbing with a towel or use a hairdryer on a cool setting to dry the vulva.
- Baking Soda soaks. Soak in lukewarm (not hot) bath water with 4-5 tablespoons of baking soda to help soothe vulvar itching and burning. A sitz bath that goes on the toilet is best. Soak 1 to 3 times a day for 10-15 minutes when you have vulvar symptoms.
- Use white, unscented toilet paper. If paper has a perfumed scent or lotion, avoid using it. Avoid “wiping” after urinating; blot or dab only.
- Avoid all feminine hygiene sprays, perfumes, adult, or baby wipes. Pour lukewarm water over the vulva after urinating if urine causes burning of the skin. Pat dry rather than rubbing with a towel.
- Avoid the use of deodorized pads and tampons. Tampons should be used when the blood flow is heavy enough to soak one tampon in four hours or less. Tampons are safe for most women, but wearing them too long or when the blood flow is light may result in vaginal infection, increased discharge, odor, or toxic shock syndrome. Also, use only pads that have a cotton liner that comes in contact with your skin (no dry weave pads).
- Avoid all over the counter creams or ointments, except A&D Ointment (if you have wool allergy do not use A&D). Ask your health care provider first. Small amounts of A&D Ointment or Crisco may be applied to your vulva as often as needed to protect the skin. It may also help to decrease skin irritation during your period and when you urinate. Brands that have been helpful are the Fougera brand, Toys R Us brand, Rugby brand, or NMC brand.
- DO NOT DOUCHE. Baking soda soaks will help rinse away extra discharge and help with odor.
- DO NOT SHAVE, wax or laser the vulvar area (the bikini line is ok).
- Some women may have problems with chronic dampness. Keeping dry is important.
- Choose cotton fabrics whenever you can.
- Keep an extra pair of underwear with you in a small bag and change if you become damp during the day at work/school.
- Gold Bond Powder or Zeosorb Powder may be applied to the vulva and groin area one to two times per day to help absorb moisture.
- Dryness and irritation during intercourse may be helped by using a lubricant. Use a small amount of a pure vegetable oil/olive oil or Crisco (solid or oil). The vegetable oils contain no chemicals to irritate vulvar/vaginal skin. Vegetable oils will rinse away with water and will not increase your chances of infection. Water-based products like K-Y Jelly are helpful, but may tend to dry before intercourse is over and also contain chemicals that can irritate your vulvar skin. It may be helpful to use a non-lubricated, non-spermicidal condom, and use vegetable oil as the lubricant. This will help keep the semen off the skin which can decrease burning and irritation after intercourse.
BIRTH CONTROL OPTIONS
- All hormonal contraceptives will have an effect on vaginal secretions but should not increase your frequency of vaginitis.
- Lubricated condoms, contraceptive jellies, creams, or sponges may cause itching and burning. Ask your health care provider for help.
- The use of latex condoms with a vegetable oil as a lubricant (#14 above) is suggested to protect your skin. Oil based lubricants may affect the integrity of condoms when used for birth control or prevention of sexually transmitted diseases. Our experience has not found this to be a problem with vegetable based oils. However, the Centers for Disease Control recommends that condoms not be used with any oil based lubricants for birth control or prevention of sexually transmitted disease.