The vulva is the external part of the female genitalia. It includes all the structures you can see between your legs, from the soft mound of tissue over the pubic bone down to the perineum. Many people use “vagina” when they actually mean “vulva,” but the vagina is the internal muscular canal (about 7 to 9 cm long) that connects the cervix to the outside of the body. Your vaginal opening is located inside the vulva, not the other way around.
Parts of the Vulva
The vulva is made up of several distinct structures, each with its own role.
The mons pubis is the rounded pad of fatty tissue that sits over the pubic bone. After puberty, it’s typically covered in hair and acts as a cushion during physical contact.
The labia majora are the outer lips, two folds of skin and fat that run from the mons pubis downward. They protect the more delicate structures underneath. The labia minora are the thinner inner lips nestled within the outer ones. They vary widely in size, shape, and color from person to person, and all of that variation is normal.
The clitoris sits at the top where the inner lips meet. The small, visible part (the glans) is covered by a hood of skin, but most of the clitoral tissue extends internally. It contains thousands of nerve endings and plays a central role in sexual pleasure.
The vestibule is the area between the two inner lips, stretching from the clitoris to the back of the vaginal opening. It contains the urethral opening (where urine exits), the vaginal opening, and the openings of small glands that produce moisture. Remnants of the hymen also surround the vaginal opening in this area.
Common Vulvar Conditions
Because the vulva is exposed to friction, moisture, and contact with various products, it’s susceptible to several conditions. The most common include vulvovaginitis (swelling or infection of the vulva and vagina), contact dermatitis from allergens or irritants, lichen sclerosus, and vulvodynia (chronic vulvar pain).
Lichen sclerosus causes white, patchy skin that may become thin and crinkled. It can lead to intense itching, tearing, and discomfort. Treatment typically involves applying a potent steroid ointment once daily for about three months, then tapering to once or twice a week for long-term maintenance. A small skin biopsy under local anesthesia confirms the diagnosis.
Contact dermatitis is essentially an allergic or irritant reaction on vulvar skin. Fragranced soaps, laundry detergents, wet wipes, and even some lubricants are frequent culprits. Switching to fragrance-free, hypoallergenic products often resolves it.
Vulvodynia: Chronic Vulvar Pain
Vulvodynia is persistent pain in the vulvar area that lasts three months or longer without a clear identifiable cause like an infection or skin disease. It affects people differently depending on its type.
Generalized vulvodynia involves burning or aching across the entire vulva. It’s often constant, sometimes radiating into the thighs, buttocks, or abdomen. Women with this form tend to be postmenopausal and describe pain that is “just there all the time,” not triggered by touch or pressure.
Localized vulvodynia, particularly vestibulodynia, is different. It centers on the vestibule and flares with contact: inserting a tampon, having sex, or even sitting for long periods. Women with this type are typically younger and often describe the sensation as tearing at the vaginal entrance or feeling like something is blocking penetration. Between episodes, they may feel completely fine.
Treatment usually starts with skin care changes and a daily hypoallergenic moisturizer or barrier cream to protect the vulvar skin. Pelvic floor physiotherapy helps many people, especially those with vestibulodynia. Topical numbing agents applied before sex can reduce mild discomfort. For postmenopausal women, localized estrogen replacement is often the first recommendation. Oral pain medications are reserved for cases where daily pain significantly interferes with quality of life.
How to Care for Vulvar Skin
Vulvar skin is more sensitive than the skin on the rest of your body, and many common hygiene products do more harm than good. Current guidelines recommend washing the vulva once or twice a day, ideally after a bowel movement, using a gentle soap-free liquid cleanser (sometimes called a syndet) with moisturizing ingredients. Wash from front to back, and use your hands rather than a washcloth.
The list of things to avoid is longer than the list of things to use:
- Conventional soaps, shower gels, and bubble bath. These strip natural moisture and disrupt the skin barrier.
- Antiseptic products. They can kill beneficial bacteria and irritate tissue.
- Vaginal douching. This disrupts the internal environment and is linked to infections.
- Fragranced products. Deodorants, perfumes, and scented wipes are common irritants.
- Water alone for prolonged washing. Repeated or extended water exposure can actually dry out vulvar skin.
After menopause, the vulvar skin thins and becomes drier, making it more vulnerable to irritation. Fragrance-free, pH-balanced formulations designed to maintain moisture are particularly important during this stage.
Warning Signs to Watch For
Most vulvar symptoms are caused by infections, irritation, or benign skin conditions. But some changes warrant prompt evaluation. According to the CDC, you should pay attention to color changes in vulvar skin, particularly areas that turn noticeably redder or whiter than your normal. Sores, lumps, or ulcers that don’t heal are another red flag, as are rash-like changes or wart-like growths. Persistent itching, burning, or bleeding that lasts two weeks or longer and isn’t typical for you also deserves a closer look. Vulvar cancer is uncommon, but catching it early makes a significant difference in outcomes.