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Vulvar Skin Care Guidelines

November 10, 2010
The goal is to promote healthy vulvar skin by decreasing and removing chemicals, moisture, or rubbing (friction). Products listed have been suggested for use because of their past success in helping to decrease or relieve vulvar/vaginal burning, irritation, or itching.

Laundry Products

  • Use a detergent free of dyes, enzymes and perfumes on all laundry that goes into your washer. Use 1/3 to 1/2 the suggested amount per load. We recommend All Free Clear.
  • Do not use a fabric softeners or dryer sheets in the washer or dryer, even those advertised as “free”. If you use a shared washer or dryer, such as a laundromat, hand wash and line dry your underwear, towels, and any other clothing that comes in contact with your vulva.
  • Stain removing products (including bleach). Soak and rinse in clear water all underwear and towels on which you have used a stain removing product. Wash in a regular wash cycle. This removes as much of the product as possible. White vinegar or lemon juice, 1/4-1/3 cup per laundry load, can be used to freshen clothing and remove oils.

Clothing

  • Wear white all cotton underwear, not nylon with a cotton crotch. Cotton allows air in and moisture out. Do not wear underwear when sleeping at night. Loose fitting cotton boxers or cotton pajama bottoms are fine.
  • 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 inch of fabric from the seam to prevent running) or wear thigh high hose. Many stores now carry thigh high hose.
  • Avoid tight clothing, especially clothing made of synthetic fabrics. Remove wet bathing and exercise clothing as soon as you can.

Bathing and Hygiene

  • Do not use 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”. 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. We recommend: Dove For Sensitive Skin, Neutrogena, Basis, Aveeno or Pears.
  • Do not use bubble baths, bath salts and scented oils. You may apply a neutral (unscented, non-perfumed) oil or lotion to damp skin after getting out of the tub or shower. Do not apply lotion directly to the vulva.
  • Do not scrub vulvar skin with a washcloth, washing with your hand and warm water is enough for good cleaning
  • Pat dry rather than rubbing with a towel. Or, use a hair dryer on a cool setting to dry the vulva.
  • Baking Soda soaks. Soak in lukewarm (not hot) bath water with four to five tablespoons of baking soda to help soothe vulvar itching and burning. Soak one to three times a day for 10 minutes. If you are using a sitz bath, use one to two teaspoons of baking soda.
  • Use white, unscented toilet paper. Do not use toilet paper with aloe.
  • Do not use feminine hygiene sprays, perfumes, adult or baby wipes. If urine causes burning of the skin, pour lukewarm water over the vulva while urinating. Pat dry rather than wiping.
  • Do not use deodorized pads and tampons. Tampons may 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 cotton liner that comes in contact with your skin. We recommend Stayfree, Carefree, or 7th Generation.
  • Do not use over-the-counter creams or ointments until you ask your health care provider. When buying ointments, be sure that they are paraben and fragrance free.
  • Small amounts of extra virgin olive oil, vegetable oil, or zinc oxide ointment may be applied to your vulva as often as needed to protect the skin. It also helps to decrease skin irritation during your period, and when you urinate.
  • Do not douche. Baking soda soaks or rinsing with warm water will help rinse away extra discharge and help with odor
  • Do not shave or use hair removal products on the vulvar area. You may use scissors to trim the pubic hair close to the vulva. Laser hair removal is an option.
  • Some women may have problems with chronic dampness. Keeping dry is important.
    • Do not wear pads on a daily basis
    • Choose cotton fabrics whenever you can
    • Keep an extra pair of underwear with you, and change if you become damp
    • Gold Bond or Zeasorb powder may be applied to the vulva and groin area one to two times per day to help absorb moisture. Do not use powders that contain cornstarch.
  • Dryness and irritation during intercourse may be helped by using a lubricant. Use a small amount of a pure vegetable oil (solid, liquid, or extra virgin olive oil). These oils contain no chemicals to irritate vulvar/vaginal skin. Vegetable oils will rinse away with water and will not increase your chances of infection. Over-the-counter water-based lubricants tend to dry out before intercourse is over and may 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

  • The new low-dose oral birth control pills do not increase your chances of getting a yeast infection
  • Lubricated condoms, contraceptive jellies, creams, or sponges may cause itching and burning
  • The use of latex condoms with a vegetable oil as a lubricant (#14) is suggested to protect your skin. Petroleum-based lubricants may affect the integrity of condoms when used for birth control or prevention of sexually transmitted infections. 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 infections.

Source: University of Iowa Hospitals and Clinics

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