Vulvar Care: Reviewing Concepts in Daily Hygiene

Area of Science:

• Gynecology
• Dermatology
• Microbiology

Background:

• Vulvar hygiene is essential for removing debris and secretions, ensuring comfort, hydration, and protecting the vulvar microbiota.
• Limited national and international guidelines exist for vulvar hygiene practices.
• The vulvar subregions exhibit variations in glands, keratin, water content, pH, and microbiota.

Purpose of the Study:

• To review current literature on vulvar hygiene practices and their impact on vulvar health.
• To identify appropriate methods and products for maintaining vulvar hygiene.
• To understand the relationship between vulvar microbiota and vaginal microbiota.

Main Methods:

• A comprehensive search of the PubMed database was conducted up to November 30, 2024.
• Keywords included 'hygiene', 'washing', 'vulva', 'vulvar', 'microbiota', 'hydration', 'syndet', 'soap', 'detergent', 'water', and 'customs'.
• Abstracts were reviewed, and relevant full-text articles were examined.

Main Results:

• Washing with water alone can damage the stratum corneum.
• Soap-based washing alters stratum corneum proteins and lipids, increasing water loss and irritation.
• Vaginal douching and hair removal may negatively impact vulvar microbiota and increase dermatological risks.
• Syndet-based products offer mild cleansing, promote hydration, maintain suitable pH, and protect vulvar microbiota.

Conclusions:

• Syndet-based products, formulated with surfactants, emollients, antioxidants, and buffering agents, are most suitable for vulvar care.
• Maintaining vulvar microbiota balance is critical and can be influenced by washing practices.
• Further research and guidelines are needed to establish optimal vulvar hygiene protocols.