Vulvar Care: Reviewing Concepts in Daily Hygiene

Vulvar hygiene is an important part of general hygiene: the goals are to clear the vulvar area of microbial and cellular debris and vaginal and fecal secretions, ensure local comfort, provide natural levels of hydration, and protect the vulvar microbiota. There are few national and international guidelines on vulvar hygiene. We searched the PubMed database up until 30 November 2024, using logical combinations of the following terms: hygiene, washing, vulva, vulvar, microbiota, hydration, syndet, soap, detergent, water, and customs. The abstracts were reviewed, and potentially relevant full-text articles were retrieved and examined. The subregions of the vulva vary with regard to the presence of sweat and sebaceous glands, the keratin content, the water content, the pH, and the microbiota (notably Lactobacillus, Corynebacterium, Staphylococcus, and Prevotella). An alteration in the vulvar microbiota can cause an imbalance in the vaginal microbiota, and vice versa. Vaginal douching may have negative effects on vulvar microbiota. Hair removal might increase the risk of long-term dermatological complications. Repeated washing with water alone exposes the stratum corneum to damage, and washing with soap alters the stratum corneum proteins and lipids, increases skin water loss, and accentuates the risk of irritation. Syndet-based products have a mild detergent effect, promotion of hydration, a suitable pH for the vulvar area, and protection of the vulvar microbiota. Syndet-based products (containing a blend of surfactants, emollients, antioxidants, and buffering agents) appear to be the most appropriate for vulvar care.