Vulvovaginal Concerns &
Vulvar Dermatology

Vulva and vagina are not the same!

“Vulva” is the term used to describe the external genitalia for people who have vaginas/were assigned female at birth. “Vagina” is the term used to describe the internal canal that leads to the cervix and uterus. It is very common for people to use the term “vagina” when referring to the vulva. But this would be like if everyone only referred to the penis as “scrotum”!

What is “Vulvar Dermatology”?

Vulvar dermatology describes a subspecialty that focuses on the evaluation of skin disorders of the vulva. This could include concerns such as:

  • lichen sclerosus

  • lichen simplex chronicus

  • lichen planus

  • skin changes (like maybe you have noticed color or texture changes)

  • cysts

  • unexplained itching

  • unexplained pain

Other vulvovaginal concerns that I address include recurrent/resistant yeast (candida), recurrent bacterial vaginosis, and chronic itching.

What a vulvar dermatology visit includes:

  • History-taking: I will ask questions about your specific concerns, as well as take a thorough personal, family, social, and medical history.

  • Exam: For vulvar and vaginal concerns, I will pretty much always recommend a physical exam. However, this doesn’t need to be done at your first appointment if you don’t feel ready. If we are meeting each other for the first time, I will schedule you for a full 80 minutes. This way we will have ample time to talk first, and if you consent to an exam, you won’t feel rushed.

  • Exam - Q-tip test: I will often perform this test if people have concerns about pain. This simply involves gently touching different areas of the vulva with a cotton q-tip to help determine the cause of the pain.

  • Exam - Wet Mount: I often will collect a sample using a cotton swab so I can evaluate this under a microscope. I do this evaluation during your appointment, after your exam is complete.

  • Discussion: We will spend the remainder of your appointment discussing the exam findings and recommended interventions.

All history-taking and discussion will take place in my office (separate from the exam room) and you will remain fully clothed!

If a biopsy or procedure is recommended after your exam, this will take place at a future appointment. All associated costs will be discussed and disclosed up front. I can provide you with a printed cost estimate with billing codes, especially if you want to discuss reimbursement with your insurance company prior.

General recommendations, especially if you have to wait a short time for your appointment:

Avoid any scented products to the vulva. This includes laundry detergent, soaps, and fabric softeners. Avoid peri-wipes altogether. Basically, most “feminine hygiene” products are actually not great for your vulva and can cause irritation. Avoid scratching and scrubbing. Using warm water and fingertips is really all you need to clean the vulva. No douching or cleaning inside the vagina. If you make these changes and still have vulvar itching or irritation, then please make an appointment for further evaluation.

Want more information?

  • Check out the https://vulvovaginaldisorders.com/. This site has great patient information and handouts.

  • There is also a professional organization, the International Society for the Study of Vulvovaginal Disorders (ISSVD), which has a searchable database with handouts and information as well.

If you don’t live in the Vancouver or Portland area:

If you live in an area where you cannot find a specialist, check out my “Health Advocacy & Coaching” offering. I will work with you and your local provider to help address your concerns.

All services are cash-pay. No insurance accepted.