Everything about the vulva, explained by an OB-GYN

The female vulva, like a face, varies in shape from person to person and naturally changes over time. However, since most people rarely see another person's vulva directly, it's easy to worry alone, "Am I the only one who looks strange?" In the clinic, we see many people asking if their labia minora have elongated or if the pigmentation is severe. This article will first outline the normal structure of the vulva and then systematically examine four common concerns: itching, pigmentation, sagging, and dampness. Finally, we will distinguish between what can be managed at home and signals that require a visit to the hospital.

When patients come, I often draw diagrams on paper to explain. While many people have encountered male genitalia through movies or images, accurate illustrations of the female vulva are rare, making communication difficult.

At the very top is the clitoris, and from the clitoris, the labia minora descend in two folds. There is a hood covering the clitoris, and outside of that, the labia majora with a fatty layer are located. Inside the labia minora, there is a small urethra visible at the top, and below it, a larger vaginal opening.

Some people have an almost fully exposed clitoris, while others have it covered by a hood; both are normal structures. The hymen inside the vaginal opening is donut-shaped with a hole in the center, and its size and shape also vary from person to person. If you want to know more, the article Understanding Normal Vulvar Anatomy and Variation may also be helpful.

"My labia minora have elongated, is that normal?" is one of the most frequently asked questions. The size and shape of the labia minora have such a wide range of variation that size alone is not used to diagnose a condition. Nor do we distinguish between normal and abnormal based solely on shape or thickness.

However, if they are large or thick, you may experience discomfort in daily life.

• A feeling of being pinched when wearing tight clothing
• Dampness and chafing during exercise, cycling, or long runs
• Increased friction during menstruation or discomfort from discharge getting trapped

If discharge gets trapped and moisture lingers, it can lead to itching or lichenification, where the skin thickens. Therefore, rather than "is it normal or abnormal?", we decide together whether to leave it as is or consider correction based on "how much discomfort it causes in daily life." If the discomfort is clear, you can refer to Guidance on External Vaginal Rejuvenation.

Many people worry about their color appearing dark. To put it simply, pigmentation itself is not a disease or evidence of a hygiene problem. Think of your elbows. Areas subjected to continuous friction turn brown. The same applies to the labia minora and majora; repeated friction from pinching and rubbing naturally darkens them.

Pigmentation can also suddenly deepen during puberty or significant hormonal changes. Just as people have different skin tones, the color of the vulva also varies.

If pigmentation causes a loss of confidence or bothers you significantly, you might consider whitening laser treatment along with hair removal. Laser treatment takes about 10 minutes per session but is usually repeated three to five times, not just once. Since friction can cause repigmentation, it's generally better to manage it at more frequent intervals than facial treatments. You can find more details in Y-Zone Whitening and Lifting Guide and What to Know Before Vulvar Hyperpigmentation and Whitening Treatment.

The labia majora have a fatty layer on the outside, so changes can be more prominent than in the labia minora. Their shape changes with age, weight gain and loss, childbirth, body shape changes, and the effects of gravity. The wrinkles or sagging that occur here should be seen as natural changes, like facial wrinkles, rather than an abnormality.

Many people also come in for itching of the labia majora. It's often hard to distinguish if it's internal or external, leading to hesitation between dermatology and obstetrics/gynecology. However, vulvar skin problems can be addressed together in gynecology, so you don't have to worry alone.

It's easy to think that if you're itchy, you should wash more. In fact, some people came in with red, sore skin after scrubbing vigorously three or four times a day, or even for a long time. Rubbing with hot water, or using salt or lemon juice, all worsen itching.

The vulva, like facial skin, needs its barrier protected. Reducing irritation and managing moisture well are key. Moisture easily builds up when wearing sweat-soaked workout clothes for a long time or tight pants in summer. If these conditions repeat, itching and lichenification can progress together. Lichenification is a state where the skin thickens and roughens to protect itself; at this stage, moisturizing alone may not be enough, and ointment, injection treatment, or a hospital visit may be necessary.

Here are five things to keep in mind at home:

If vulvar itching is severe enough to disrupt sleep, also refer to the article Vulvar Itching Affecting Sleep.

"Are the vulva and vagina the same?" is also a frequent question. They have different environments and different management methods. The outer surface of the vulva can be thought of like facial skin, while the inside of the vagina is a mucous membrane, like the inside of the mouth, maintaining a unique environment with an acidic pH. Therefore, the outside should be approached by protecting the skin barrier, and the inside by not disturbing its acidic environment.

Hair removal and hygiene are also often misunderstood. Vulvar hygiene depends more on reducing irritation and managing moisture well than on the presence or absence of hair. While hair removal can be more comfortable by reducing the entanglement of menstrual blood or discharge, it is not the definitive answer to hygiene itself.

If your condition does not improve after changing your lifestyle habits or if you notice the following signs, we recommend stopping self-care and seeking medical attention.

• When blisters or ulcers appear
• When there is pain or it feels warm to the touch
• When accompanied by foul odor, changes in discharge, or fever
• When itching persists for more than 2-3 days

During your consultation, providing information about the location (vulva, inside the vagina, perineum, or near the urethra), sensation (itching, stinging, burning), timing of worsening (day or night, after menstruation or exercise), and any new products used or medications taken will help us examine you much more accurately.

I hope today's content has made you feel a little more familiar with the vulva. Differences in shape and color are mostly within the normal range, and for itching and dampness, the basic approach is to wash less and irritate less. However, if there are clear signs such as blisters, pain, fever, or persistent itching, please seek medical attention promptly. If it's difficult to decide alone, feel free to leave your symptoms via chat.

Author: Lee Dong-hee Chief Director · Obstetrician and Gynecologist · View Medical Staff Profile

This article is based on YouTube video content · First published March 4, 2026 · Last reviewed May 30, 2026

This article provides general health information and is not a substitute for individual diagnosis or treatment. If you have symptoms, please consult a doctor for advice.