Vulva pigmentation, or the colour of the skin of the vulva, can vary naturally from person to person. Changes in colour may occur due to hormones, age, skin type, or minor skin conditions. Most changes are normal, but some may need assessment by a gynaecologist. This guide provides clear, general information to help you understand vulva pigmentation, including conditions like VIN, lichen sclerosus, squamous cell carcinoma (SCC), and vulvar melanoma, and when it may be important to seek professional advice.
What Is Vulva Pigmentation?
Normal Variations
Vulva pigmentation refers to the natural colour of the inner and outer lips of the vulva:
- Labia minora: the inner lips, often darker than the surrounding skin.
- Labia majora: the outer lips, which may be lighter or similar to the rest of your skin.
- Vulvar pigmentation: covers all colour variations in the vulva.
Colours can range from pink to brown, dark brown, or even black. Changes over time can occur due to hormones, pregnancy, or ageing. These differences are usually normal and not a cause for concern.
Common Causes of Vulva Colour Changes
Hormonal Changes
- Puberty: darkening of the vulva as the body matures.
- Pregnancy: increased melanin may cause temporary darkening.
- Menopause: gradual changes in colour can occur due to hormonal shifts.
Skin and Dermatological Factors
- Minor pigmentation changes from friction or irritation.
- Post-inflammatory changes after rashes or infections.
- Benign pigmentation conditions, such as melanosis.
- Lichen sclerosus: a chronic skin condition that can cause white, thin patches on the vulva, sometimes leading to discomfort or itching. Early assessment can help manage symptoms and prevent complications.
Medical Concerns
While most pigmentation changes are harmless, some may indicate a condition that requires evaluation:
- Vulvar Intraepithelial Neoplasia (VIN): a pre-cancerous condition that may appear as white, red, or dark patches on the vulva. VIN is not cancer but can develop into it if untreated. A gynaecologist will assess, monitor, and manage VIN safely.
- Squamous Cell Carcinoma (SCC): a type of skin cancer that can develop on the vulva, often arising from VIN or chronic conditions like lichen sclerosus. SCC may appear as persistent sores, lumps, or thickened areas that do not heal. Early assessment by a gynaecologist is essential.
- Vulvar Melanoma: a rare but serious form of skin cancer on the vulva. It may appear as dark, irregularly shaped patches or lesions and sometimes cause itching, bleeding, or ulceration. Early detection is important for the best outcomes.
When to See a Gynaecologist
Women should seek advice from a gynaecologist for vulva pigmentation if they experience any of the following:
- New or Changing Lesions: Any new pigmentation or changes in existing lesions—such as alterations in size, shape, colour, or texture—should prompt a visit. Early assessment is important for detecting potential malignancies, including melanoma.
- Atypical Features: Lesions that feel hard, are attached to underlying tissue, bleed, or are ulcerated require evaluation. In such cases, a gynaecologist may recommend a biopsy to rule out malignancy.
- Symptoms of Malignancy: Symptoms such as itching, bleeding, or ulceration may indicate more serious conditions, including vulvar melanoma. Early evaluation improves outcomes.
- Rapid Changes: Lesions that quickly change in colour, border, or size should be promptly evaluated for early detection of potential malignancies.
These symptoms indicate the need for a thorough evaluation, which may include examination, vulvoscopy, or biopsy, to ensure an accurate diagnosis and appropriate management.
Medical Evaluation of Vulva Pigmentation
When you visit a gynaecologist, they may:
- Take a detailed history – including changes, symptoms, and medical background.
- Perform a physical examination – sometimes using a magnifying tool (vulvoscope) to closely inspect the vulva.
- Perform a biopsy – if a lesion looks unusual or there are white patches, a small sample may be taken for analysis. This is especially relevant for VIN, SCC, vulvar melanoma, or persistent lichen sclerosus.
- Develop a management plan – benign lesions may just be monitored, VIN, SCC, or melanoma may require treatment, and lichen sclerosus can be managed with topical treatments to reduce symptoms.
- Follow-up – regular appointments help monitor changes and ensure early detection of new or concerning lesions.
Treatment Options for Vulva Pigmentation
Treatment depends on the underlying cause and individual needs:
- Topical creams – may help reduce pigmentation or manage conditions like lichen sclerosus.
- Chemical peels or laser therapy – sometimes used for persistent pigmentation changes.
- Management of VIN, SCC, and vulvar melanoma – careful monitoring, removal of abnormal areas if necessary, and regular follow-up.
- Sun protection – prevents further pigmentation or irritation.
Your gynaecologist will recommend the safest approach based on your situation.
Patient-Friendly FAQ
Is vulva pigmentation normal?
Yes. Variations in colour are common and usually reflect natural differences in skin tone or hormones.
Can pigmentation changes indicate a medical problem?
Most changes are harmless. Sudden, uneven, or unusual changes, especially with other symptoms, should be assessed. Conditions like VIN, SCC, vulvar melanoma, or lichen sclerosus may require evaluation and monitoring.
What should I do if I notice a sudden change?
See a gynaecologist for an examination. Keeping track of any changes and symptoms helps your doctor provide the best advice. Suspicious lesions, especially dark or irregular patches, should be assessed promptly.
Key Points to Remember
- Vulva colour varies widely and is usually normal.
- Seek advice for rapid or unusual changes, discomfort, white patches, persistent lesions, or non-healing sores.
- Regular self-observation can help detect changes early.
- VIN, SCC, vulvar melanoma, and lichen sclerosus are conditions that can be managed safely when assessed by a gynaecologist.
All gynaecological treatments come with potential risks and complications. We recommend seeking a second opinion from a qualified health practitioner before proceeding. The photos and videos on our website and social media are shared with patient consent. Individual outcomes, including risks and recovery times, vary based on factors such as genetics, health, and lifestyle. As a result, these images do not guarantee similar results for everyone. The information on our page is general and should not be taken as medical advice. For more specific guidance, please contact us directly.
If you have any questions or would like to book a consultation, please give us a call on 07 3219 6868.