Intimate hygiene in patients with genital itching and dryness

Chernova N.I., Zadorozhnaya I.S., Proskurina M.I.

Moscow Scientific and Practical Center for Dermatovenerology and Cosmetology, Moscow Healthcare Department, Moscow, Russia

The article presents the data which are available in the modern literature on the possibilities for patients with itching and dryness of the vulva to use cleansers. Washing the skin without special products is not effective enough as most biological contaminants are poorly soluble in water. The type, concentration, combination of surfactant with other components, its washability and pH can significantly affect the epidermal barrier and lead to transdermal water loss, dryness, skin irritation in healthy people and worsening of symptoms in patients with skin problems. Therefore, it is extremely important to understand these differences in order to determine the most appropriate cleanser for each situation. There are two most common types of cleansers: natural soaps and synthetic detergents (syndets). According to scientific studies, syndets can effectively maintain the natural structure, function and integrity of the skin, whereas natural soaps tend to negatively affect the skin and cause an impairment of the protective epidermal barrier, dissolution of lipids and pH changes, which can lead to dryness, itching and imbalance of microbial composition. The article covers the advantages and disadvantages of soap-based products and synthetic cleansers.
Conclusion: In order to preserve the health of the vulva and eliminate and/or reduce existing complaints and symptoms in patients with pathological conditions, it is important to use specialized detergents that are soft in nature, highly effective, and have minimal effect on the stratum corneum. The products of Ginocomfort® line have such properties and are able to restore the hydro-lipid layer of the epidermis, reduce itching, dryness and inflammation; they can moisturize, saturate and retain fatty components.

Authors’ contributions: Chernova N.I. – developing the concept and design of the study; editing; Chernova N.I., Zadorozhnaya I.S., Proskurina M.I. – preparing the material, writing the text.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
For citation: Chernova N.I., Zadorozhnaya I.S., Proskurina M.I. 
Intimate hygiene in patients with genital itching and dryness.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (12): 190-196 (in Russian)
https://dx.doi.org/10.18565/aig.2023.285

Keywords

intimate hygiene
dryness and itching of the vulva
cleansing detergents

References

  1. Farage M.A., Maibach H.I. Tissue structure and physiology of the vulva. The vulva: anatomy, physiology and pathology. New York: Informa Healthcare. 2016: 9-26.
  2. Mathias C.G., Maibach H.I. Dermatotoxicology monographs I. Cutaneous irritation: factors influencing the response to irritants. Clin. Toxicol. 1978; 13(3): 333-46. https://dx.doi.org/10.3109/15563657808988241.
  3. Bruning E., Chen Y., McCue K.A., Rubino J.R., Wilkinson J.E., Brown A.D.G. A 28 day clinical assessment of a lactic acid-containing antimicrobial intimate gel wash formulation on skin tolerance and impact on the vulvar microbiome. Antibiotics (Basel). 2020; 9(2): 55. https://dx.doi.org/10.3390/antibiotics9020055.
  4. Chen Y., Bruning E., Rubino J., Eder S.E. Role of female intimate hygiene in vulvovaginal health: global hygiene practices and product usage. Womens Health (Lond). 2017; 13(3): 58-67. https://dx.doi.org/ 10.1177/1745505717731011.
  5. Korting H.C., Hübner K., Greiner K., Hamm G., Braun-Falco O. Differences in the skin surface pH and bacterial microflora due to the long-term application of synthetic detergent preparations of pH 5.5 and pH 7.0. Results of a crossover trial in healthy volunteers. Acta Derm. Venereol. 1990; 70(5): 429-31.
  6. Murina F., Caimi C., Felice R., Di Francesco S., Cetin I. Characterization of female intimate hygiene practices and vulvar health: a randomized double-blind controlled trial. J. Cosmet. Dermatol. 2020;19(10):2721-6. https://dx.doi.org/ 10.1111/jocd.13402.
  7. Pany A., Klang V., Brunner M., Ruthofer J., Schwarz E., Valenta C. Effect of physical and chemical hair removal methods on skin barrier function in vitro: consequences for a hydrophilic model permeant. Skin Pharmacol. Physiol. 2019; 32(1): 8-21. https://dx.doi.org/10.1159/000493168
  8. Kang C.N., Shah M., Lynde C., Fleming P. Hair removal practices: a literature review. Skin Therapy Lett. 2021; 26(5): 6-11.
  9. DeMaria A.L., Rivera S., Meier S., Wakefield A.L., Long L.F., Miller A.R. "You have to be clean:" a qualitative study of pubic hair grooming behaviours among women living in Italy. Cult. Health Sex. 2021; 23(5): 593-607. https://dx.doi.org/10.1080/13691058.2020.1717631.
  10. Серов В.Н., Аполихина И.А., Потекаев Н.Н., Баранов И.И., Олина А.А., Зароченцева Н.В., Чернова Н.И., Юренева С.В., Пасман Н.М., Полуэктова Е.А., Рахматулина М.Р., Припутневич Т.В., Пустотина О.А.,Доля О.В., Тетерина Т.А. Резолюция Совета экспертов в области акушерства-гинекологии, дерматовенерологии, гастроэнтерологии и микробиологии «Принципы интимной гигиены у здоровых женщин и при заболеваниях вульвы». Акушерство и гинекология. 2023; 8: 229-34. [Serov V.N., Apolikhina I.A., Potekayev N.N., Baranov I.I., Olina A.A., Zarochentseva N.V., Chernova N.I. et al. Resolution of the Council of Experts in obstetrics-gynecology, dermatovenerology, gastroenterology and microbiology "Principles of intimate hygiene in healthy women and in vulvar diseases". Obstetrics and Gynecology. 2023; (8): 229-34. https://dx.doi.org/10.18565/aig.2023.8.229-234.
  11. Рыбкин В.С. Предмет и задачи гигиены история возникновения и развития гигиены (избранные лекции по общей гигиене). Астраханский вестник экологического образования. 2011: 1; 98-102. [Rybkin V.S. The subject and tasks of hygiene are the history of the emergence and development of hygiene (selected lectures on general hygiene). Astrakhan Bulletin of Environmental Education. 2011: 1; 98-102.(in Russian)].
  12. Farage M.A., Maibach H.I., eds. The vulva: physiology and clinical management. CRC Press; 2017.
  13. Warren R., Bauer A., Greif C., Wigger-Alberti W., Jones M.B., Roddy M.T. et al. Transepidermal water loss dynamics of human vulvar and thigh skin. Skin Pharmacol. Physiol. 2005;18(3):139-43. https://dx.doi.org/10.1159/000084911.
  14. Ключарева С.В., Белова Е.А., Нечаева О.С., Гусева С.Н., Слободских Е.О. Нарушение эпидермального барьера при дерматозах и возможности его восстановления. Санкт-Петербургские дерматологические чтения. материалы XIV научно-практической конференции дерматовенерологов и косметологов. Санкт-Петербургское научное общество дерматовенерологов им. В.М. Тарновского. Санкт-Петербург; 2020: 52-4. [Klyuchareva S.V., Belova E.A., Nechaeva O.S., Guseva S.N., Slobodskikh E.O. Violation of the epidermal barrier in dermatoses and the possibility of its recovery. St. Petersburg Dermatological Readings. Materials of the XIV scientific and practical conference of dermatovenerologists and cosmetologists. St. Petersburg Scientific Society of Dermatovenerologists named after V.M. Tarnovsky. Saint Petersburg; 2020: 52-4. (in Russian)].
  15. Ковалева Ю.С., Ведлер А.А., Кожевникова П.Е. Роль керамидов в сохранении эпидермального барьера. Клиническая дерматология и венерология. 2019; 18(4): 513 8. [Kovaleva Yu.S., Vedler A.A., Kozhevnikova P.E. The role of ceramides in preserving the epidermal barrier. Klinicheskaya Dermatologiya I Venerologiya. 2019; 18(4): 513 8. (in Russian)]. https://dx.doi.org/10.17116/klinderma201918041513.
  16. Gondwe T., Ness R., Totten P.A., Astete S., Tang G., Gold M.A. et al. Novel bacterial vaginosis-associated organisms mediate the relationship between vaginal douching and pelvic inflammatory disease. Sex Transm. Infect. 2020; 96(6): 439-44. https://dx.doi.org/10.1136/sextrans-2019-054191.
  17. Brown S.E., He X., Shardell M.D., Ravel J., Ghanem K.G., Zenilman J.M., Brotman R.M. Douching cessation and molecular bacterial vaginosis: a reanalysis of archived specimens. Sex Transm. Infect. 2023; 99(3): 156-61.https://dx.doi.org/10.1136/sextrans-2022-055459.
  18. Захарова Н.И., Якорнова Г.В., Леонова И.А. Эпидермальная протекция. StatusPraesens. Педиатрия и неонатология. 2019; 1(56); 64-72. [Zakharova N.I., Khakarnova G.V., Leonova I.A. Epidermal protection. StatusPraesens. Pediatrics and neonatology. 2019; 1(56); 64-72. (in Russian)].
  19. Boer M, Duchnik E, Maleszka R, Marchlewicz M. Structural and biophysical characteristics of human skin in maintaining proper epidermal barrier function. Postepy Dermatol. Alergol. 2016; 33(1):1-5. https://dx.doi.org/10.5114/pdia.2015.48037.
  20. Royal College of Obstetricians and Gynaecologists. The management of vulval skin disorders. Green-top Guideline No. 58. 2011: 1-23.
  21. Arab H., Almadani L., Tahlak M., Chawla M. The Middle East and Central Asia guidelines on female genital hygiene. BMJ Middle East. 2011; 19: 99-106.
  22. van der Meijden W.I., Boffa M.J., Ter Harmsel B., Kirtschig G., Lewis F., Moyal-Barracco M. et al. 2021 European guideline for the management of vulval conditions. J. Eur. Acad. Dermatol. Venereol. 2022; 36(7): 952-72.https://dx.doi.org/10.1111/jdv.18102.
  23. Ananthapadmanabhan K.P., Moore D.J., Subramanyan K., Misra M., Meyer F. Cleansing without compromise: the impact of cleansers on the skin barrier and the technology of mild cleansing. Dermatol. Ther. 2004; 17 Suppl 1: 16-25. https://dx.doi.org/10.1111/j.1396-0296.2004.04s1002.x.
  24. Mijaljica D., Spada F., Harrison I.P. Skin cleansing without or with compromise: soaps and syndets. Molecules. 2022; 27(6): 2010. https://dx.doi.org/10.3390/molecules27062010.
  25. Schulte to Brinke A., Mehlich A., Doberenz C., Janssens-Böcker C. Acidification of the skin and maintenance of the physiological skin pH value by buffered skin care products formulated around pH 4. Journal of Cosmetics, Dermatological Sciences and Applications. 2021; 11: 44-57. https://dx.doi.org/10.4236/jcdsa.2021.111005.
  26. Lambers H., Piessens S., Bloem A., Pronk H., Finkel P. Natural skin surface pH is on average below 5, which is beneficial for its resident flora. Int. J. Cosmet. Sci. 2006; 28(5): 359-70. https://dx.doi.org/10.1111/j.1467-2494.2006.00344.x.
  27. Misra M., Ananthapadmanabhan K.P., Hoyberg K., Gursky R., Prowell S., Aronson M.P. Correlation between surfactant-induced ultrastructural changes in epidermis and transepidermal water loss. J. Soc. Cosmet. Chem. 1997; 48: 219-34.
  28. Guaschino S., Benvenuti C.; SOPHY Study Group. SOPHY project: an observational study of vaginal pH, lifestyle and correct intimate hygiene in women of different ages and in different physiopathological conditions. Part II. Minerva Ginecol. 2008; ;60(5): 353-62.
  29. Bahamondes M.V., Portugal P.M., Brolazo E.M., Simões J.A., Bahamondes L. Use of a lactic acid plus lactoserum intimate liquid soap for external hygiene in the prevention of bacterial vaginosis recurrence after metronidazole oral treatment. Rev. Assoc. Med. Bras. (1992). 2011; 57(4): 415-20. https://dx.doi.org/10.1590/s0104-42302011000400015.
  30. Anstey Watkins J., Ross J.D.C., Thandi S., Brittain C., Kai J., Griffiths F. Acceptability of and treatment preferences for recurrent bacterial vaginosis-Topical lactic acid gel or oral metronidazole antibiotic: Qualitative findings from the VITA trial. PLoS One. 2019; 14(11): e0224964. https://dx.doi.org/10.1371/journal.pone.0224964.
  31. O’Hanlon D.E., Moench T.R., Cone R.A. In vaginal fluid, bacteria associated with bacterial vaginosis can be suppressed with lactic acid but not hydrogen per-oxide. BMC Infect. Dis. 2011; 11: 200. https://dx.doi.org/10.1186/1471-2334-11-200.
  32. Zhang L., Wei W. Anti-inflammatory and immunoregulatory effects of paeoniflorin and total glucosides of paeony. Pharmacol. Ther. 2020; 207: 107452. https://dx.doi.org/10.1016/j.pharmthera.2019.107452.
  33. Batiha G.E., Tene S.T., Teibo J.O., Shaheen H.M., Oluwatoba O.S. et al. The phytochemical profiling, pharmacological activities, and safety of malva sylvestris: a review. Naunyn-Schmiedeberg’s Arch. Pharmacol. 2023; 396(3): 421-40. https://dx.doi.org/10.1007/s00210-022-02329-w.
  34. Islam M., Ali E., Saeed M.A., Jamshaid M., Khan M.T.J. Antimicrobial and irritant activities of the extracts of Malva parviflora L., Malvastrum coromandelianum L., and Amaranthus viridis L. - a preliminary investigation. Pak. J. Pharm. 2007-2010; 20-23(1&2): 3-6.
  35. El-Saber Batiha G., Magdy Beshbishy A., El-Mleeh A., Abdel-Daim M.M., Prasad Devkota H. Traditional uses, bioactive chemical constituents, and pharmacological and toxicological activities of Glycyrrhiza glabra L. (Fabaceae). Biomolecules. 2020; 10(3): 352. https://dx.doi.org/10.3390/biom10030352.
  36. Качалина О.В., Матузкова А.А. Активированная глицирризиновая кислота в комплексном лечении пациенток с вагинитами и дисбиозом: результаты много­центрового исследования. Акушерство и гинекология. 2023; 3: 115-20. [Kachalina O.V., Matuzkova A.A. Activated glycyrrhizic acid in the combination treatment of patients with vaginitis and dysbiosis:results of a multicenter study. Obstetrics and Gynecology. 2023; (3): 115-20 (in Russian)]. https://dx.doi.org/10.18565/aig.2023.26.
  37. Gold D., Nicolay L., Avian A., Greimel E., Balic M., Pristauz-Telsnigg G. et al. Vaginal laser therapy versus hyaluronic acid suppositories for women with symptoms of urogenital atrophy after treatment for breast cancer: A randomized controlled trial. Maturitas. 2023; 167: 1-7. https://dx.doi.org/10.1016/j.maturitas.2022.08.013.
  38. Шперлинг Н.В., Шперлинг М.И. Лечение и профилактика рецидивирования склероатрофического лихена половых органов у женщин. Акушерство и гинекология. 2022; 12: 122-30. [Shperling N.V., Shperling M.I. Treatment and prevention of recurrent genital lichen sclerosus in women. Obstetrics and Gynecology. 2022; (12): 122-30 (in Russian)]. https://dx.doi.org/10.18565/aig.2022.280.
  39. Соколова А.В., Аполихина И.А. Лечение склерозирующего лихена наружных половых органов у женщин: от стандартов к инновациям. Акушерство и гинекология. 2020; 7: 37-46. [Sokolova A.V., Apolikhina I.A. Treatment for female external genital lichen sclerosus: from standards to innovations. Obstetrics and Gynecology. 2020; (7): 37-46 (in Russian)].https://dx.doi.org/10.18565/aig.2020.7.37-46.

Received 08.12.2023

Accepted 15.12.2023

About the Authors

Nadezhda I. Chernova, Dr. Med. Sci., Head of the Department of Anogenital Dermatosis and Sexually Transmitted Infections, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, +7(916)692-83-35, d.chernova@mail.ru, https://orcid.org/0000-0002-4111-6670, 127473, Russia, Moscow, Seleznevskaya str., 20.
Irina S. Zadorozhnaya, PhD, Junior Researcher of the Department of Anogenital Dermatosis and Sexually Transmitted Infections, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, d.zadorozhnayais@mail.ru, https://orcid.org/0000-0001-7291-3149, 127473, Russia, Moscow, Seleznevskaya str., 20.
Maria I. Proskurina, dermatovenereologist, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, mariapro425@gmail.com,
https://orcid.org/0000-0002-9571-1512, 127473, Russia, Moscow, Seleznevskaya
Corresponding author: Nadezhda I. Chernova, d.chernova@mail.ru

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.