Vulval dermatology is the assessment and treatment of skin conditions affecting the vulva — the external female genitalia. Because this skin is different in structure and sensitivity to skin elsewhere on the body, and sits immediately alongside the gynaecological tract, vulval conditions can be more complex to diagnose and often benefit from a specialist familiar with this area specifically, rather than general skin assessment alone.
A wide range of conditions can affect the vulva, including:
Symptoms vary by condition but commonly include itch, burning, or pain; changes in skin colour or texture, including white, red, or thickened patches; lumps or lesions; pain or discomfort during intercourse (dyspareunia); and, in some cases, associated symptoms such as vaginismus or pelvic floor muscle spasm. Because many vulval conditions look and feel similar in their early stages, an accurate diagnosis is essential before starting treatment.
The Skindepth Vulva Clinic is a specialist multidisciplinary service for women with vulval skin and gynaecological concerns, bringing dermatology and gynaecology expertise together in the one appointment. Patients are seen by both a dermatologist and a gynaecologist, allowing a complete assessment of both the skin and the gynaecological system in a single visit — particularly valuable for conditions where skin, pain, and pelvic floor symptoms overlap. Patients are generally referred into the clinic by their GP, dermatologist, or gynaecologist when this kind of combined assessment is likely to be helpful.
As a general guide, a dermatologist is usually the right first step for concerns that are primarily about the skin itself — persistent itch, a rash, changes in skin colour or texture, lumps, or a suspected skin condition such as lichen sclerosus, lichen planus, dermatitis, or psoriasis affecting the vulva.
A gynaecologist is generally the right first step for concerns involving the internal reproductive organs — abnormal bleeding, pelvic pain, cervical screening and abnormalities, or issues more clearly linked to the vagina or cervix rather than the external vulval skin.
Many patients don't fit neatly into one category, particularly where pain, skin changes, and pelvic floor symptoms overlap — this is exactly the kind of presentation the combined Vulva Clinic is designed for, so you're not left trying to work out which specialist to see first. If you're ever unsure, your GP is a good starting point and can guide the right referral.
Vulval skin conditions arise from a range of causes, including autoimmune processes (as in lichen sclerosus and lichen planus), infections (such as candidiasis or HPV-related warts), general inflammatory skin conditions (such as dermatitis and psoriasis) that happen to affect this area, and hormonal changes (such as the vulvovaginal atrophy that can accompany menopause). Some conditions, such as vulvodynia, involve pain-processing and pelvic floor factors rather than a visible skin change, which is part of why they can be harder to diagnose.
Not every vulval concern needs to be seen in the multidisciplinary Vulva Clinic — many straightforward presentations, such as uncomplicated thrush or a single, clearly diagnosed skin issue, are well managed by a GP or a single specialist. The combined clinic is most valuable for more complex or overlapping presentations, such as:
The clinic is not the right pathway for every concern — in particular, known vulval or vaginal intraepithelial neoplasia (VIN/VAIN) or cervical abnormalities requiring colposcopy are referred directly to specialised gynaecological services rather than assessed here. Your referring doctor can help determine whether the multidisciplinary clinic, or a single specialist, is the right fit for your particular concern.