3 Common Vaginal Skin Concerns That Can Happen As You Age — and How to Tackle Them

You read a lot about skin-care for your face. But your vagina? Not so much. Here, how to care for the precious cargo you keep undercover.

3 Common Vaginal Skin Concerns and How to Tackle Them, Marble statue of Venus on the facade of the Lloyd Palace in Trieste, Italy, made by Ugo Härdlt in 1883
Photo: Getty Images

You probably already know that the body's production of spongy collagen — the stuff that makes skin plump and firm — decreases with age. But what surprises most people is that collagen loss also extends to the vagina, leaving it less elastic. Similarly, other skin-aging concerns, such as dryness, discoloration, and increased sensitivity, become more bothersome in the bikini area too.

As you get older, you produce less estrogen, and "estrogen is to the vagina what lotion is to the face," says Karyn Eilber, M.D., a urologist in California who specializes in female pelvic medicine. "Without enough estrogen, the vagina and vulva areas become dryer, the skin there thins and is more easily irritated, and pH levels can become imbalanced, leading to more yeast and bacterial infections." Aging can also affect skin tone in the nether region.

Even though all of these changes are totally normal and okay, you might feel a bit self-conscious about the way things look and feel. So if you want to take care of your skin downstairs, try one the following strategies — some at home, some in-office — to help your vagina stay healthy and hydrated, just like the rest of you.

Dryness

Why It Happens

The gradual drop in estrogen that typically happens in our 40s can render the vaginal area — both the outer vulva and the vaginal canal — noticeably dryer.

What You Can Do About It

Hydrating topicals moisturize the delicate vulva skin and ease dry vaginal skin. Try Womaness Daily V Soothe (Buy It, $15, target.com), a fragrance-free, water-based formula; Miss Bud's Hemp Feminine Balm (Buy It, $18, amazon.com); and Apivita Gentle Cleansing Gel for the Intimate Area (Buy It, $20, amazon.com).

For extreme dryness inside the vagina, there's VSpot Good Sex (Buy It, $125, vspotmd.com), an over-the-counter, hormone-free moisturizing suppository. Or prescription topical estrogen treatments — creams, suppositories, or rings — help counter estrogen loss. When used as prescribed, the estrogen formulas can be effective, low-risk solutions, says Dr. Eilber.

For dry vaginal skin plus loss of elasticity, some doctors recommend laser rejuvenation (such as the FemiLift by Alma, average cost is $1,000). "Typically done with a CO2 laser, this treatment creates microdamage inside the vagina, triggering the body's healing response. The result is an increase in both collagen and lubrication," says Dr. Eilber, who adds that laser rejuvenation is best for women who are finished having children since a vaginal delivery may undo the benefits. Expect two to three 10-minute sessions that can feel a bit uncomfortable (think: a very warm Pap smear) spaced about four weeks apart. And you'll need to abstain from sex for 48 hours post-procedure.

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Womaness Daily V Soothe Moisturizer

Womaness Daily V Soothe Moisturizer
Target
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Miss Bud's Hemp Feminine Balm

Miss Bud's Hemp Feminine Balm
Amazon
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Apivita Gentle Cleansing Gel for the Intimate Area

Apivita Gentle Cleansing Gel for the Intimate Area
Amazon
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VSpot Good Sex

VSpot Good Sex
VSpot

Loss of Elasticity

Why It Happens

"Lots of women in their early 40s complain about painful sex. While a lack of moisture is a culprit, the primary cause is something called vaginal atrophy, a condition in which, because of collagen loss, the vaginal walls become thinner, and the vagina stiffens and tightens," says Cindy Barshop, the owner of VSpot, a vaginal-health medical spa in New York and Philadelphia. This loss of stretchiness in the vaginal canal can make sex (as well as the inflamed skin after sex) very uncomfortable. (Experiencing pain after sex? Here are some likely reasons you could be experiencing pelvic pain post-intercourse.)

The loss of collagen can also leave any skin that was stretched in childbirth permanently slack. "The vaginal skin of younger women typically bounces back six months after childbirth. But if you are a 40-something mom, age-related collagen loss may mean what became loose stays loose," says Dr. Eilber.

What You Can Do About It

The remedies for internal dryness can also help with a loss of elasticity and slack skin. Topical estrogen, a vaginal moisturizer, and CO2 laser treatments have been shown to boost collagen production in the vaginal canal, and more collagen equals stretchier, more resilient skin. If you have a significant loss of elasticity but may have another child, radio frequency, such as ThermiVa, is another option. (

Having sex also helps. "Regularly engaging the vaginal tissue helps it maintain some pliability," says Dr. Eilber. "If sex is painful, use a lubricant to minimize the friction or tug on fragile vaginal walls." Try oil-based URJA Intimates Intense Hydrating Lubricant (Buy It, $52, verishop.com), which contains cannabidiol (aka CBD) to help with pain, or water-based Glissant Sea Salt & Caramel Intimate Lubricant Spray (Buy It, $55, bluemercury.com), which is best for when you're using condoms.

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URJA Intimates Intense Hydrating Lubricant

URJA Intimates Intense Hydrating Lubricant
Verishop
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Glissant Sea Salt & Caramel Intimate Lubricant Spray

Glissant Sea Salt & Caramel Intimate Lubricant Spray
Blue Mercury

Irritation

Why It Happens

Aging skin plus a pH imbalance brought on by seesawing estrogen levels can cause sensitized skin, yeast and bacterial infections, and hyperpigmentation.

What You Can Do About It

"Avoid douching," says Dr. Eilber. Using anything to clean the inside of the vagina can disrupt the good-to-bad ratio of bacteria, exacerbating a pH imbalance and upping the chance of an infection. Stick to gentle external washes like Gillette Venus for Pubic Hair and Skin 2-in-1 Cleanser Shave Gel (Buy It, $15, amazon.com).

If you're prone to yeast and bacteria infections, also avoid regular use of vaginal moisturizers or lubricants that contain glycerin, parabens, phthalates, or propylene glycol. Try Good Clean Love Almost Naked Organic Personal Lubricant (Buy It, $8, amazon.com). You can also calm external skin with Rael Soothing Vulva Relief Gel (Buy It, $11, nordstrom.com).

Discoloration in the bikini area is more common in women of color. "Hyperpigmentation is how Black and brown women age," says Shape Brain Trust member Mona Gohara, M.D., a dermatologist in Connecticut. "Years of shaving and waxing, plus friction from exercise can exacerbate it." Exfoliation is key because dark skin cells turn over slowly, and holding on to dead cells makes uneven tone more apparent. "Apply a lotion with lactic acid at night," she says. Try AmLactin Rapid Relief Restoring Cream (Buy It, $25, amazon.com). During the day, use a product with niacinamide. "I like Dove Even Tone Antiperspirant [Buy It, $15 for 3, amazon.com] applied in the folds of the groin. It's soothing and helps control excess moisture."

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Gillette Venus for Pubic Hair and Skin 2-in-1 Cleanser Shave Gel

Gillette Venus for Pubic Hair and Skin 2-in-1 Cleanser Shave Gel
Amazon
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Good Clean Love Almost Naked Organic Personal Lubricant

Good Clean Love Almost Naked Organic Personal Lubricant
Amazon
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Rael Soothing Vulva Relief Gel

Rael Soothing Vulva Relief Gel
Nordstrom
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AmLactin Rapid Relief Restoring Cream

AmLactin Rapid Relief Restoring Cream
Amazon
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Dove Even Tone Antiperspirant

Dove Even Tone Antiperspirant
Amazon
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