Why “Just Water” Isn’t Enough: New Insights on Vulvar Hygiene

Dr. Kim Capone, Lead educator of the Institute for Vaginal Health and Chief Science Officer for Vaginal Biome Science.

A new 2025 review in Healthcare (Bohbot JL, Rebelo C, Nappi RE. Vulvar Care: Reviewing Concepts in Daily Hygiene, challenges the long-held belief that washing the vulva with plain water is the gentlest approach. Drawing from dermatologic and gynecologic evidence, the authors conclude that water alone may actually compromise the vulvar barrier, while mild, pH-balanced cleansers can help preserve hydration, comfort, and microbiota balance.

Why Vulvar Hygiene Matters

The review makes a compelling case for why daily vulvar hygiene is a cornerstone of women’s health, not an afterthought. As the authors write:

“The goals of personal intimate hygiene are to clear the vulvar area of microbial and cellular debris, remove vaginal and fecal secretions that may have settled on the area, and ensure local comfort. Washing should not alter the stratum corneum, the surface hydrolipid film, the pH, or the skin microbiota. For optimal effectiveness, personal intimate hygiene must therefore achieve two fundamental objectives: natural levels of hydration and preservation of the natural vulvar microbiota” (Bohbot et al., 2025).

They go on to note that water is lost more readily from the vulva than from nearby tissues, making the region prone to dehydration when inappropriate products or even just water are used. Moreover, vulvar dysbiosis can increase the risk of irritation, inflammation, and secondary vaginal dysbiosis, given that the vulvar and vaginal microbiota are closely connected.

This framing transforms intimate hygiene from a cosmetic concern into a clinical one: the goal isn’t just cleanliness, but maintaining barrier function, hydration, and microbial harmony.

Understanding the Vulvar Ecosystem

The vulva is a delicate transition zone between skin and mucosa. The outer labia resemble skin, but the inner folds and vestibule are thinner, more hydrated, and naturally acidic (pH ~4.5). This acid mantle supports Lactobacillus species that defend against pathogens and inflammation. Because of this complexity, the vulva needs specialized care - not soap, and not water alone.

Key Takeaways from the 2025 Review

• Water alone isn’t ideal. Repeated rinsing or prolonged exposure to water depletes essential lipids, increasing transepidermal water loss (TEWL) and dryness.

• Traditional soaps are too harsh. High-pH soaps (> 9) disrupt stratum-corneum proteins and lipids, heightening irritation risk, especially in the vestibular area.

• Syndet (synthetic-detergent) cleansers are preferred. Mild, low pH formulations designed for vulvar use are ideal. These are formulated with non-ionic surfactants and emollients to maintain hydration, respect microbiota, and reduce irritation potential.

 Good Clean Love® Balance Daily Intimate Wash

Formulated with 60% aloe and Bio-Match® low-pH technology, Balance Wash provides gentle yet effective cleansing that helps the vulva retain moisture, soothe irritation, and maintain its protective microbiome. This design reflects the principles outlined by Bohbot et al.: that optimal vulvar hygiene should support natural hydration and microbiota balance while preserving barrier integrity. As a mild, pH-balanced syndet cleanser, Balance Wash offers a physiologic option formulated according to current evidence-based principles for vulvar care.

Advancing the Science

Vaginal Biome Science is currently conducting a clinical study of Balance Wash in women with vulvar pain conditions, evaluating changes in the vaginal and vulvar microbiome, pain and comfort scores, and tissue health. To our knowledge, this is the first study conducted in vulvar pain patients linking intimate cleansers to both microbiome modulation and symptom improvement.

To learn more about the work at Vaginal Biome Science, visit vaginalbiomescience.com