Breast checks and mole checks get talked about a lot, and checking the vulva rarely comes up. That gap matters, because the vulva is skin that changes over time, and you're the person most likely to notice a change first. Our article on lichen sclerosus explains why a missed change can mean a late diagnosis.
A vulvar self-exam is simple. All it takes is a hand mirror and some idea of what you're looking at. This guide follows the method an NHS hospital trust gives its patients, explains what normal looks like, and lists the changes worth showing a clinician. It's information, not a diagnosis.
In this article
- Why look at your own vulva
- What a normal vulva looks like
- When and how often to check
- How to do a vulvar self-exam, step by step
- Changes worth noting
- When to see a clinician, and what happens next
- Putting the risk in context
- Frequently asked questions
Why look at your own vulva
The vulva is the outside part of the genitals: everything you can see between your legs, from the pubic mound down to the skin in front of the anus. The vagina is the canal inside. A self-exam is about the vulva.
Many conditions can affect the skin there. Newcastle Hospitals, an NHS trust in England, explains in its patient leaflet that infections and skin conditions such as eczema can affect vulval skin, that pre-cancerous changes sometimes occur, and that cancer is very rare. It adds that finding a problem early generally means less treatment and fewer side effects.
Cleveland Clinic gives the same idea from another angle. Its page on vulvar cancer suggests you become familiar with all parts of your body, including your vulva, so you know its normal appearance and can spot a change. The point of a self-exam is to know your own baseline, so you notice when something is new.
What a normal vulva looks like
There's no single normal. A study at a London hospital measured the genitals of 50 women before unrelated surgery and found a wide range of values for every measurement, including the size of the clitoris, the length and width of the labia, and their colour and texture. The differences had no link to age, number of births, ethnicity, hormone use or sexual history.
Cleveland Clinic's page on the vulva says it plainly: no two vulvas are the same. It notes that the outer lips come in different shapes and sizes for everyone, and that the inner lips come in many varieties too. Some are symmetrical and others aren't.
So when you look, there's no picture you need to match. Inner lips that show past the outer lips, one side longer than the other, darker or pinker skin at the edges, and a wrinkled texture can all fall within that range. The aim is to learn what yours looks like, so a change stands out later.
Here are the parts you'll look at, in the order of the exam, using the names Cleveland Clinic uses.
| Part | Where it is | What to know |
|---|---|---|
| Mons pubis | The soft, V-shaped area over the pubic bone, where most pubic hair grows | Check the skin under the hair as well as on top |
| Clitoris | At the top, where the inner lips meet, under a small hood of skin | The visible part is small; the hood can be gently drawn back |
| Labia minora (inner lips) | The hairless folds inside the outer lips | Size, shape and colour vary widely, and many aren't symmetrical |
| Labia majora (outer lips) | The fleshy, usually hair-covered folds on each side | Look in the creases between the inner and outer lips too |
| Urethral and vaginal openings | Below the clitoris, the urethra first, then the vaginal opening | You look around them, nothing goes inside |
| Perineum | The skin between the vaginal opening and the anus | Easy to miss unless you tilt the mirror |
| Anus | At the bottom | The last area in the check |
When and how often to check
The Newcastle leaflet suggests a self-exam once a month, between periods, for sexually active women and all women over 20. It also says to check at any time if you notice vulval itching or pain, pain during sex, a lump, or skin that feels thicker.
If you don't have periods, pick a date that's easy to remember, such as the first of the month.
The first look can feel awkward. You can stop at any point and pick it up another day.
How to do a vulvar self-exam, step by step
The steps below follow the Newcastle leaflet, with a few practical details added.
- Find a private place and good light. A bedroom with a lamp you can point works well. Wash your hands first.
- Get comfortable. Sit on the bed with your knees bent and apart, or stand with one foot on the edge of the bath. Use whichever position lets you see without straining.
- Hold a hand mirror in one hand. Use your other hand to gently separate the outer lips so you can see the inner area clearly.
- Start at the top, with the mons pubis. Look at the skin, parting the hair with your fingers, then touch it gently.
- Move to the clitoris and its hood, then the inner lips, then the outer lips, looking first and then touching each area gently with a fingertip.
- Look around the openings. Check the skin around the urethral and vaginal openings without putting anything inside.
- Finish with the perineum and the anus. Tilt the mirror to see the skin between the vaginal opening and the anus, then the anus itself.
- Note what you see. A few words in your phone's notes app, with the date, are enough. Some people take a photo to compare from month to month, which can help if you're keeping an eye on a spot.
The whole check takes a few minutes. Touch matters as much as sight here, because a patch of thicker or rougher skin can be easier to feel than to see.
If you can't see well
Not everyone can see easily at that angle. A larger mirror propped on a pillow, a mirror with a stand, or a phone's front camera can make it easier. If it's still difficult, ask a clinician to show you during your next appointment.
Changes worth noting
The Newcastle leaflet lists the changes to look for in vulval skin:
- Colour changes, such as whitening or a distinct darker patch.
- Thickened skin, such as warts or skin tags.
- Ulcers or sores.
- Itching or soreness that doesn't go away.
Cleveland Clinic's vulvar cancer page lists similar signs, including skin that looks darker or lighter than usual or patches of white skin, growths or ulcers that don't go away, itching or burning that persists, bleeding that isn't related to your period, and pain.
These signs have many possible causes. The NHS says the symptoms are very common and can be caused by many different conditions, and that having them doesn't mean you have cancer. Our articles on a swollen vulva and itching around perimenopause go through some of the everyday causes.
Some things are part of everyday life and worth knowing so they don't alarm you, such as an ingrown hair after shaving, or colour and size that differ from what you see in pictures. What counts is what is new for you, or what doesn't go away.
When to see a clinician, and what happens next
See your family doctor, a nurse practitioner or a gynecologist if you notice any of the changes above, or anything new that doesn't go away. The NHS says to see a GP if you have any symptoms of vulval cancer, and the Newcastle leaflet asks patients to report every change so it can be checked.
A self-exam looks at the skin, so a new smell or discharge is a different question; our article on why a vulva can smell different covers that one.
Bring your notes or photos if you have them, and say when you first noticed the change. That saves time and helps the clinician see whether it has grown or changed.
The Newcastle leaflet says that in most cases a simple check-up is enough. Depending on what they find, treatment may be a moisturizing emollient, a short course of steroid cream, or occasionally a small biopsy, where a tiny piece of skin is taken to look at under a microscope. The word biopsy can sound frightening, and you can ask for each step to be explained before anything happens.
If you're already being followed for a vulvar skin condition, check your vulva the way your clinic asks, and contact them sooner if you see a change between visits.
Putting the risk in context
It helps to know how rare the serious outcome is. Cleveland Clinic says vulvar cancer is rare, with just under 6,500 new cases diagnosed in the US each year. Nearly 80% of people diagnosed are over 50, and the average age at diagnosis is 68.
The same page lists the main risk factors: age, infection with HPV, lichen sclerosus, vulvar intraepithelial neoplasia (abnormal changes in the skin cells), HIV and smoking. Knowing them helps you and your clinician decide how closely to watch.
If one of those applies to you, ask your clinician whether they'd like you to check more often than once a month, or to come in for regular visits. A monthly look also makes the rest of your vulva care routine easier to judge, because you'll know what your skin looks like on an ordinary day.
Frequently asked questions
How often should I do a vulvar self-exam?
Once a month is the usual advice. An NHS hospital trust suggests a monthly check between periods for sexually active women and all women over 20, and a check any time you notice itching, pain, pain during sex, a lump or thicker skin. If you don't have periods, pick an easy date each month.
What does a normal vulva look like?
There isn't one normal look. A study of 50 women found a wide range of sizes, shapes, colours and textures, with no link to age, ethnicity or sexual history. Cleveland Clinic notes that no two vulvas are the same. Normal means what is usual for you, which is why a monthly look helps.
Is it normal for my labia to be uneven?
It can be. Cleveland Clinic says the inner lips come in many varieties, and that some are symmetrical and others aren't. A study of 50 women found a wide range of labial lengths and widths. Talk to a clinician if one side changes in size, becomes painful or swells.
What changes should I look for on my vulva?
Look for colour changes such as white or darker patches, thickened skin such as warts or skin tags, sores or ulcers, and itching or soreness that doesn't go away. Bleeding that isn't from your period and a sore that doesn't go away are also worth reporting. Many of these have common causes.
Should I worry if I find a lump on my vulva?
Many lumps turn out to have a common cause, such as an ingrown hair. The NHS notes that vulvar symptoms are very common and can be caused by many different conditions. Still, any new lump, and any lump that grows, bleeds or hurts, should be checked by a clinician.
What happens if I see a doctor about a change?
Usually a simple examination. An NHS trust leaflet says most people only need a check-up, and that treatment, if needed, may be an emollient, a short course of steroid cream, or occasionally a small biopsy. A biopsy takes a tiny piece of skin to look at under a microscope, and you can ask for each step to be explained first.
Sources
- Why and how to examine the vulva, how often, and what to report: Newcastle Hospitals NHS Foundation Trust, Self-examination of the vulva
- Variation in genital appearance among 50 women: Lloyd and colleagues, BJOG, 2005, PubMed 15842291
- Parts of the vulva and how they vary: Cleveland Clinic, Vulva
- Signs, rarity, age and risk factors of vulvar cancer: Cleveland Clinic, Vulvar cancer
- Symptoms and when to see a GP: NHS, Vulval cancer symptoms
About this article
Written by the Peach & Cream team, based in Montréal. Published October 15, 2026. Last updated October 15, 2026. Facts come from an NHS hospital trust's patient leaflet, the NHS, Cleveland Clinic and the peer-reviewed study linked above. This article is general information, not medical advice. A self-exam doesn't replace an examination by a clinician.