Important info for every woman.
Skin cancer can occur anywhere on your body—and that includes your vulva (your external genitalia, including the inner and outer lips and clitoris), along with your vagina. In fact, two of the most common forms of vulvar cancer—vulvar squamous cell cancer and vulvar melanoma—are skin cancers.
But slathering sunscreen on your private parts won’t do anything to prevent vulvar or vagina cancer from occurring. “I’ve treated a number of women who have vulvar melanoma or vaginal melanoma and none of them have been sunbathing nude,” Robert Debernardo, MD, an ob-gyn at the Cleveland Clinic, tells Health.
That’s because only some melanomas are caused by sun exposure. For these, sun protection—from avoiding rays to applying sunscreen—is a powerful preventative method. But other melanomas are genetic, and can occur nearly anywhere on your body, Larisa J. Geskin, MD, a dermatologist at New York-Presbyterian Columbia University Medical Center, tells Health.
While vulvar and vaginal cancers are rare—just 6% of gynecological cancers occur in this area, according to the CDC—they're also incredibly difficult to detect. Discover the risk factors, and how to spot symptoms early on.
Vulvar cancer has several types
The most common is squamous cell cancer, caused by changes in the skin cells lining the vagina and vulva. It tends to affect postmenopausal women in their 70s and 80s, says Dr. Debernardo, but some forms are related to HPV and occur in younger women. Risk factors include smoking, a weakened immune system, lichen sclerosus (a skin condition), and precancerous conditions.
Melanoma is the second most common form of vulvar cancer. “Melanoma is the kind of skin cancer that we all fear. It starts with melanocytes, which is the pigmented cell,” says Dr. Debernardo. And while doctors see vulvar melanomas in an older age group, they’re also found in younger women as well, he adds.
Other cancers, not related to the skin, can also occur in the vulva and vagina, including adenocarcinoma, or cancers that begin in the gland cells, as well as sarcomas, which begin in the cells of bones, muscles, and tissue.
Spotting skin cancer on your vulva is challenging
Melanomas can appear as black or brown marks on the skin of your vulva, but they can also be the same pigment as your vulvar skin, says Dr. Geskin. Squamous cell cancers can take the form of a lump, sores, rash, or warts. Pigment changes in the vulva and vagina are very common, adds Dr. Debernardo, and many of these changes are natural and non-problematic.
Most of us, though, probably aren't peering at our privates on the lookout for pigment changes very frequently—and we wouldn't necessarily be able to distinguish between normal and abnormal developments.
“This is the one of reasons that we suggest women visit the gynecologist every year,” says Dr. Debernardo. During your standard gynecological exam—whether or not you get a pap test, depending on the most recent guidelines—your doctor will examine your vulva and vagina for signs of vulvar skin cancer. Just a dermatologist can pinpoint potentially problematic moles, your gynecologist knows which pigment and skin changes are run of the mill, and which ones require further investigation with a biopsy.
Along with an annual visit to the gynecologist, Dr. Debernardo suggests women do vulva self-exams. Women should know what's normal for their vulva—just as you have a sense of what that mole on your shin looks like and how your breasts typically look and feel throughout your cycle. No need to contort your body or even get a hand mirror involved. Dr. Debernardo recommends using the front-facing camera on a smartphone to snap a photo of your vulva (just make sure to delete the snapshot once you’ve reviewed it).
During these self-exams, be on the lookout for skin that has changed pigmentation, as well as growths, sores, or bumps. Often, these are the only sign of the disease. “That’s the problem with the majority of cancers, including melanoma—it doesn’t really hurt,” says Dr. Geskin. “Having said that, sometimes our own bodies recognize these spots as malignant or abnormal, and have an immune reaction against cancer, and can be symptomatic, with itching or irritation around the spot,” she says. If you experience discomfort, incessant itching, non-menstrual bleeding, and pain in the area, visit your doctor.
If you have signs of vulvar cancer, see your ob-gyn
That’s worth repeating: Visit your doctor if you experience any visible skin changes in the vaginal and vulvar area, as well as any discomfort or unusual symptoms, from irritation to itching. Your gynecologist views this part of the body all day and may be able to visually identify if any symptoms are a concern—or simply a normal change. While it may seem scary, this is an easy area to biopsy and not very uncomfortable, says Dr. Debernardo.
“If someone has a melanoma of the vulva, they should definitely see a gyno oncologist, probably not a dermatologist,” recommends Dr. Debernardo. He advises going to a treatment center with melanoma specialists, too. "Since melanoma is much more common in other areas of the body, it’s worth seeing a group of people who treat melanoma all the time."
"The best prevention is early diagnosis," he says. "The bottom line is you need to keep an eye on this area. If something looks different to you or funny, get ahold of a gynecologist."