The pH of the vulvar region in the life cycle: scoping review
DOI:
https://doi.org/10.5216/ree.v26.75717Keywords:
Vulva, Hydrogen-Ion Concentration, Skin, Hygiene, Weights and MeasuresAbstract
Introduction: to map the studies that measured the Potential of Hydrogen (pH) of the vulvar region in women’s life cycle. Methods: scoping review according to recommendations from the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis in the SCOPUS, Web of Science, Academic Search Premier, PubMed, Bielefeld Academic Search Engine and Google Scholar databases in January 2022. Studies published in Portuguese, Spanish, French, and English, without time limit, were included. Results: of the 954 documents retrieved, 13 were selected. Different measurement procedures in relation to equipment, environment and preparation of participants were used in the studies. The average age of the female population ranged between 31 and 43 years. The vulvar measurement sites were the labia majora and minora, interlabial sulci and perineum. The lowest pH value measured was 4.6 and the highest was 6.3. Conclusions: there was a low production of studies on vulvar pH and an emphasis of studies on the population of adult women. The diversity of procedures and measurement sites found does not allow for safe statements about a range of pH values on the surface of the vulvar skin.
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References
Farage MA, Maibach HI. Tissue structure and physiology of the vulva. In: Farage MA, Maibach HI, editors. The vulva: physiology and clinical management. Boca Raton: CRC Press; 2017. p. 6-13. https://doi.org/10.1201/9781315113739
Farage MA, Lennon L, Ajayi F. Products used on female genital mucosa. Curr Probl Dermatol. 2011;40:90-100. https://doi.org/10.1159/000321058
Al-Niaimi F, Felton S, Williams J. Patch testing for vulval symptoms: our experience with 282 patients. Clin Exp Dermatol. 2014 June;39(4):439-42. https://doi.org/10.1111/ced.12330
Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO). Guia prático de condutas. Higiene genital feminina [Internet]. 2009 [cited 2022 Sep 15]. Available from: https://missali.site.med.br/fmfiles/index.asp/::XPR3638::/Guia_de_Higiene_Feminina.pdf
Earage MA. Vulvar susceptibility to contact irritants and allergens: a review. Arch Gynecol Obstet. 2005;272(2):167- 72. https://doi.org/10.1007/s00404-005-0732-4
Proksch E. pH in nature, humans and skin. J Dermatol. 2018 Sep;45(9):1044-52. https://doi.org/10.1111/1346-8138.14489
du Plessis JL, Stefaniak AB, Wilhelm KP. Measurement of skin surface pH. Curr Probl Dermatol. 2018;54:19-25. https://doi.org/10.1159/000489514
Ali SM, Yosipovitch G. Skin pH: from basic science to basic skin care. Acta Derm Venereol. 2013 May;93(3):261-7. https://doi.org/10.2340/00015555-1531
van Rensburg SJ, Franken A, Du Plessis JL. Measurement of transepidermal water loss, stratum corneum hydration and skin surface pH in occupational settings: a review. Skin Res Technol. 2019 Sep;25(5):595-605. https://doi.org/10.1111/srt.12711
Chen Y, Bruning E, Rubino J, Eder SE. Role of female intimate hygiene in vulvovaginal health: global hygiene practices and product usage. Womens Health (Lond). 2017 Dec;13(3):58- 67. https://doi.org/10.1177/1745505717731011
Umami A, Paulik E, Molnár R, Murti B. The relationship between genital hygiene behaviors and genital infections among women: a systematic review. Journal Ners. 2022;17(1):89- 101. https://doi.org/10.20473/jn.v17i1.34402
Felix TC, Araújo LB, Röder DVDB, Pedroso RS. Evaluation of vulvovaginitis and hygiene habits of women attended in primary health care units of the family. Int J Womens Health. 2020 Jan;12:49-57. https://doi.org/10.2147/IJWH.S229366
Summers PR, Hunn J. Unique dermatologic aspects of the postmenopausal vulva. Clin Obstet Gynecol. 2007 Sep;50(3):745-51. https://doi.org/10.1097/GRF.0b013e3180db96ae
van der Meijden WI, Boffa MJ, Ter Harmsel B, Kirtschig G, Lewis F, Moyal-Barraco M, et al. 2021 European guideline for the management of vulval conditions. J Eur Acad Dermatol Venereol. 2022;36(6):952-72. https://doi.org/10.1111/jdv.18102
Royal College of Obstetricians & Gynaecologists. The management of vulval skin disorders [Internet]. RCOG; 2011 [cited 2022 Dez 13] Available from: https://bssvd.org/wp-content/uploads/2018/06/RCOG-Vulval- Guidelines-1.pdf
Kaur J, Kalsy J. Study of pruritus vulvae in geriatric age group in tertiary hospital. Indian J Sex Transm Dis AIDS. 2017 Jan-Jun;38(1):15-21. https://doi.org/10.4103/0253-7184.192632
Edwards D, Panay N. Treating vulvovaginal atrophy/ genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition? Climacteric. 2015 Apr;19(2):151-61. https://doi.org/10.3109/13697137.2015.1124259
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: Scoping Reviews (2020 version) [Internet]. In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. JBI; 2020 [cited 2022 Dec 13]. Available from: https://synthesismanual.jbi.global/
Murina F, Caimi C, Felice R, Di Francesco S, Cetin I. Characterization of female intimate hygiene practices and vulvar health: a randomized double-blind controlled trial. J Cosmet Dermatol. 2020 Oct;19(10):2721-6. https://doi.org/10.1111/jocd.13402
Bruning E, Chen Y, McCue KA, Rubino JR, Wilkinson JE, Brown ADG. A 28 day clinical assessment of a lactic acid-containing antimicrobial intimate gel wash formulation on skin tolerance and impact on the vulvar microbiome. Antibiotics (Basel). 2020 Feb;9(2):55. https://doi.org/10.3390/antibiotics9020055
Vongsa R, Hoffman D, Shepard K, Koenig D. Comparative study of vulva and abdominal skin microbiota of healthy females with high and average BMI. BMC Microbiol. 2019 Jan;19(1):16. https://doi.org/10.1186/s12866-019-1391-0
Miyamoto T, Akiba S, Sato N, Fujimura T, Takagi Y, Kitahara T, et al. Study of the vulvar skin in healthy Japanese women: components of the stratum corneum and microbes. Int J Dermatol. 2012 Dec;52(12):1500-5. https://doi.org/10.1111/j.1365-4632.2012.05582.x
Fujimura T, Sato N, Ophaswongse S, Takagi Y, Hotta M, Kitahara T, et al. Characterization of vulvar skin of healthy Thai women: influence of sites, age and menopause. Acta Derm Venereol. 2013 Mar;93(2):242-5. https://doi.org/10.2340/00015555-1534
Fujimura T, Sato N, Takagi Y, Ohuchi A, Kawasaki H, Kitahara T, et al. An investigator blinded cross-over study to characterize the cutaneous effects and suitability of modern sanitary pads for menstrual protection for women residing in the USA. Cutan Ocul Toxicol. 2011 Sep;30(3):205-11. https://doi.org/10.3109/15569527.2011.554936
Löwhagen GB, Bonde E, Forsgren-Brusk U, Runeman B, Tunbäck P. The microenvironment of vulvar skin in women with symptomatic and asymptomatic herpes simplex virus type 2 (HSV-2) infection. J Eur Acad Dermatol Venereol. 2006 Oct;20(9):1086-9. https://doi.org/10.1111/j.1468-3083.2006.01729.x
Runeman B, Rybo G, Forsgren-Brusk U, Larkö O, Larsson P, Faergemann J. The vulvar skin microenvironment: impact of tight-fitting underwear on microclimate, pH and microflora. Acta Derm Venereol. 2005;85(2):118-22. https://doi.org/10.1080/00015550410024562
Runeman B, Rybo G, Forsgren-Brusk U, Larkö O, Larsson P, Faergemann J. The vulvar skin microenvironment: influence of different panty liners on temperature, pH and microflora. Acta Derm Venereol. 2004;84(4):277-84. https://doi.org/10.1080/200484277284
Runeman B, Rybo G, Larkö O, Faergemann J. The vulva skin microclimate: influence of panty liners on temperature, humidity and pH. Acta Derm Venereol. 2003;83(2):88-92. https://doi.org/10.1080/00015550310007409
Wilhelm D, Elsner P, Maibach HI. Standardized trauma (tape stripping) in human vulvar and forearm skin. Effects on transepidermal water loss, capacitance and pH. Acta Derm Venereol. 1991;71:123-6. PMID: 1675519.
Elsner P, Wilhelm D, Maibach HI. Multiple parameter assessment of vulvar irritant contact dermatitis. Contact Dermatitis. 1990 July;23(1):20-6. https://doi.org/10.1111/j.1600-0536.1990.tb00078.x
Elsner P, Maibach HI. The effect of prolonged drying on transepidermal water loss, capacitance and pH of human vulvar and forearm skin. Acta Derm Venereol. 1990;70(2):105-9. PMID: 1969192.
Kaur P, Patil RK, Bansal R, Patil HC. A review of practices related to genital hygiene and its awareness in women. Panacea Journal of Medical Sciences. 2021;11(3):366-9. https://doi.org/10.18231/j.pjms.2021.074
Voegeli R, Gierschendorf J, Summers B, Rawlings AV. Facial skin mapping: from single point bio-instrumental evaluation to continuous visualization of skin hydration, barrier function, skin surface pH, and sebum in different ethnic skin types. Int J Cosmet Sci. 2019 Oct;41(5):411-24. https://doi.org/10.1111/ics.12562
Monti M. Chamomile extract in a cleansing wash (Saugella Poligyn) in menopause hygiene. Global Science Research Journals [Internet]. 2016;4(1):162-6.
Banga L. The microbiota of the vulva and vagina: ways of washing to optimise the protective function of the vulvo- vaginal microbiota during pregnancy. New Zealand College of Midwives Journal. 2021;57:34-40. https://doi.org/10.12784/nzcomjnl57.2021.5.34-40
Attieh E, Maalouf S, Roumieh D, Abdayem P, Abitayeh G, Kesrouani A. Feminine hygiene practices among female patients and nurses in Lebanon. Reprod Health. 2016 May;13(1):59. https://doi.org/10.1186/s12978-016-0182-4
Stefaniak AB, du Plessis J, John SM, Eloff F, Agner T, Chou TC, et al. International guidelines for the in vivo assessment of skin properties in non-clinical settings: part 1. pH. Skin Res Technol. 2012 Dec 26;19(2):59-68. https://doi.org/10.1111/srt.12016
Parra JL, Paye M; EEMCO Group. EEMCO guidance for the in vivo assessment of skin surface pH. Skin Pharmacol Appl Skin Physiol. 2003 May-Jun;16(3):188-202. https://doi.org/10.1159/000069756
Linhares IM, Summers PR, Larsen B, Giraldo PC, Witkin SS. Contemporary perspectives on vaginal pH and lactobacilli. Am J Obstet Gynecol. 2011 Feb;204(2):120. e1–5. https://doi.org/10.1016/j.ajog.2010.07.010
Donders GGG, Grinceviciene S, Ruban K, Bellen G. Vaginal pH and microbiota during fluconazole maintenance treatment for recurrent vulvovaginal candidosis (RVVC). Diagn Microbiol Infect Dis. 2020 Jun;97(2):115024. https://doi.org/doi:10.1016/j.diagmicrobio.2020.115024
Alexiades MR. Fractional Co2 laser treatment of the vulva and vagina and the effect of postmenopausal duration on efficacy. Lasers Surg Med. 2021 Feb;53(2):185-98. https://doi.org/10.1002/lsm.23247
Carter J, Baser RE, Goldfrank DJ, Seidel B, Milli L, Stabile C, et al. A single-arm, prospective trial investigating the effectiveness of a non-hormonal vaginal moisturizer containing hyaluronic acid in postmenopausal cancer survivors. Support Care Cancer. 2021 Jan;29(1):311-22. https://doi.org/10.1007/s00520-020-05472-3
De Seta F, Caruso S, Di Lorenzo G, Romano F, Mirandola M, Nappi RE. Efficacy and safety of a new vaginal gel for the treatment of symptoms associated with vulvovaginal atrophy in postmenopausal women: a double-blind randomized placebo-controlled study. Maturitas. 2021 May;147:34-40. https://doi.org/10.1016/j.maturitas.2021.03.002
Melo MO, Campos PMBGM. Função de barreira da pele e pH cutâneo. Cosmetics & Toiletries. 2016 Mai-Jun;28:34-8.
Blaak J, Staib P. The relation of pH and skin cleansing. Curr Probl Dermatol. 2018;54:132-42. https://doi.org/10.1159/000489527
Lambers H, Piessens S, Bloem A, Pronk H, Finkel P. Natural skin surface pH is on average below 5, which is beneficial for its resident flora. Int J Cosmet Sci. 2006 Oct;28(5):359-70. https://doi.org/10.1111/j.1467-2494.2006.00344.x
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