Aunt Vadge: what are these white dots on clitoris and underwear?

A small Asian girl stands under a pink umbrella, it is raining the white dots and specks the woman discussed being in her underwear in this Ask Aunt Vadge question

Dear Aunt Vadge,

I notice these tiny white dots around and inside my clitoris and/or dry specks in my underwear.

Am I okay?

It’s random, I noticed after a shower. Please help.
From Judy
Age 35, Oregon, USA

_______________

Dear Judy,

Tiny white dots around your clitoris could be several things, many of which are completely benign. Without more information, I’ll outline some possibilities, but it’s important to get a proper diagnosis from a healthcare provider who can examine you.

When you see them next, take a good photo with your phone, just in case when you’re at your appointment with the doctor, the dots aren’t there.

The tiny white dots you’re observing could be:

  1. Fordyce spots: These are small, painless, pale or white spots that can appear on the genitals. They’re sebaceous glands that have become visible on the skin and are completely harmless​1–3​. But, Fordyce spots don’t go into your underwear, so that might be something else.
  2. Keratin buildup: Sometimes, the skin cells can accumulate and form small, harmless white or yellowish deposits called keratin pearls​4​.
  3. Vestibular papillomatosis: This is a normal anatomical variation where small skin tags or projections appear around the vulvar vestibule, including near the clitoris.
  4. Yeast infection: A common but treatable vaginal overgrowth of yeast that can cause white spots to appear on underwear. It often comes with itching and discomfort.
  5. Toilet paper: this happens all the time, to everyone! Little pieces of toilet paper ball up as you wipe after the toilet, and you’ll find them all over the place if you go hunting. Try to use thicker toilet paper (2 or 3 ply versus 1 ply).

As for the dry specks in your underwear, they could just be natural vaginal discharge that has dried, which can sometimes occur. If it is particularly bothersome or accompanied by other symptoms (like itching, burning, or odour), it could indicate an imbalance or infection that warrants further investigation.

Given you’re noticing this after showering, it could also be related to the products you use. Harsh soaps or shower gels can sometimes cause irritation or dryness, but also, what are you drying yourself with?

At 35, you’re unlikely to be in the perimenopausal range where hormonal changes might typically cause such symptoms, but it’s always good to be mindful of any other changes in your body or cycle that could provide more clues.

It’s crucial to see a GP or a gynaecologist who can examine you and provide an accurate diagnosis, if one is required. There may be a very simple explanation, though, so don’t worry. It doesn’t sound like you’re in any pain or itchy, which is great.

In the meantime, avoid using any heavily fragranced products, douches, or printed toilet paper around your vulva, as these can cause irritation. Stick to plain water or a gentle, pH-balanced wash formulated for that area. Try another brand of toilet tissue, the thicker the better. Thin toilet paper balls more easily.

Please remember, noticing changes in your body is a good indicator that you are in tune with yourself, and seeking advice is a positive step in taking care of your health.

Warm regards,
Aunt Vadge

References​5​

  1. 1.
    Lee JH, Lee JH, Kwon NH, et al. Clinicopathologic Manifestations of Patients with Fordyce’s Spots. Ann Dermatol. Published online 2012:103. doi:10.5021/ad.2012.24.1.103
  2. 2.
    Pietkiewicz P, Navarrete-Dechent C, Goldust M, Korecka K, Todorovska V, Errichetti E. Differentiating Fordyce Spots from Their Common Simulators Using Ultraviolet-Induced Fluorescence Dermatoscopy—Retrospective Study. Diagnostics. Published online March 4, 2023:985. doi:10.3390/diagnostics13050985
  3. 3.
    Wootton C, Saihan E. Fordyce spots. BMJ. Published online May 20, 2015:h2545-h2545. doi:10.1136/bmj.h2545
  4. 4.
    Bragiel RM, Umasankar N, Burgis JT, Tomlin KV. Treatment of Clitoral Keratin Pearls with Topical Estrogen Cream: Case Report. Journal of Pediatric and Adolescent Gynecology. Published online June 2023:321-323. doi:10.1016/j.jpag.2022.10.002
  5. 5.
    Majerovich J, Canty A, Miedema B. Chronic vulvar irritation: could toilet paper be the culprit? Can Fam Physician. 2010;56(4):350-352. https://www.ncbi.nlm.nih.gov/pubmed/20393094


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