Smegma is a naturally oily protective substance produced by oil glands that can accumulate between the labia and under the clitoral hood1.
How much smegma you get is personal and changes with your overall health and habits, but cleaning can be tricky since smegma is oily and doesn’t always rinse off easily with soap and water.
(Smegma is the yucky name given to what would normally be affectionately known as ‘dick cheese’. I know. We’re sorry. You get it, too.)
What is smegma?
Smegma is a naturally-occurring oily substance made up of dead skin cells, oils, proteins and other moisture from vaginal secretions or sweat. It acts as a lubricator for delicate genital skin that needs to move smoothly across close surfaces without friction.2
Smegma is thought to be produced by sebaceous glands in the vulva. However, a discussion on male smegma considered it could be produced by the mucosa of the foreskin (akin to the mucosa of the clitoral hood) and is produced as “living cells constantly grow towards the surface, undergo fatty degeneration, separate off, and form smegma”.
When smegma builds up, it gets smelly, though it doesn’t tend to lead to vaginal infections like bacterial vaginosis or aerobic vaginitis. Generally, it’s just a bit gross if it’s left there too long and builds up, and in some cases, can cause further issues.
The importance of cleaning smegma from the vulva
By its very nature, Smegma is a bit harder to wash off with water and soap than other oils, as it serves as a protective barrier for our delicate genitals.
Smegma keeps vaginal lips (vulva, labia)and the clitoris glans and clitoral hood hydrated and supple, and is found in all mammals.
However, smegma can build up and cause discomfort and odours, so frequent cleaning is important. Smegma also contains bacterial colonies, but unfortunately, we don’t know much about these colonies in vulvas.
How to find smegma
You’d think that regular washing would eliminate smegma, and usually, it does, but not always. You will soon discover where your blind spots are in cleaning your vulva by gently pulling your labia apart and drawing back your clitoral hood. Be gentle!
Even after showering, you may find a little parcel of a thick white substance tucked into the crevices. This is smegma.
Removing smegma from between the labia and around the clitoris
Usually, smegma is removed during normal bathing and towel-drying. However, it’s important to check yourself – you don’t want any nasty, smelly surprises for your lovers or to encourage bacterial overgrowth.
Experts recommend gently wiping the smegma away with a dry towel after washing the labia. You can also find your ‘trouble spots’ where smegma typically accumulates amongst your vulval folds and remove it gently with your hands in the bath or shower.
You’ll notice that this thick white stuff doesn’t budge as easily as you might want, so use a soft wet or dry washcloth (not soap) to remove it manually.
It’s important not to hurt yourself doing this, so be gentle and take good care of your delicate vulva. Rips are easy when pulling the labia apart to get into crevices, particularly the joins where the clitoral hood meets the labia.
Preventing smegma buildup
Thick white smegma is normal, so don’t concern yourself with the whys and what for – you can’t prevent smegma from developing – but remember that some elements may cause more smegma build-up than others.
For example, at My Vagina, we’ve noticed that when things aren’t going so well vaginally or on the vulva, more smegma is produced, likely as a protective process. This does not mean there’s something wrong if you are producing a lot of smegma, but we do notice it ebbs and flows in our patients with vagina issues.
Tips on prevention and cleaning of smegma on the vulva
- Wash your vulva with warm water and a small amount of very gentle soap every day
- Use a very soft washcloth
- Sit with a mirror and find the secret little hidey holes that you may miss in the shower
- Avoid tight synthetic fabric underwear
- Don’t use vaginal deodorisers or feminine hygiene products
- Do not douche needlessly
- If you are caring for a young girl, ask your paediatrician how to carefully remove smegma
Teaching young girls how to check for vulvar smegma
When teaching your girls how to care for their vulva, teaching them about smegma is useful since later they will know to check for it.
Many people have no idea what the crevices of their vulva hold, and while it typically doesn’t matter at all, we should know about smegma, and teach our girls, so they know it needs to be cleaned regularly.
Smegma in babies and young children
Smegma is a protective emollient that can occur more frequently in babies. If smegma occurs in excess in a baby, see your paediatrician for more information on causes and cleaning.
Smegma and labial and clitoral adhesions
Vulval smegma may protect from labial and clitoral adhesions by providing an oily barrier between surfaces so skin can move freely.
However, when there is a closed compartment of the clitoral structures and hood and labial tissues, smegma may build up and contribute to adhesions if smegma can’t escape3.
The smegma and cells accumulate, resulting in smegmatic pseudocysts, keratin pearls, or both. This build-up of cells can form concentrated layers and result in masses that can be several millimetres across, which create irritation, swelling and possibly infection.
The issue is very uncomfortable, with the feeling of having sand in your eye, a ‘persistent foreign body sensation’, and can result in vulval or clitoral hypersensitivity, clitorodynia sexual pain disorder4, and even persistent genital arousal disorder (PGAD).
The smegma microbiome
There are no studies on the microbial makeup of smegma in vulvas, but there is one research study in uncircumcised young boys using culture5.
Until someone does this research on the vulva, what it tells us is that smegma definitely has microbial populations, but it can also serve as a warning to always use condoms with new penises!
- 31 bacteria were isolated from the male smegma (15 gram-positive, 16 gram-negative)
- The most common bacteria isolated from the boys’ smegma were Escherichia coli (26%), Enterococcus faecalis (19%) and Enterococcus avium (13%)
- Most of the species found were multi-drug resistant (61%)
- Smegma may be a cause of urinary tract infections in young boys
To reiterate, these microbial findings were in young boys aged around 2-3 years and not in girls, adult women, or vulvas.
The smegma cancer myth
There is an old myth – perpetuated by many doctors and researchers since the 1900s – that smegma caused reproductive cancers in males and females. This has been debunked6. Pay it no heed.
References
- 1.Fahmy MAB. Smegma. Normal and Abnormal Prepuce. Published online 2020:153-161. doi:10.1007/978-3-030-37621-5_17
- 2.Streckfus CF. Exocrine Glands of the Reproductive System. Exocrinology. Published online 2022:83-99. doi:10.1007/978-3-030-97552-4_7
- 3.Aerts L, Rubin RS, Randazzo M, Goldstein SW, Goldstein I. Retrospective Study of the Prevalence and Risk Factors of Clitoral Adhesions: Women’s Health Providers Should Routinely Examine the Glans Clitoris. Sexual Medicine. Published online March 17, 2018:115-122. doi:10.1016/j.esxm.2018.01.003
- 4.Parada M, D’Amours T, Amsel R, Pink L, Gordon A, Binik YM. Clitorodynia: A Descriptive Study of Clitoral Pain. The Journal of Sexual Medicine. Published online August 1, 2015:1772-1780. doi:10.1111/jsm.12934
- 5.Chung JM, Park CS, Lee SD. Microbiology of smegma: Prospective comparative control study. Investig Clin Urol. Published online 2019:127. doi:10.4111/icu.2019.60.2.127
- 6.Van Howe R, Hodges F. The carcinogenicity of smegma: debunking a myth. Acad Dermatol Venereol. Published online August 22, 2006:1046-1054. doi:10.1111/j.1468-3083.2006.01653.x
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