Aunt Vadge: white stuff and tears on my clitoral hood

A super cute bacteria sits on a hand holding a pile of cottage cheese, and they're in the bathroom for no particular reason. It was that or toast.

Dear Aunt Vadge,
I have this white, cottage cheese-looking substance coming out/inside of my clitoris. There was also a bit of the same stuff at the connection point of the clitoris.

At first, I thought it was normal and just smegma, as I don’t have serious itching or abnormal discharge. My discharge is a transparent white when it’s fresh and then gets yellowed as it dries, so I think it’s normal.

Nothing hurt or burnt when I pee. I’m not sexually active, FYI.

Anyway, my main concern is this very small tear at the connection point of my clitoris. It hurts to touch and bleeds a little if I poke at it. I’ve had this same tear maybe 2 weeks ago, but it was on both sides of the connection point instead of one.

I think I got it because I had washed myself after eating jalapeno, and it maybe did something to my vagina. It quickly healed within 3-4 days.

This recent one appeared when I was washing myself with unscented Dove soap, a small, wet towel, and hot water. I usually don’t use soap when I clean, but I was trying to get rid of the supposed smegma.

I did some searching around online and I have found people with the exact same symptoms, but the problem still had no name.

I don’t think it’s a yeast infection, personally, but I could be wrong.

What is this? How can I treat it? When will the small tear go away? Is this healthy, or normal?

Sincerely,
Cheesy
Age 14, USA

________

Dear Cheesy,

The small joins of the clitoral hood to the labia are very delicate and can tear easily, especially when you’re still growing and learning about your vulva.

If those corners of your clitoral hood are splitting over and over again and bleeding, it’s possible they will simply heal in a new way that won’t tear, and that’s your vulva going forward.

You may be in a period of your body changing, with expanding hips, which causes what used to be your slimline child’s body to start to stretch your skin outwards. Don’t ignore this, however, as your body could be trying to tell you something.

Sorry to bring penises into this, but…

Did you know that uncircumcised boys have a foreskin that completely covers the end of their penis, and to help them keep the underneath area clean from smegma, they need to learn to pull their foreskin down over their penis regularly?

This stretches the skin out and can also be quite painful until this new ‘way’ is established. Something similar could be happening to your vulva, as your body is growing and your vulva with it.

… and back to your vulva!

In this sense, it sounds like you have splits or cuts in your clitorial/labial junction, and the area is producing extra protective substances. Yes, it is probably protective smegma, an oily, thick, white substance that protects your skin.

Sometimes, smegma is produced in greater quantities, especially, in my experience, when there is something going on in the area that requires it, like some sort of damage.

Is it smegma?

Unfortunately, smegma can be quite hard to dislodge and doesn’t always get washed off that easily with soap and water. If you were struggling to wash the white stuff off, then it could have been smegma—it’s notoriously sticky!

It sounds like smegma or yeast to me, but if it’s neither of those things, it needs to be looked at by a real person, a doctor or nurse.

Because you had the same issue two weeks ago, it sounds like you have something (minor) going on, and while you seem pretty certain it’s not yeast, yeast on the vulva looks different to yeast inside the vagina. Also, yeast can cause your vulvar tissue to crack or split more easily.

If you live in a city or town that has free sexual health services, you can pop in and ask questions about your situation, and they’ll be able to help you. Working out without seeing what you’re talking about is a little tricky.

Is it yeast?

Yeast will grow anywhere moist and dark, and up inside the clitoral hood is a delightful little spot to hide out.

You can have a yeasty vulva (outer genitalia, including clitoral hood) without symptoms of a vaginal yeast infection, the same as you can get a yeast infection in your mouth or on your skin. The cottage cheese substance you describe could be caused by yeast, so don’t discount it unless you’ve had a test.

What’s the itching?

You say you don’t have serious itching, but that indicates that you may have some itching. It’s normal for healing skin to itch a little as it gets better, but it’s also a sign of an overgrowth of a microbe, perhaps yeast —I know, I’m sorry!

You also don’t mention any bad smells, so let’s assume it all smells normal. That’s great. If it does have an odour, that could provide extra clues.

How to help your vulva heal from the small tears

Keep the area clean, and use a little healing, soothing vulva cuts balm, pawpaw ointment, or, at a pinch, some olive oil to keep the clitoral hood joins moving freely. This ensures your skin won’t pinch or get stuck as it heals.

If you have some tea tree oil at home, you could consider mixing two drops of tea tree oil with a teaspoon of coconut oil or other vegetable oil. Rub the oil very gently up into your clitoral hood. Never use tea tree oil without diluting it, as it will burn.

If the area does have a minor overgrowth of some sort of microbe, such as yeast, the tea tree will deter it.

Cleaning the white stuff from your clitoral hood and clitoris

Keeping the white cottage-cheesy substance from under your clitoral hood and clitoris will help with other symptoms, so keep it clean without overcleaning.

You may like to use a cotton tip dipped in warm water with the cuts balm or oil. Remember to be really gentle to avoid further tears.

If you’re touching yourself, use coconut oil or another gentle lubricant to avoid further tears. Be sure to leave it alone for a few days so it can heal.

Taking care of your vulva going forward

It’s important to understand where this cut comes from since twice in two weeks is becoming a pattern!

If the cuts are happening without much provocation, you may have something happening like clitoral adhesions, a skin condition, or be doing something to hurt yourself without realising it.

As your vulva develops into a whole new creature during puberty, it can take a while to get to know its quirks, which you can guarantee yours has (like all of ours!). Your body – and vulva – is still growing, so be gentle, seek advice (like you’re doing here, and with your doctor) when things don’t seem quite right, and keep poking around.

Check in with a healthcare professional if it doesn’t go away soon to avoid further damage and potentially infection. You’re doing a great job caring for your vulva and vagina, so keep up the good work!

Best,
Aunt Vadge

References​1​

  1. 1.
    Davis VJ. What the paediatrician should know about paediatric and adolescent gynecology: The perspective of a gynecologist. Paediatrics & Child Health. Published online October 2003:491-495. doi:10.1093/pch/8.8.491


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