Are there differences in the vulva according to ethnicity? Reasonable evidence suggests that there are some differences in vulvar skin properties and function between ethnic (racial) groups. Previous studies have demonstrated equally thick stratum corneum in black and white skin, although black skin contains more cell layers (1). Black skin has a higher transepidermal water loss (TEWL), variable blood vessel reactivity, decreased skin surface pH, and larger mast cell granules than white skin (2). Such differences in skin properties could account for racial disparities with regard to diagnosis of vulvar dermato-logic conditions.

We searched MD Consult; Science Citations Index; PubMed; Cochrane Database; the Melvyl Catalogue in the CDL-Hosted Database of University of California, San Francisco; Google; Yahoo; dermatology textbooks; as well as the University of California, San Francisco, Surge Building library files for relevant literature published between 1967 and December 2004. The following key words were searched: race, ethnicity, black, African, white, Caucasian, Hispanic, Asian, vulva, skin of vulva, and skin physiology.

We found that there were few studies of vulvar ethic differences and that the few existing studies often had inconclusive results and findings that conflicted with other studies. This chapter presents a compilation of results of the studies of the vulvar ethnic differences with regard to TEWL, water content, corneocyte variability, blood vessel reactivity, skin elastic recovery, skin extensibility, pH gradient, lipid content, and skin surface microflora.

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