This article is aimed at providing information on variations in the clinical appearance of the vulva. The appearance of the vulva can be altered by reversible or permanent conditions both of which may result in minor or major changes. Reversible conditions include those associated with infections or acute trauma which results in distortion of the vulva. Some permanent changes are caused by life threatening conditions which are present at birth whereas others develop more slowly or as the result of a deliberate act either traditional female surgery or surgery performed by a registered medical practitioner. To the inexperienced practitioner changes from the normal vulvar appearance can be confusing. The aim of this article is to highlight and categorise changes that can affect the appearance of the vulva. Whatever the presentation the importance of obtaining a detailed history and performing an appropriate, sensitive and thorough examination can not be over emphasised.
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