Dark patches on the outer vaginal area are often caused by aging, pregnancy, or other hormonal changes. But they can sometimes occur with health conditions that require medical attention.

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Photography by Megan Madden; Prop Styling by Sara Schipani

In most cases, it’s natural (and normal) for the vagina and vulva to change in shape, texture, or even color over time.

In terms of color, it’s worth noting that the labia or vulva tissue doesn’t always correspond to the color of your skin. A dark-skinned woman may have a lighter-colored vulva, while a light-skinned woman may have a dark brown labia.

Age-related changes to your vagina may cause areas of discoloration on the vulva that sometimes appear as darker spots or patches of skin. This is not typically a cause for concern unless you’re experiencing other symptoms such as menstrual irregularities or pain during sex.

In this article, we explore the possible causes of dark spots on the vagina, including when to see a doctor for them.

Older age is one of the most common causes of changes to the vagina. Potential changes may include differences in the shape, texture, and overall appearance of the vagina, including a darkening of the vulva.

When the vulva darkens with age, it can cause the skin to become darker in certain spots or patches around the vagina. Generally, these patches can appear even darker if there are more folds or creases in the area.

Other changes that can happen to the vagina and vulva as we age include a decrease in the amount of pubic hair, an increase in vaginal or vulvar dryness, and less elasticity within the skin of the vagina or vulva.

Treatment is not always necessary for the physical changes that accompany aging. However, you should visit your doctor if you’re having other concerns that accompany these changes, such as:

  • menstrual irregularities
  • pain during sex
  • other concerning symptoms

Female sex hormones, which include estrogen and progesterone, play a crucial role in puberty, menstruation, and more. Changes in estrogen levels can impact the production of melanin, which can cause sensitive areas, such as the labia or nipples, to darken.

In conditions that cause hormonal changes, such as pregnancy, increased estrogen can cause the vulva to appear as if it has dark spots or patches. However, this discoloration is only temporary in nature and is caused by normal hormonal changes.

Symptoms of pregnancy or other conditions that cause hormonal changes can vary, depending on the underlying cause. Outside of pregnancy, these types of conditions can cause changes in menstruation, mood, and more.

Treatment for potential hormonal changes begins with an official diagnosis from your doctor or gynecologist. With the proper testing, you can determine the underlying cause and discuss the best treatment options for your condition.

Polycystic ovary syndrome (PCOS) is a condition that’s characterized by menstrual irregularities and increased ovarian cysts. High levels of male hormones called androgens often cause changes in insulin levels, which can influence skin pigmentation.

Skin pigmentation changes that occur with PCOS is quite different than changes that happen due to aging or pregnancy. For example, acanthosis nigricans, which is caused by PCOS, can cause defined dark spots on the vulva that are different in color, texture, and even smell.

PCOS symptomsOvarian cysts due to PCOS symptoms
irregular periodsabdominal pain
increased bleedingbloating
excess body hairpelvic or thigh pain
acnebreast discomfort
weight gainnausea
hair lossvomiting

Treatment for PCOS generally begins with making dietary and lifestyle changes to help regulate insulin levels.

Birth control, fertility drugs, and even surgery are alternative treatment options that can help reduce symptoms of PCOS when lifestyle changes are not enough.

Acanthosis nigricans is a common skin pigmentation disorder that is characterized by dark, thick patches of skin. Most often, these dark patches of skin appear within the folds and creases of the body, such as the armpits or groin.

Acanthosis nigricans that affects the groin area may also cause dark spots to appear on the vulva. These patches of skin appear as thick, velvety skin, and may be spread across the entire groin area or confined to just the vulva.

Potential causes of acanthosis nigricans include PCOS, certain hormonal medications, and other factors that influence the production of insulin. When another underlying condition is the cause of acanthosis nigricans, there will be additional symptoms of that condition, as well.

People who are of Native American, African, Caribbean, or Hispanic descent, have a family history of acanthosis nigricans, or who are overweight, have diabetes, or prediabetes are more likely to develop this condition.

Treatment for acanthosis nigricans generally involves treating the underlying condition and bringing insulin levels back to normal. In some cases, this may involve taking medications that can help keep blood sugar levels under control.

Vulvar cancer is a type of cancer that affects the vulva, which is the external area of the female genitals. Vulvar cancer can cause a variety of symptoms, including lumps, bumps, moles, or patches on the vulva.

Vulvar cancer can sometimes look like a red, white, or even dark brown spot or patch on the skin of the vulva. This spot or patch can appear as flat or raised and is often distinctly different from the rest of the skin around it.

Other symptoms of vulvar cancer may include bleeding, pus, or other fluids leaking from the vulva, as well as itching, burning, or pain. However, some of these symptoms can also appear with other conditions, such as thrush, so they’re not exclusive to cancer.

Treatment for vulvar cancer may involve non-invasive laser therapy or even surgery, depending on how far the cancer has spread. Chemotherapy and radiation may also be necessary to help stop the spread of the cancer to other areas of the body.

Dark spots or patches on the outside of the vagina are not always a cause for concern and are oftentimes just normal symptoms of aging, pregnancy, or other hormonal changes.

However, unexplained dark spots on the vulva that are accompanied by other symptoms may indicate an underlying condition, such as acanthosis nigricans or even vulvar cancer.

If you’ve noticed a new, unexplained dark spot on your vagina, schedule a visit with a doctor or gynecologist as soon as possible to determine the underlying cause.