Introduction

Smegma is a combination of shedded skin cells and oils that can build up around the genital area of both, people assigned male at birth and people assigned female at birth. Although stigma surrounds the topic of smegma, smegma is a natural substance produced by the body, which helps to protect and lubricate the genitals. However, overtime due to personal hygiene implications, it can be found to give an unpleasant odour, and even result in irritation, inflammation or infection.¹ 

This article will cover the importance of understanding smegma, including myths and misconceptions. It will also cover, how smegma differs between people assigned male at birth and people assigned female at birth genitalia, as well as social and cultural influences on our view of smegma.

Overview

Smegma is a naturally occurring substance that collects around the genital region. It is composed of dead skin cells, oils and other secretions.² Smegma has beneficial natural oils that maintain the good bacteria in the genital region. When this is stripped away by excessive washing, or built up too much due to insufficient washing, then problems can occur. This can be identified by foul smells, irritation, inflammation and infection within the genital region and applies to both, people assigned male at birth,  and people assigned female at birth genitalia. 

In people assigned female at birth, smegma builds up around the clitoris hood, and in the folds of the labia and vulva. When an excessive amount of smegma is produced overtime, this can lead to painful clitoral stimulation during sex, general discomfort in the vaginal region, and risk of infection due to irritation. In people assigned male at birth, smegma builds up and collects underneath the foreskin. Lack of personal hygiene can lead to discomfort and rubbing under the foreskin, which can result in infection.³ 

The role of smegma in the body

Smegma has two important roles in the body. The first is natural lubrication, the natural oils help to keep the genital area moisturised, and prevent dryness, which can be uncomfortable and irritating. This is particularly important when it comes to activities, such as sex or exercise to help prevent friction. The second is protection to help form a thin protective barrier, so that, sensitive skin of the genital region is not damaged by irritants. This protective barrier, also serves as protection against overgrowth of bacteria, and fungi that exist in our body’s microbiome.⁴ Our microbiome refers to the microorganisms that are present on and in our bodies, they are natural and harmless unless an imbalance occurs. 

Over-washing can strip away these oils, which can lead to dryness in the genital region. Under-washing can lead to excess build up of oils, which can solidify, and cause discomfort. This build up from a lack of personal hygiene, creates a warm and moist environment, which can act as a breeding ground for bacteria and fungi. This is how overgrowth can occur, thus, increasing risk of irritation and infection.^4,5 

Myths and misconceptions about smegma

Smegma is often associated with negative connotations, such as ‘cheesy’, ‘crusty’, and ‘foul’. That's why it is important to debunk myths and misconceptions, and really understand what smegma is.¹ 

The most common myth is that smegma is a sign of poor hygiene. As mentioned previously, smegma is a natural substance that occurs in the body, most people produce smegma, and if following basic hygiene protocols, such as a warm wash, or shower smegma, is a harmless substance. It is only when overwashing or underwashing that smegma is able to grow in excess, and can result in health problems, such as unfamiliar smells and infections.¹

Another myth is that only uncircumcised people assigned male at birth produce smegma. Although there is a higher likelihood that people assigned male at birth, who still have their foreskin, can collect smegma, people assigned female at birth also collect smegma.¹ 

Thirdly, one myth that can be heard is that smegma can lead to cancer. Although it has been proven, that, when personal hygiene is not taken care of, this can result in smegma build up, that leads to infection overtime, there is no evidence to suggest that smegma causes genital cancers.⁶ 

Smegma and personal hygiene

Personal hygiene is crucial for maintaining optimal health. These are simple tasks we can incorporate into our daily routines, including appropriate washing, and following basic sanitation practices. Specifically, genital hygiene is important for both, people assigned male at birth, and people assigned as female at birth. to prevent irritation and infections.^7,8,9 

This involves washing the genital area, avoiding harsh products that could remove beneficial bacteria or natural oils, and thoroughly drying the genital area to prevent a moist, warm environment conducive to bacterial growth. To properly clean smegma, all you need is mild soap, clean hands, and warm water. Ensure the area is patted dry afterward. Gentle cleansing and drying, can prevent bacterial imbalances, and reduce the risk of infection. For people assigned male at birth, it's important to clean under the foreskin, and for people assigned female at birth, to gently clean between the folds and hood of the vagina.^7,8,9 

Smegma and health concerns

The accumulation of smegma over time, due to inadequate personal hygiene practices, can eventually result in negative health consequences. These may include unpleasant odours, dryness-related irritation, and inflammation caused by friction. Additionally, there is a risk of bacterial infections, which display symptoms such as itchiness, irritation, and swelling. These infections, such as balanitis in people assigned men at birth, and vulvovaginitis in people assigned women at birth, occur due to poor personal hygiene.^10,11 

Furthermore, there is a risk of fungal infections, commonly known as yeast infections, caused by the fungus Candida, which naturally resides in our body's microbiome. Candida thrives in warm, moist environments, so improper cleaning of the genital area can lead to its overgrowth, resulting in irritation and infection. If concerned about bacterial or fungal infection, it's crucial to seek medical advice, as these conditions require antibiotic and antifungal treatment, to restore the balance of bacteria and fungi in the genital area.¹² 

It's important to note that, while smegma itself is not a sexually transmitted infection, excessive buildup can increase the risk of contracting one Therefore, any changes in genital health, such as unusual odours, swelling, spots, or abnormal secretions, should be promptly checked, and medical advice should be sought, to ensure the best possible health outcomes.¹³

Cultural and social perspectives on smegma

Smegma isn't a common topic in today's discussions. It's often misunderstood as a sign of poor hygiene, shaping how society views it. Descriptions such as “cheese” do not make it sound pleasant. But in reality, it's a natural and harmless substance everyone's body produces. The name actually comes from a Greek word that means soap. Thus, educating people about it, could help them understand, and manage, any excess build up before it becomes a problem. While some cultures and religions may see smegma as impure, it's important to accept our bodies and their functions.¹

Summary

In summary, smegma is a natural substance commonly found in the genital area. While practising good personal hygiene is vital for preventing genital infections, it's also important to pay attention to any changes in this area, and seek medical advice if something seems unusual. Smegma occurs in both, people assigned male at birth and people assigned female at birth, and shouldn't be considered dirty or unclean. By following simple hygiene practices, we can maintain overall genital health. Additionally, it is important to distinguish facts from misconceptions about smegma, as believing myths can lead to unnecessary concerns.