There are few things more unnerving than finding a sore or any kind of rash or growth down there. While your brain may immediately think that a sore on the vulva = an STI or something worse—like cancer—know that there are several far more common (and far less scary) potential causes of vulvar sores.
Sit back and get comfortable. We’re gonna take you through the various causes, how the sores may look and feel with each cause, and how they’re treated.
First, a little vulva 101
If you already know the difference between the vulva and vagina, bear with us. The terms are often used interchangeably despite being different parts of the genitalia.
The vulva is the outside portion, while the vagina is the inside portion. The vulva consists of a few components, including the mons pubis (a.k.a. the pubic mound), the labia majora and minora, which are your outer and inner lips, your clitoris, and your vaginal opening and urethral opening. You can find out a lot more about these body parts here: Innies & Outies: The Vagina, Clitoris, Uterus and More.
Now, onto the causes of vulva sores…
Injuries
An unfortunate pube-shaving mishap, some over-enthusiastic dry humping or other sex act, or just accidentally scratching yourself while rushing to get your underpants on are just some of the ways you can injure your vulva skin and cause irritation that looks like a weird sore.
A scratch, cut or other skin abrasion may seem like no biggie, but any break in the skin raises the risk of infection. A skin infection can cause the area to become swollen and red, and even develop painful bumps or sores.
If you have a sore on your vulva and recall feeling a recent ouch in the region, think about whether you may have injured yourself. Here are some examples that may help jog your memory:
- An accidental scratch or purposeful scratching of an annoying itch
- A razor cut or razor burn
- Friction from tight undies or other clothing
- Sex, either with your hand, a sex toy, or a partner
What it looks and feels like
It depends on the type and severity of the injury, but if you have what looks like a sore, you may notice signs of infection, like skin that’s red, swollen, and warm to the touch. There may also be yellow, green, or white fluid or pus coming from the opening. If you notice red streaks on the skin spreading out from the cut, that’s a sign that the infection is spreading and a sign that you need to see a doctor immediately for treatment.
How it’s treated
Treatment also depends on the injury and severity. Keeping the skin clean and avoiding further irritation may be all you need to do. For infections, antibiotic cream or medication may be needed.
Skin conditions
Skin conditions and rashes don’t discriminate and can develop anywhere on the body, including the vulva.
Contact dermatitis
Contact dermatitis is a very common skin reaction to irritants and allergens that cause skin irritation and itching, and the delicate skin of the vulva is especially susceptible to damageexternal link, opens in a new tab.
Poison oak and poison ivy are common causes of contact dermatitis, but below the belt the most likely culprits are things like soaps, detergents, and skin products, toilet paper, and menstrual products like pads, pantyliners, and tampons. Spermicides can cause it, too.
What it looks and feels like
Vulva dermatitis can cause patches of skin that feel thicker than the rest of your skin, which can be red or darker than the surrounding skin. These patches can feel raw, and cause burning or stinging, and weep fluid.
How it’s treated
If it’s contact dermatitis, avoiding the irritant is usually enough to get rid of it and prevent it from happening again. Sticking to cotton underwear, keeping the area clean with gentle washing, and not rubbing or scratching will help, too.
You can also ask a doctor or pharmacist for an over-the-counter cream to help with the itching if needed.
Lichen sclerosus
Lichen sclerosus is a rareexternal link, opens in a new tab chronic skin condition that causes itchy and painful sores and blisters, mainly on the skin of your genitals. Experts don’t exactly know what causes it, but some believe it may be linked to autoimmune disease or caused by genetics or sex hormones. In some people, it’s triggered by trauma, like sexual abuse or injury, and it’s also more common in people who have experienced menopause, including those who came to menopause earlier in life by way of medications or medical treatments.
It’s not contagious and it’s not sexually transmitted.
What it looks and feels like
At first, lichen sclerosus looks like small, raised white, shiny patches. Eventually, more patches may develop and join together, forming a large white patch that almost looks like wrinkled wax paper. You may have sores or ulcers that hurt, itch or burn and may crack. The condition can also affect your urethra and cause pain or burning when you pee, or trouble peeing.
How it’s treated
There’s no cure for it yet, but there are treatments that can help manage symptoms and reduce the risk of complications, like corticosteroid creams, light therapy, and immunotherapy drugs.
The key to managing it is getting it diagnosed as soon as possible, so see a doctor right away if you develop white, shiny sores on your vulva.
Hidradenitis suppurativa
Hidradenitis suppurativa (HS) is also called acne inversa, but unlike acne on the face, this chronic skin condition causes bumps or tunnels to form under the skin in areas where skin rubs together, like the crease where your vulva and thigh meet. The lumps or tunnels can become inflamed and break open, causing painful abscesses that drain.
What it looks and feels like
HS causes bumps or tunnels under the skin that eventually rupture. You might notice tiny blackheads embedded in the skin, or have painful red lumps that grow, break open, and drain fluid or stinky pus. The symptoms can range from mild and just a few sites to severe with many HS sites over a large area that can make even basic daily activities painful.
How it’s treated
Ain’t gonna lie—HS can be hard to manage and lead to depression and anxiety because of this. There’s no cure, so treatment usually involves medications and lifestyle changes to manage symptoms. This can include antibiotics, steroids, pain relievers and autoinflammatory drugs, losing weight, avoiding heat and humidity, and taking care not to chafe or injure the area.
Behçet’s disease
Behçet’s diseaseexternal link, opens in a new tab is another uncommon condition, but worth talking about as a potential cause of vulvar sores. The condition causes blood vessels throughout the body to swell. Along with sores on the vulva, it can cause sores on penises, mouth sores, and sores on other parts of the body, as well as eye irritation and swelling.
What it looks and feels like
Mouth sores that look like round canker sores are the most common sign. When it affects the vulva, it causes open sores that hurt and leave scars. The sores usually last from 1 to 3 weeks but often come back.
How it’s treated
There’s no cure for it yet, but flares can be managed with corticosteroid creams and ointments that you apply to the sores. If the condition affects other parts of the body, treatment depends on the parts affected, like eye drops if it’s in your eyes, mouthwashes for mouth sores, or medications you take by mouth.
Skin growths
Skin growths on the vulva are a thing, but they’re not always a bad or scary thing.
Ingrown hair
If you grow hair on your vulva, as most people do once puberty hits, then you can get an ingrown hair on your vulva. Just like it sounds, an ingrown hair is a hair that grows inward instead of outward. When this happens, it can form a bump, and you may or may not be able to see the hair inside. They’re the result of shaving, waxing, or any other hair removal method, and you’re more likely to get them if your razor is dull, you shave against the grain, or your clothes often cause friction over your vulva.
What it looks and feels like
An ingrown hair looks kinda like a pimple and is usually darker than the surrounding skin, or red or purplish. You may be able to see the hair just under the surface, or not. The bump might be sore or itchy, and you might feel some discomfort when your clothes rub against it.
How it’s treated
You can usually get rid of ingrown hair at home.
If you can see the hair under the skin, use clean tweezers to gently pull it out. If you can’t see it, apply a warm damp cloth over it for 10-15 minutes at a time, 3 or 4 times per day, or gently scrub the area with a clean, damp cloth to help coax it out.
Folliculitis
Think you have what looks like a sudden acne breakout on your vulva? It may be folliculitisexternal link, opens in a new tab. Sounds intense, but it’s actually a very common skin infection that can develop in the hair follicles when they’re damaged and let bacteria inside. This can happen from shaving and other hair removal methods, scratching, or from friction to the area caused by rubbing, tight clothing, or skin rubbing on skin. Spending time in a hot tub or whirlpool can also cause it.
What it looks and feels like
Folliculitis really does look a lot like an acne breakout with small pimple-like bumps that may be pink or look like a typical white-headed pimple with a ring of redness around it. The area can also sometimes be a bit painful or itchy.
How it’s treated
Keeping the area clean and dry and avoiding friction can help, and so can refraining from shaving or hair removal for a month if that’s what caused it. If that doesn’t help, a dermatologist can prescribe topical or oral antibiotics to clear the infection.
Boils
Boilsexternal link, opens in a new tab, furuncle, or skin abscess—whatever you call ‘em, they’re painful, ugly, and can develop anywhere on the body, including the vulva, when staph bacteria get into your hair follicles through broken skin. The infection has the potential to spread to other parts of your body and can also spread to other people through skin-to-skin contact with the boil.
What it looks and feels like
Boils can range in size from small like a pimple to as big as a golf ball. It may be red, sore, and feel warm when you touch it. It can also fill up with white or yellow pus, which could ooze out and form a crusty layer on top. You could develop other signs of infection, like swollen lymph nodes or even a fever.
How it’s treated
Good news—boils can usually be treated at home with some TLC and clean hands. Applying a warm, damp washcloth over the boil 3 or 4 times a day can help draw the pus up to the surface to help the boil drain. Be sure to use a clean washcloth each time.
Please oh please never pick at or try to pop the boil and for the love of [INSERT DEITY OF YOUR CHOOSING HERE] wash your hands before and after touching the boil.
If it doesn’t get better, or you notice signs of it getting worse, high-tail it to a healthcare provider for treatment, which may involve lancing the boil to drain it and antibiotics.
Bartholin gland cyst
Your Bartholin glands are located on both sides of your labia minora (inner lips), and their job is to produce fluid to keep your vagina lubricated. Sometimes, the opening to one of these glands becomes blocked and the fluid builds up, creating a cyst.
Bartholin cysts are very common, especially between the ages of 20 and 40, and 2 percentexternal link, opens in a new tab of people born with a vagina will develop them at some point.
What it looks and feels like
A Bartholin cyst looks like a round, solid bump on your inner lip that can be pea-sized or as big as a golf ball. If you have one, that side of your inner lip may look swollen, or well, a bit deformed. They don’t usually hurt unless they get infected.
How it’s treated
A small Bartholin cyst that doesn’t bother you doesn’t need treatment. Leaving it alone is a good idea to keep it from becoming a problem. In other words: don’t pick, poke or pop it. If it’s uncomfortable, sitting in a shallow bath of warm water (also called a sitz bath) might help.
Cancer
I hate that we need to go there, but cancer is a potential cause of vulva sores, albeit an uncommonexternal link, opens in a new tab one. It’s actually the least common gynecological cancer and it typically affects older people.
There are a few different types of cancer that can develop on the vulva. Depending on the type, it may cause changes to the skin’s color or texture, or open sores or lesions.
What it looks and feels like
How vulvar cancer looks and feels really depends on the type and stage of cancer and where it starts. You may have a sore that doesn’t heal, a lump or growth, or a patch of skin that looks and feels different than the skin around it. You may also have other symptoms, like pain, unusual discharge, or vaginal bleeding outside of your usual period.
Though the chance of the sore on your vulva being cancer is low, it does underscore the importance of getting any new sores or symptoms checked out.
How it’s treated
In many cases, the earlier cancer is caught, the better the chance of catching it while it’s still treatable.
How it’s treated depends on lots of factors, like the type of cancer and whether it has spread. One or a combination of treatments may be used, including surgery, chemotherapy, radiation, and medications.
STIs
Take a deep calming breath. Exhale. It’s time to talk about the STIs that can cause sores on the vulva. Remember that they’re treatable, so even if your sore turns out to be caused by one, it’s going to be alright.
Genital warts (HPV warts)
Genital warts are caused by certain types of the human papillomavirus (HPV) and are very common, with 360,000external link, opens in a new tab people getting them every year. The wartsexternal link, opens in a new tab can be flat or raised, skin-colored or whitish, and can kinda look like little fleshy cauliflowers on or around the vulva, vagina, cervix, anus, penis, or scrotum. You can get them from skin-to-skin contact with someone who’s infected, but genital warts can be sneaky and may grow inside the vagina or anus, so they’re not visible, and HPV can still spread even if there are no obvious symptoms. You don’t need to treat them if you don’t want to or unless they’re causing pain or discomfort, but getting rid of the warts does lower the chance of passing the infection to someone else. A prescription cream or having them removed in the doctor’s office (after numbing, of course) are other options.
Genital herpes
Genital herpes is a very common STI, especially in people with vulvas. Roughly between 40 million and 50 millionexternal link, opens in a new tab in the U.S. have it. It’s caused by the HSV II strain of the herpes simplex virus, though HSV I that causes oral herpes, a.k.a. cold soresexternal link, opens in a new tab, can sometimes cause genital herpes, too (and vice versa). The infection can cause blisters or open sores on the vulva or other parts of the genital area, as well as the thighs, butt cheeks, or anus. Some people feel tingling, burning, or itching before an outbreak. Prescription anti-herpes meds can help make outbreaks shorter and less severe when taken as soon as you feel an outbreak start.
Molluscum contagiosum
Molluscum contagiosum is a common, contagious viral skin infection that mostly affects kids 10 and underexternal link, opens in a new tab, but adults can get it, too, usually through sexual contact. It causes firm, painless white, pink, or skin-colored bumpsexternal link, opens in a new tab with a tiny dent in the center. They can show up anywhere, but when sexually transmitted, they appear on the genitals, lower belly, or inner thighs. The infection usually clears on its own within 6 months to 2 years, but it’s contagious as long as you have the bumps. If they’re on the genitals, doctors might suggest treating them instead of waiting it out. This can be done with cream, or by scraping, freezing, or using a laser to remove them (yes, after numbing).
Syphilis
Syphilis is a curable STI that can cause sores called chancroidsexternal link, opens in a new tab on the vulva, genitals, penis, scrotum, and anus. It usually shows up as a small sore about 12 weeks after exposure to the bacteria. Where the sore appears depends on the type of sex you had, which could be on the vulva, or in and around your vagina, mouth, or anus. They can develop on the penis and scrotum, too. Early diagnosis and treatment with antibiotics can cure syphilis before potentially serious complications occur. If you don’t treat it, syphilis progresses and causes a body-wide rash, fever, fatigue, and muscle aches, and eventually leads to nerve, heart, or brain damage that can be irreversible. In other words, syphilis is no joke and needs to be diagnosedexternal link, opens in a new tab and treated ASAP, even if you start to feel better on your own.
Granuloma inguinale (donovanosis)
Granuloma inguinale (donovanosis)external link, opens in a new tab is a rare genital STI in the U.S. and Canada, but more common in tropical areas like the Caribbean, Brazil, and South Africa that can also spread through nonsexual skin-to-skin contact. It starts as a painless red bump or sore on or around your genitals, usually within 3 months of exposure (but sometimes up to a year), which grows into a round lump with irregular edges and turns into a smelly, painful open sore. If left untreated, it can lead to some gnarly complications like genital inflammation and scarring, or even cancer. The infection is treated with a long course of antibiotics, but you may need surgery if it spreads and damages other tissues, so quick diagnosis and treatment is important.
Seeing a healthcare provider about a sore on the vulva: What to expect
I get that talking to someone about a sore on your vulva might be the last thing you want to do. I really do. But unless you’re positive it was caused by a minor injury or a reaction to a new product; any sore on the vulva warrants a trip to your doctor or a clinic whether you’ve been or are sexually active or not.
When you see a doctor about a vulva sore, the doctor will:
- Examine the sore and the area around it, including feeling the lymph nodes in your groin to check for swelling
- Use a cotton swab to check for STIs
- Order blood tests to look for signs of infection and other illnesses
- Perform a biopsy by scraping or cutting a sample of the sore or growth, if needed
Think it’s an STI and don’t want to see your family doctor? Here’s what to do:
If there’s a chance you could have an STI but aren’t comfortable seeing your family doctor about it for whatever reason, here are some good-to-knows about testing:
- You don’t need parental permission to get tested and treated for STIs in most states if you’re 13 or older.
- STI test results are confidential.
- You can get tested at public health, private or independent clinics, including places like Planned Parenthood, Brook, Marie Stopes, Better2Know or other clinics that are nationwide in some countries.
A lot of times, vulvar sores are caused by something as simple as chafing or changing your soap, but unless you’re sure that’s it, you really should get checked out. Don’t let shyness or a bit of an ick factor keep you from getting it taken care of sooner rather than later. You’ll be glad you did. Promise.
