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Vulvar bump

SYMPTOMS

What are vulvar bumps?

Vulvar bumps are a general term used by patients to describe rashes in the vulvar area, as they lack professional knowledge about various types of rashes.

These bumps may manifest as macules, papules, herpes, nodules, cysts, tumors, growths (polyps), or symptoms like wheals, edema, maculopapular rashes, vesicles, bullae, or ulcers [1].

Common conditions causing vulvar bumps include: folliculitis, boils and carbuncles, allergies, genital herpes, condyloma acuminatum, eczema, tinea cruris, pseudocondyloma, Bartholin's cyst, chancroid, and more [1,2].

What area does the vulva refer to?

The vulva, also known as the female external genitalia, refers to the exposed part of the female reproductive organs. It is located between the upper thighs, bounded anteriorly by the pubic symphysis and posteriorly by the perineum.

The vulva includes the mons pubis, labia majora, labia minora, clitoris, and vaginal vestibule [1].

TREATMENT

How to Alleviate and Reduce Vulvar Bumps After They Appear?

The causes of vulvar bumps are diverse, and precautions vary depending on the condition. Here, we can only provide general advice.

  1. Get adequate rest, avoid fatigue and excessive stress, and prevent mental overstimulation (for patients with folliculitis or herpes).

  2. Strengthen physical fitness, exercise regularly, and boost immunity (for patients with genital herpes, condyloma acuminatum, or vulvar boils)[3].

  3. Avoid scratching or squeezing the affected area (for all types of rashes).

  4. Clean daily with warm water, avoid excessive cleansing, and maintain skin hydration (for patients with eczema or dermatitis)[3].

  5. Wear cotton underwear and loose-fitting pants to minimize friction (for all types of rashes)[3].

  6. Reduce intake of greasy, spicy, and sugary foods. It is recommended that adults consume 300–500 g of fresh vegetables daily, preferably dark-colored varieties like eggplant and purple cabbage, and 200–400 g of fresh fruits rich in vitamins, such as oranges and kiwis (for patients with folliculitis, etc.)[4].

It is important to note that vulvar bumps may stem from various causes, each requiring different treatments. Therefore, it is advisable to seek medical attention promptly for an accurate diagnosis and appropriate treatment plan to avoid worsening the condition.

DIAGNOSIS

Which department should I see for vulvar bumps?

You should visit dermatology, gynecology, or obstetrics and gynecology.

Under what circumstances should I seek medical attention for vulvar bumps?

Vulvar conditions are difficult to observe closely on your own, and non-medical professionals often cannot accurately diagnose the issue. Therefore, if you notice vulvar bumps, it is best to consult a dermatologist or gynecologist for an in-person diagnosis and treatment.
Especially in the following situations, you should seek medical attention as soon as possible:

  1. Obvious symptoms such as redness, swelling, skin warmth, or pain;
  2. Multiple or increasing skin lesions;
  3. Persistent lesions or no improvement after self-medication;
  4. High-risk sexual behavior (unprotected sex, multiple partners, etc.) before the lesions appeared;
  5. Recurrent bleeding from the lesions;
  6. Older age (higher risk of vulvar tumors in perimenopausal and postmenopausal women)[1].

Do not avoid treatment or seek unqualified medical help due to embarrassment or fear, as this may delay proper care. It is recommended to visit a reputable medical institution.

What tests might be performed for vulvar bumps?

  1. Physical examination: The doctor will take a detailed medical history and visually inspect or palpate the vulvar lesions. Visual examination can identify ulcers, dermatitis, or growths in the perineal area.

  2. Laboratory tests: Depending on the lesions, blood tests or fungal tests may be recommended. For suspected genital herpes, herpes virus antibody tests may be required; for suspected syphilitic chancres, syphilis antibody tests may be needed; for suspected tinea cruris, a skin fungal test may be performed by scraping skin flakes from the lesion edge for microscopic examination[2,5].

  3. Acetic acid white test: The doctor may suggest this test to differentiate between genital warts and pseudowarts. Pseudowarts are usually pink, smooth, and resemble fish eggs or villi, with non-fused rashes and a negative test result. Genital warts, however, are rough, cauliflower-like, and may fuse into larger patches, often yielding a positive test result[1,2].

POTENTIAL DISEASES

What diseases can cause vulvar bumps?

  1. Folliculitis: Commonly known as pimples, they can occur not only on the face but also on the vulva, often appearing as single or multiple bumps. Essentially, it is an inflammation of hair follicles, mostly caused by Staphylococcus aureus infection. Hormone levels, excessive sebum secretion, a diet high in sugar and fat, and scratching are all contributing factors. Mild cases may resolve on their own, while moderate to severe cases may require anti-infective treatments such as mupirocin ointment or clindamycin gel [2,5]. Some patients may experience side effects like itching or a burning sensation; those with severe kidney impairment or pregnant women should use with caution; it is contraindicated for those allergic to the medication.

  2. Furuncles and carbuncles: Often develop from untreated folliculitis, appearing as single or multiple lesions. A furuncle is a deep-seated infection of the hair follicle and surrounding tissue, presenting as a hard, painful nodule with redness, swelling, and eventual pus formation. A carbuncle is a cluster of interconnected furuncles, forming a larger, inflamed, pus-filled mass. Systemic antibiotics like penicillin or cephalosporins are recommended, along with topical treatments such as mupirocin ointment or fusidic acid cream. Incision and drainage may be needed for pus accumulation [2,5]. Side effects may include itching or burning; caution is advised for those with kidney impairment or pregnancy; contraindicated for those with drug allergies.

  3. Genital herpes: Caused by herpes simplex virus (HSV), it is contagious and typically transmitted sexually, with symptoms appearing 2–14 days after exposure. It presents as clustered red blisters or sores, often painful. Treatment includes oral or topical antiviral medications like acyclovir or famciclovir [5]. Possible side effects include menstrual irregularities, diarrhea, headache, or nausea; contraindicated for those with liver/kidney dysfunction, drug allergies, or pregnancy.

  4. Genital warts: Caused by human papillomavirus (HPV), it is contagious and primarily spread through sexual contact. Typically appears as cauliflower-like growths with a rough surface, usually painless and non-itchy. Treatments include laser therapy, cryotherapy, or photodynamic therapy [5].

  5. Eczema: A non-contagious inflammation of the skin’s superficial layers. Its pathogenesis is complex, involving genetic and environmental factors. Symptoms include redness, papules, oozing, peeling, or thickening of the skin, often accompanied by itching. Treatment involves avoiding triggers and using anti-inflammatory, antipruritic, or antihistamine therapies [2,5].

  6. Tinea cruris (jock itch): A fungal infection that is mildly contagious, spread through contact. Presents as ring-shaped, scaly, red patches with itching. Treatment includes oral antifungals like terbinafine or itraconazole and/or topical agents like butenafine or amorolfine [2,5]. Side effects may include nausea, vomiting, diarrhea, or loss of appetite; contraindicated for infants under one year, pregnant women, those with liver dysfunction, or drug allergies.

  7. Pseudocondyloma (vestibular papillomatosis): Also called hirsutoid vulvae, many healthy women naturally have this condition, considered a normal anatomical variation. In some cases, it may develop due to inflammatory irritation. It appears as multiple, clustered, grain-like or velvety papules on the inner labia minora or around the urethra, pink or reddish, often non-confluent and sometimes mildly itchy. No treatment is needed, and it is non-contagious [2].

  8. Bartholin’s cyst: Caused by blockage of the Bartholin’s gland duct. Small cysts without infection are usually asymptomatic; larger cysts may cause vulvar discomfort or pain during intercourse. Asymptomatic cases require no treatment; larger cysts may need marsupialization [5].

  9. Chancre: A hallmark of primary syphilis, caused by Treponema pallidum, transmitted sexually or via blood. The incubation period averages 2–4 weeks. It presents as one or two painless ulcers on the vulva. Prompt antibiotic treatment (e.g., penicillin or tetracycline) can cure syphilis [2]. Side effects may include chills, fever, or shock; contraindicated for those allergic to the medication.