A lump or bump discovered on the vulva or surrounding genital area can cause concern. Changes in the skin of the external genitalia are common and often have a benign explanation. The vulvar skin contains hair follicles, sweat glands, and oil glands, making it susceptible to the same issues that affect skin elsewhere on the body. This guide offers an overview of potential causes, but it is not a substitute for a professional medical evaluation, which is necessary for an accurate diagnosis and appropriate treatment.
Superficial Bumps Related to Skin and Hair
Many common bumps result from external factors or issues localized to the hair structures of the vulva. The most frequent cause of a small, red, and tender bump is folliculitis, an inflammation or infection of a hair follicle. This condition often results from shaving, waxing, or friction, allowing bacteria, typically Staphylococcus aureus, to enter the follicle opening. Folliculitis presents as small, pus-filled pimples that are generally self-limiting and resolve with gentle hygiene.
A related issue is an ingrown hair, which occurs when a cut or broken hair curls back and grows into the skin, creating a small, sometimes painful, round bump. The body reacts to the hair as a foreign object, causing the bump to form.
The vulvar skin is also sensitive to contact dermatitis, an allergic or irritant reaction to substances like harsh soaps or fragranced detergents. This reaction typically appears as an itchy, red rash or small, irritated bumps across the area of contact.
Other superficial skin bumps include molluscum contagiosum, a viral infection causing small, firm, dome-shaped papules. These lesions are skin-colored or pink and often display a central dent. They are generally painless and tend to disappear without treatment within several months.
Blockages, Swelling, and Glandular Cysts
The vulva contains glands that produce lubricating fluid and oil. A blockage in their ducts can lead to the formation of cysts. A Bartholin’s cyst is common, forming when the duct of one of the two Bartholin’s glands, located near the vaginal opening, becomes obstructed. The resulting bump is a soft, round lump on one side of the labia, ranging in size from a pea to a golf ball.
While many Bartholin’s cysts are small and asymptomatic, they can develop into a painful abscess if the trapped fluid becomes infected. An abscess is characterized by rapid enlargement, significant pain, and the area becoming red, swollen, and hot.
Sebaceous glands on the vulva can also become blocked, leading to epidermal inclusion cysts. These cysts arise when surface skin cells become trapped beneath the skin, creating a lump filled with keratin. These inclusion cysts are typically firm lumps found on the labia majora and are not usually painful unless infected.
Understanding the difference between a cyst (a fluid-filled sac) and a solid lump is relevant for diagnosis, as a solid lump may represent a skin tag, a fibroma, or, rarely, a cancerous lesion. Most vulvar cysts are benign, but any persistent or rapidly changing lump warrants medical attention.
Bumps Resulting from Viral or Bacterial Infections
Certain bumps arise from infections caused by specific pathogens, some of which are sexually transmitted and require targeted treatment. Genital warts, caused by the Human Papillomavirus (HPV), typically appear as small, skin-colored, or pink growths that may be single or clustered. These lesions often have a rough, irregular surface texture, sometimes described as cauliflower-like, and are usually painless.
In contrast, an outbreak of genital herpes, caused by the Herpes Simplex Virus (HSV), begins with a cluster of small, painful, fluid-filled blisters on a red base. These blisters quickly rupture to form shallow, tender ulcers that eventually crust over and heal. Before the lesions appear, a person may experience a prodrome of tingling, burning, or itching, and initial outbreaks are often accompanied by flu-like symptoms.
A third infectious cause is primary syphilis, a bacterial infection that manifests as a chancre, a solitary sore at the site of infection. This chancre is firm, round, and painless, differentiating it from the painful lesions of herpes. Although the chancre may heal on its own, the bacterial infection remains in the body and requires antibiotic treatment to prevent progression to later, more severe stages.
Knowing When to Contact a Healthcare Provider
While many vulvar bumps are benign and may resolve spontaneously, certain signs indicate the need for medical evaluation. A healthcare provider should be consulted if a bump persists for more than a few days without improvement, or if it grows rapidly in size.
Seek medical attention if the bump is severely painful, bleeds easily, or shows signs of secondary infection, such as foul-smelling pus. Other concerning symptoms include fever, chills, or feeling unwell.
Any open or ulcerated sore that does not heal within a month must be evaluated to rule out rare conditions like vulvar cancer. Specialists such as a gynecologist, dermatologist, or primary care provider can perform a thorough examination and provide the correct diagnosis. Self-diagnosis can be misleading due to the overlapping appearance of many conditions.