Vulvar sores are breaks in the skin’s integrity, appearing as lesions, bumps, ulcers, or erosions on the external female genitalia. These physical changes can signal various underlying issues, from minor irritation to significant health conditions. Appearance alone cannot definitively determine the cause, making self-diagnosis unreliable. This article describes the common visual characteristics and potential origins of vulvar sores, but professional medical evaluation is necessary for accurate diagnosis and management.
How Vulvar Sores Appear
Vulvar sores manifest in distinct forms categorized by shape, texture, and structure. Ulcers are open, crater-like breaks in the skin that expose underlying tissue. They may be shallow or deep, intensely painful or completely painless, sometimes featuring a gray or yellowish crust.
Vesicles and blisters are small, raised sacs filled with clear or straw-colored fluid. These fluid-filled lesions often rupture quickly, leaving behind shallow, tender, and highly sensitive erosions.
Solid, raised bumps are classified as papules (small) or nodules (larger). They present as firm, flesh-colored, or pearly white elevations. Lesions that are flat-topped, raised, and cover a wider area are known as plaques, which may appear scaly, thickened, or discolored.
The surrounding skin may show changes in pigmentation, such as redness or white patches (hypopigmentation). These visual characteristics, including the lesion’s color, texture, and whether it is fluid-filled or solid, provide initial descriptive clues for healthcare providers.
Infectious Conditions that Cause Sores
Infectious agents cause distinct lesion types. The Herpes Simplex Virus (HSV) typically causes outbreaks that begin as small, painful clusters of vesicles. These blisters quickly erode into multiple, shallow, tender ulcers with a red base, which often crust over before healing.
Syphilis, a bacterial infection, presents with a unique primary lesion called a chancre. This sore is classically described as a single, firm, round, and painless ulcer, which can sometimes go unnoticed.
The Human Papillomavirus (HPV) causes genital warts, which are non-ulcerative lesions. These growths appear as flesh-colored, raised bumps that can be flat or have a rough, cauliflower-like texture, often occurring in clusters.
Molluscum contagiosum, a viral infection, produces small, dome-shaped papules that are skin-colored or pearly white. These lesions have a small central dent, or umbilication, on the top of the bump.
Severe fungal infections, such as those caused by Candida, can lead to intense inflammation and redness. While not true ulcers, these infections can cause tiny cracks or fissures in the vulvar skin that resemble sores.
Non-Infectious Reasons for Lesions
Lesions can result from inflammatory, autoimmune, or traumatic processes. Contact dermatitis is a frequent non-infectious cause, resulting from the skin reacting to irritants like perfumed soaps, detergents, or lubricants. This reaction typically appears as redness, swelling, small itchy bumps, or sometimes painful fissuring of the skin.
Trauma and friction can lead to breaks in vulvar skin integrity. Vigorous scratching from chronic itching, shaving injuries, or intense friction can cause linear erosions and ulcers. These lesions often heal once the source of irritation is removed, provided they do not become secondarily infected.
Chronic inflammatory skin conditions may also cause vulvar changes. Lichen sclerosus often presents as white patches of thin, crinkled skin that can resemble cigarette paper. Because the skin becomes fragile, minor friction can cause it to tear easily, resulting in painful, non-infectious ulcers.
Another inflammatory condition, Lichen Planus, can manifest in the vulva in several patterns, including an erosive form. This type causes painful, raw, red areas on the inner vulvar tissue that represent locally destructive sores.
Warning Signs and Medical Consultation
Medical consultation is necessary for any new or unexplained vulvar sore, lump, or skin change. Self-treating or delaying diagnosis is discouraged because the cause could be an infectious condition requiring specific medication or a more serious, though rare, condition.
Seek immediate medical attention if a sore is accompanied by systemic symptoms such as fever, chills, or swollen lymph nodes in the groin. Severe pain or difficulty with urination requires urgent evaluation.
Any lump, ulcer, or discolored patch that persists for more than a few weeks without healing requires examination. A healthcare provider will typically perform a physical examination and may use tests such as swabs, blood tests, or a small tissue sample (biopsy) to establish a precise diagnosis. This helps differentiate between infectious, inflammatory, and other potential causes.