A Bartholin cyst appears as a soft, round lump on one side of the vaginal opening, ranging from the size of a pea to as large as a golf ball. Small cysts may be barely noticeable, while larger ones create visible swelling that makes one side of the outer vaginal lips look noticeably bigger than the other. Understanding what you’re looking at, and how the appearance changes if infection sets in, can help you figure out what’s going on and how urgently you need to act.
Location and Shape
The Bartholin glands sit at roughly the 4 o’clock and 8 o’clock positions on either side of the vaginal opening. Their job is to secrete small amounts of fluid that help with lubrication. When the duct of one of these glands gets blocked, fluid backs up and forms a cyst. Because it develops from a specific gland, the lump almost always shows up on just one side, not both.
The cyst itself is typically round or oval, smooth-surfaced, and sits just beneath the skin of the inner labia (the smaller vaginal lips) or at the lower portion of the vaginal opening. It may feel like a marble or small ball under the skin. When it’s small, you might only notice it by touch during bathing. A larger cyst pushes outward enough to create a visible bulge, and the affected side of the labia can look obviously fuller or puffier than the other side.
Size and Skin Appearance
An uncomplicated Bartholin cyst, one that isn’t infected, tends to be skin-colored. The overlying skin usually looks normal, without redness or discoloration. The lump feels soft and somewhat movable, like a fluid-filled sac rather than a hard mass. Many small cysts cause no pain at all and are only discovered incidentally during a routine exam or while showering.
As the cyst grows, it can reach several centimeters across. At that size, it becomes uncomfortable during walking, sitting, or sex. You may feel a sense of pressure or fullness on one side of the vulva. The skin over a larger cyst can look stretched or taut, but it still usually stays close to your normal skin tone as long as no infection is present.
How an Infected Cyst Looks Different
The appearance changes dramatically when a Bartholin cyst becomes infected and develops into an abscess. The lump grows rapidly, sometimes over just a day or two, and becomes intensely tender to the touch. The skin over it turns red, hot, and swollen. On darker skin tones, the redness may be harder to see, but the area will still feel noticeably warm and look more swollen than the surrounding tissue.
An abscess is firmer and more painful than a simple cyst. You may notice smelly discharge if the abscess begins to leak. Some people develop systemic symptoms like fever, chills, or a general feeling of being unwell, which signals that the infection is significant. Surrounding skin can develop cellulitis, a spreading redness and tenderness that extends beyond the lump itself. At this stage, walking and sitting become very painful, and you’ll likely need medical drainage rather than home care alone.
Other Lumps That Can Look Similar
Not every bump near the vaginal opening is a Bartholin cyst. Inflamed epidermoid cysts (sometimes called sebaceous cysts) can appear in the vulvar area and feel similar, though they tend to sit more superficially in the skin and may have a visible central pore. Cysts of the Skene glands, which are located near the urethral opening rather than the lower vaginal opening, can also cause a soft lump but in a distinctly different spot. Ingrown hairs and blocked sweat glands are common causes of smaller, more superficial bumps. The key distinguishing feature of a Bartholin cyst is its deep location at the lower portion of the vaginal opening, on one side only.
What You Can Do at Home
Small, painless Bartholin cysts often resolve on their own. Warm sitz baths are the primary home treatment: fill a bathtub or shallow basin with 3 to 4 inches of warm water (around 104°F or 40°C) and soak the area for 15 to 20 minutes. Doing this three to four times a day for several days can encourage the blocked duct to open and drain naturally. Some cysts respond within a few days; others persist.
Do not try to squeeze or pop the cyst yourself. The gland sits deeper than a typical pimple, and pressing on it risks pushing bacteria further into the tissue or causing incomplete drainage that leads to recurrence.
What Medical Treatment Looks Like
If a cyst doesn’t resolve with sitz baths, or if it becomes infected, a healthcare provider has a few options. The most common first step is a Word catheter, a small balloon-tipped tube inserted into the cyst after a small incision. The catheter stays in place for several weeks, creating a permanent drainage channel so the gland can function normally again. You can go about daily life with it in place, though you’ll feel some initial soreness.
For cysts that keep coming back, marsupialization is a minor surgical procedure. The provider cuts a small slit in the cyst wall, drains it, and then stitches the edges open so they form a small permanent pouch that prevents fluid from building up again. Full healing takes about two to four weeks.
A Note for Those Over 40
Bartholin glands naturally shrink by around age 30. A new lump in this area after age 40, particularly one that feels firm, fixed in place, or irregularly shaped, warrants a biopsy. The American Academy of Family Physicians recommends biopsy with or without excision for patients 40 and older to rule out rare vulvar cancers. This doesn’t mean a lump at this age is likely cancer, but it does mean it shouldn’t be dismissed as a simple cyst without further evaluation.