A Bartholin cyst appears as a round, smooth lump on one side of the vaginal opening, typically ranging from the size of a pea to as large as a golf ball. While photos can help you recognize the general shape and location, knowing exactly where these cysts form and how they change when infected is what will help you figure out whether the bump you’re looking at matches.
Where Exactly They Appear
Bartholin glands sit on either side of the vaginal opening, at roughly the 4 o’clock and 8 o’clock positions if you imagine the opening as a clock face. A cyst forms when the duct of one of these glands gets blocked, trapping fluid inside. Because of this specific location, the lump will always appear on the lower left or lower right side of the vaginal opening, tucked between the inner and outer labia. If the bump you’re examining is directly on the outer labia, near the clitoris, or centered above or below the vaginal opening, it’s likely something else.
Only one side is affected at a time in most cases. The cyst sits deep enough that small ones may only be felt rather than seen. Larger ones push the overlying skin outward, creating a visible, rounded bulge.
What an Uncomplicated Cyst Looks Like
A Bartholin cyst that isn’t infected is flesh-colored or slightly translucent, with no redness or discoloration of the surrounding skin. The surface is smooth and the lump feels soft and movable under the skin, similar to a water balloon. Small cysts (under 1 cm) often cause no symptoms at all and may only be discovered during a routine exam.
As the cyst grows, it becomes more visible and can reach 3 to 5 centimeters or larger. At this size, it creates an obvious asymmetry when you look at the vulva. The skin stretched over the cyst usually looks normal and unbroken. You may notice discomfort while walking, sitting, or during sex, but the area won’t feel hot to the touch and there’s no discharge.
How an Abscess Looks Different
When a Bartholin cyst becomes infected and forms an abscess, the appearance changes dramatically. The lump grows quickly, sometimes over just a day or two, and the overlying skin turns red, swollen, and shiny. The area feels warm or hot when touched, and the lump becomes firm and extremely tender rather than soft and painless.
An abscess can reach the size of a large egg or bigger. The skin may develop a whitish or yellowish point near the surface where pus is collecting. Some abscesses drain on their own, producing thick, foul-smelling discharge that may be yellow, green, or brownish. Fever and difficulty walking or sitting are common once an abscess has developed. The pain is often described as throbbing and constant, unlike the mild pressure of a simple cyst.
Conditions That Look Similar
Several other vulvar lumps can be confused with a Bartholin cyst. A Skene’s gland cyst forms near the urethral opening (closer to the top of the vaginal area), so location is the easiest way to tell them apart. Sebaceous cysts appear on the outer labia and tend to be smaller, firmer, and sometimes have a visible dark pore at the center. They can occur anywhere on the vulva, not just at the 4 and 8 o’clock positions.
Genital herpes sores are shallow, open ulcers that appear in clusters and are painful from the start, which looks quite different from the single, round, enclosed lump of a Bartholin cyst. Folliculitis (infected hair follicles) causes small, pimple-like bumps near hair-bearing skin, usually with a visible hair at the center. A Bartholin cyst is deeper, larger, and located in a hairless area closer to the vaginal opening.
Size and Shape Over Time
Bartholin cysts can stay the same size for months or even years, or they can fluctuate. Some women notice the cyst swells slightly before their period or after sexual arousal, since the gland naturally produces more fluid during these times. A cyst that was barely noticeable can become prominent within days if the duct becomes more obstructed or infection sets in.
The shape remains round or oval in nearly all cases. A mass that feels irregular, hard, or fixed in place (not movable under the skin) is less likely to be a simple cyst. For women over 40, any new or enlarging lump in this area warrants a biopsy, because the Bartholin glands naturally shrink after age 30 and new growth at that point can, in rare cases, signal malignancy. A firm, irregularly shaped, or fixed mass is particularly concerning in this age group.
What You Can Do at Home
Small, painless Bartholin cysts don’t always need treatment. If you have a small cyst that’s mildly uncomfortable or showing early signs of infection (slight redness, mild tenderness), warm sitz baths are the standard first step. Fill a bathtub with a few inches of warm water and soak for 10 to 15 minutes, several times a day, for three to four days. This can encourage a small infected cyst to drain on its own.
If the cyst doesn’t improve with sitz baths, grows rapidly, becomes very painful, or you develop a fever, you’ll need medical treatment. Procedures range from simple drainage to placement of a small catheter that keeps the duct open while it heals, which typically stays in place for a few weeks. Recovery from these office procedures is generally quick, though cysts do recur in some women.