Vestibular Papillomatosis (VP) is a common, benign anatomical variation found on the vulva. This presentation of small, fleshy bumps is a normal feature of the female anatomy, not a disease. Understanding the specific visual characteristics of VP is important for clarity and reassurance, given the potential for misidentification.
Defining Vestibular Papillomatosis
Vestibular Papillomatosis is classified as a physiological variant, meaning it is a natural structure of the genital area for some women. It is not an infection caused by a virus or bacteria, distinguishing it from sexually transmitted infections (STIs). VP is quite prevalent, with reported rates ranging from 1% to over 30% in healthy women. This condition is non-contagious, benign, and does not typically cause physical symptoms like pain, itching, or burning. VP requires no medical treatment or intervention.
The Distinctive Appearance of VP
The visual characteristic of Vestibular Papillomatosis is the appearance of numerous small, raised projections, or papillae, on the vulva. These bumps are located on the inner aspect of the labia minora and the vestibule (the tissue surrounding the vaginal opening). The individual papillae are small, typically measuring between 1 and 2 millimeters in diameter. They often have a smooth, shiny, or translucent surface texture, which helps distinguish them from other skin growths.
The shape of the papillae can vary, appearing either domed and rounded or elongated and finger-like (filiform projections). VP papillae generally match the surrounding moist mucosal tissue, appearing flesh-toned, light pink, or sometimes white. A distinctive feature is their arrangement, which is often uniform and symmetrical, frequently appearing in parallel rows or clusters on both sides of the vulva. This mirrored pattern indicates that the growths are a normal variant rather than an irregular lesion.
How VP Differs from Other Conditions
The most common point of confusion is differentiating Vestibular Papillomatosis from genital warts, which are caused by the human papillomavirus (HPV). A key distinction lies in the base of the growths: each VP papilla grows separately from its own mucosal insertion and does not merge. In contrast, genital warts are typically irregular, often fusing together at their base to create a broader, cauliflower-like appearance.
VP lesions are soft to the touch and maintain a uniform size, while genital warts tend to be firmer and vary widely in size and shape. VP is almost always symmetrically arranged across the vulva, which is rarely true for genital warts, whose distribution is usually random. Another clinical difference is the reaction to acetic acid, often used as a diagnostic aid. VP lesions generally do not whiten when exposed to the solution, but genital warts commonly exhibit a noticeable whitening reaction.