A sore or lesion on the vulva, the collective term for the external female genitalia, is often concerning. Vulvar sores, also known as ulcers, represent a break in the skin or mucous membrane that exposes the underlying tissue. These lesions can appear as bumps, blisters, or open wounds, and may be painful, itchy, or entirely asymptomatic. Causes range from simple irritation to chronic skin conditions and infectious agents, requiring professional medical evaluation for a definitive diagnosis.
Sores Caused by Irritation and Inflammation
Many vulvar sores are non-infectious, arising from reactions to the environment or physical trauma. Contact dermatitis is a common culprit, occurring when the delicate vulvar skin reacts to a chemical irritant or allergen. Typical triggers include perfumed soaps, bubble baths, laundry detergents, feminine hygiene sprays, or certain lubricants. The resulting inflammation can lead to redness, itching, and eventually small, raw, or sore areas.
Friction and minor trauma are other frequent non-infectious causes of vulvar lesions. Activities such as vigorous sexual intercourse, wearing overly tight clothing, or friction from physical activity can create small tears or abrasions. Hair removal methods like shaving or waxing can lead to folliculitis, which is the inflammation and infection of the hair follicles. Folliculitis appears as small, red, sometimes pus-filled bumps that can become sore, but these irritant-based sores often resolve spontaneously once the triggering agent is removed.
Chronic inflammatory skin conditions can also manifest as vulvar sores. Lichen Sclerosus causes the skin, primarily around the vulva and anus, to become thin, white, and crinkly. Persistent itching from this condition can lead to fissuring and open sores that bleed easily. Psoriasis is another chronic condition that affects the vulva, presenting as well-defined, red patches. Both Lichen Sclerosus and Psoriasis require specific dermatological treatment, often involving topical corticosteroids, to manage inflammation and prevent scarring.
Viral Infections that Cause Vulvar Sores
Viral infections are a significant cause of vulvar sores, with Herpes Simplex Virus (HSV) being the most common agent. HSV-1 and HSV-2 are highly contagious viruses that cause genital herpes, typically beginning with a tingling or burning sensation before the appearance of lesions. The characteristic lesions are clusters of small, painful, fluid-filled blisters that quickly rupture to form shallow, open ulcers.
During a primary outbreak, individuals may experience systemic symptoms, including fever, headache, body aches, and swollen lymph nodes in the groin. After the initial infection, the virus remains dormant in nerve cells, potentially leading to periodic, less severe recurrences. Recurrent outbreaks typically involve fewer lesions and resolve quickly, often within five to ten days.
Human Papillomavirus (HPV) is another widespread viral infection that affects the vulva, though its lesions differ from erosive sores. Low-risk types of HPV cause genital warts, which present as flesh-colored spots that can be raised, flat, or resemble small cauliflowers. These warts are generally painless and do not form ulcers, but they require distinct treatment from open sores. Other viruses, such as Varicella-Zoster Virus (chickenpox) or Molluscum Contagiosum, can also result in vulvar lesions, but HSV remains the primary concern for acute, painful ulcers.
Other Infectious Agents and Skin Conditions
Beyond viral causes, certain bacterial and autoimmune conditions can lead to vulvar sores. Primary Syphilis, caused by the bacterium Treponema pallidum, is characterized by a lesion known as a chancre. This sore is classically described as a single, firm, round, and painless ulcer with a clean base.
Another bacterial infection, Chancroid, caused by Haemophilus ducreyi, presents as a highly painful, soft ulcer with irregular, undermined edges. Chancroid is often accompanied by swollen, tender lymph nodes in the groin, which may progress to form a pus-filled abscess called a bubo. Both syphilis and chancroid require immediate and specific antibiotic treatment to prevent serious long-term complications.
Localized bacterial infections, such as those leading to an abscess or cellulitis, can also cause painful vulvar swelling and ulceration. Non-infectious conditions, including autoimmune disorders like Behçet’s disease, can cause recurrent, painful, and deep ulcers. These ulcers are not sexually transmitted but are a manifestation of systemic inflammation.
Seeking Professional Evaluation and Treatment
Professional evaluation is necessary for an accurate diagnosis, as a vulvar sore is a symptom common to many conditions, ranging from minor irritation to serious infection. Seek medical attention if the sore persists for more than one week or if it is accompanied by signs suggesting an underlying infection or systemic process:
- Fever
- Body aches
- Swollen lymph nodes
- Difficulty with urination
The diagnostic process typically begins with a thorough visual inspection of the lesion and a medical history review. A healthcare provider may perform a swab test to collect fluid or tissue from the ulcer base, testing for viruses like HSV or bacteria like Treponema pallidum. Blood tests may also be utilized to screen for systemic infections, such as syphilis. Accurate diagnosis is essential because treatments are highly specific, ranging from topical steroids for inflammatory conditions to antiviral or antibiotic medications for infections. Persistent vulvar sores that do not heal should always be evaluated by a specialist, as they can rarely be a sign of vulvar cancer.