The sudden discovery of a bump or lesion on the external genital area, anatomically known as the vulva, can cause immediate concern. The skin of the vulva is highly specialized, and many bumps that appear are simply variations of normal anatomy or temporary skin reactions. Understanding the various causes, from harmless structures to those requiring medical attention, can provide clarity. The appearance of these lumps or sores should always be evaluated based on their texture, location, accompanying symptoms, and duration.
Normal Structures and Common Skin Irritations
The vulva is covered in skin that is rich in hair follicles and sebaceous, or oil-producing, glands, which naturally creates a landscape where bumps frequently occur. Fordyce spots are a common example, presenting as small, slightly elevated yellowish or whitish papules, typically found on the labia minora. These are visible, enlarged sebaceous glands that are a normal anatomical variation and are neither contagious nor harmful.
Another frequent cause of temporary bumps is folliculitis, an infection or inflammation of the hair follicle that appears as small, red bumps or pus-filled whiteheads. Ingrown hairs are a specific type of folliculitis that occur when a hair curls back into the skin after shaving, waxing, or plucking. Both folliculitis and ingrown hairs are localized reactions to irritation, friction from tight clothing, or bacterial contamination, and they typically resolve on their own once the irritant is removed.
Generalized irritation, redness, and small bumps can also signal contact dermatitis, a reaction to an external substance. The sensitive skin of the vulva may react to fragrances in soaps, laundry detergents, feminine hygiene sprays, or dyes in colored toilet paper. This inflammatory reaction is usually characterized by itching, burning, and sometimes swelling, and it is crucial to identify and eliminate the irritating product to allow the skin to heal.
Cysts and Non-Infectious Dermatological Conditions
Some bumps are chronic localized growths that are not related to infection or trauma, such as cysts, which are closed sacs under the skin. Bartholin cysts are one of the most common, forming when the duct of one of the two Bartholin glands, located near the vaginal opening, becomes blocked. A simple cyst is usually a soft, painless lump, but if bacteria enter the trapped fluid, it can rapidly become a painful, tender abscess.
Epidermal inclusion cysts result from surface skin cells or blocked sebaceous gland ducts becoming trapped under the skin. These are typically small, white or yellow bumps, less than a centimeter in diameter, and are often asymptomatic unless they become inflamed or infected. They are benign and can form spontaneously or due to trauma.
Molluscum contagiosum is a viral skin infection that causes distinctive lesions transmitted through skin-to-skin contact, including sexual activity. These bumps are small, firm, dome-shaped papules, often described as having a pearly appearance and a characteristic central indentation, known as umbilication. Molluscum lesions are generally painless, can appear in clusters, and may persist for many months before resolving.
A chronic, non-infectious condition called lichen sclerosus can also present as thickened, white, or crinkled patches on the vulva and anus. This condition is not contagious, but it can lead to scarring and changes in the vulvar architecture if left unmanaged.
Sexually Transmitted Causes of Bumps
Bumps or lesions that are sexually transmitted have specific appearances. Genital warts are caused by certain types of Human Papillomavirus (HPV) and present as flesh-colored, raised growths that can be single, clustered, or take on a bumpy, cauliflower-like texture. They typically cause no pain, though they may occasionally cause itching or mild discomfort.
Genital herpes, caused by the Herpes Simplex Virus (HSV), has a characteristic progression that begins with a localized sensation, such as tingling, burning, or pain, known as a prodrome. The lesions then erupt as small, painful blisters that appear in a cluster on the vulva or surrounding skin. These blisters quickly rupture to form shallow, open ulcers that eventually crust over and heal, often recurring because the virus remains dormant in the nerve cells.
Primary syphilis presents as a chancre, which is the initial sore. This ulcer is typically firm, round, and has a defined border, but its most important feature is that it is usually painless. This can allow it to go unnoticed, particularly if it forms inside the vagina. The chancre will heal on its own within three to six weeks, but the infection will progress to later stages without medical treatment.
When Immediate Medical Consultation is Necessary
Certain signs should prompt immediate medical consultation. A bump or sore accompanied by systemic symptoms, such as an unexplained fever, chills, or flu-like body aches, suggests a more serious infection. A lump that is rapidly growing, hard, or fixed to the underlying tissue also requires prompt evaluation to rule out serious conditions.
Medical attention is necessary if a sore or ulcer fails to heal completely within a few days, or if a bump is painful, tender, and warm to the touch, indicating a potential abscess or acute infection. Other urgent signs include any bump accompanied by a significant change in vaginal discharge, particularly if it is foul-smelling or unusual in color, or bleeding unrelated to the menstrual cycle. These symptoms often signal an active infection or a condition that requires timely intervention.