Vulval lesions - diagnosis at OpenMed Warsaw
A lump, spot, sore, blister, painful thickening or swelling of the labia can have many causes - from irritation after hair removal and folliculitis, through a Bartholin cyst, an infection or HPV, to skin conditions of the vulva that require more detailed diagnostics. The appearance of a lesion alone does not always make it possible to establish its cause.
At OpenMed Warsaw you can have a new, painful, recurrent or non-healing lesion in the intimate area assessed. The gynaecologist will examine the vulva and the other genital organs and, if necessary, will recommend a swab, STI tests, further diagnostics or referral for procedural treatment.
Vulval lesions - gynaecological consultation in Warsaw
Lesions can appear on the labia majora and minora, in the vaginal vestibule, at the vaginal opening, around the clitoris and in the perineal area. They may take the form of a single lump or many small lesions.
Patients come to the gynaecologist after noticing, among other things:
- a hard or soft lump on the labia,
- a painful thickening at the vaginal opening,
- a spot resembling a pimple,
- bumps or warts,
- fluid-filled blisters,
- a sore or ulcer,
- a cyst in the intimate area,
- a lesion containing pus,
- swelling of the labia on one side,
- persistent itching or burning,
- a lesion that bleeds or will not heal.
Many such lesions have benign causes. At the same time, similar-looking symptoms can occur in completely different conditions, which is why new and persistent lesions in particular should not be self-diagnosed on the basis of photos found online.
Doctors assessing vulval lesions at OpenMed Warsaw
OpenMed gynaecologists see patients with lumps, cysts, pain, swelling, itching and skin lesions appearing on the vulva. During the visit the doctor can examine the lesion closely and assess its location, size, surface, tenderness and the surrounding tissues. If the picture suggests an infection or a sexually transmitted disease, diagnostics can be extended with an appropriate swab or molecular test. Atypical lesions may require a biopsy or histopathological examination.
A lump, spot, sore or blisters on the vulva - when should you see a doctor?
A single spot after shaving may disappear on its own, but not every lesion on the vulva should be watched for many weeks.
A consultation is particularly advisable when the lesion:
- grows quickly,
- is becoming increasingly painful,
- is clearly red, hot and swollen,
- contains or discharges pus,
- causes pain when walking, sitting or during intercourse,
- keeps coming back in the same place,
- appears as multiple blisters or ulcers,
- bleeds without an obvious injury,
- does not heal for a long time,
- changes colour, shape or surface texture,
- is accompanied by enlarged lymph nodes,
- occurs together with fever or feeling unwell.
A very painful, rapidly enlarging lump with fever may indicate, among others, an abscess. On the other hand, a persistent ulcer, bleeding, chronic itching or an unusual change in the skin surface requires careful assessment, even if the lesion itself does not hurt.
What lesions can appear on the labia?
The appearance of a lesion is one piece of information that helps to establish its origin, but it does not allow a diagnosis to be made on your own.
A lump or thickening may be a cyst, a blocked gland, a sebaceous cyst, folliculitis, an abscess or another skin lesion.
A spot with a white or pus-filled head often develops with folliculitis, especially on the hair-bearing skin of the labia majora.
Blisters - especially multiple, painful ones that then turn into superficial sores - may occur, among others, with genital herpes.
Warts and growths may be benign lesions or genital warts associated with HPV. They can be single or multiple, flat, raised or have an uneven surface.
A sore or ulcer may be the result of an injury, scratching, an infection, a skin condition or an STI. An ulcer that persists for a longer time needs to be checked.
Diffuse swelling and redness, on the other hand, may appear with irritation, an allergic reaction, an infection, inflammation or mechanical injury.
The most common causes of lesions on the labia
One of the most common causes of small lesions is chafing and mechanical irritation. They may appear after shaving, hair removal, vigorous intercourse, training, cycling or wearing very tight underwear.
Another group is inflammation and infections, e.g. folliculitis, a skin abscess, herpes infection or other STIs.
Lumps near the vaginal opening may be related to a blocked Bartholin gland duct. A small cyst may cause no pain, whereas its infection and the formation of an abscess can lead to severe discomfort.
Lesions on the vulva may also result from dermatological conditions, such as:
- contact eczema,
- psoriasis,
- lichen sclerosus,
- lichen planus,
- chronic dermatitis.
Chronic itching, white or red areas of skin, cracks, thickening or a change in skin texture do not always mean an infection and may require completely different treatment.
A painful lump and swelling of the labia
Pain helps to narrow down the possible causes, but it is not characteristic of any one condition.
A small, superficial and painful lump on hair-bearing skin may be related to folliculitis or an ingrown hair. It often appears a few days after shaving or hair removal.
A larger and deeper thickening may be a cyst or an abscess. If the lesion is located on one side of the vaginal opening, one possible cause is a cyst or inflammation of the Bartholin gland.
Severe inflammation can cause:
- throbbing or pressing pain,
- marked enlargement of one side of the vulva,
- redness and warmth of the skin,
- pain when sitting and walking,
- pain during intercourse,
- discharge of pus,
- fever.
Such a lesion should not be pierced or squeezed on your own.
Cysts, sebaceous cysts and inflammation of the Bartholin gland
The Bartholin glands are located on both sides of the vaginal opening. Their secretions drain through small ducts. When a duct becomes blocked, a fluid-filled cyst can form.
A Bartholin cyst may be small - the size of a pea - but it can also grow to several centimetres. Small lesions are often painless. A typical location is on one side of the vaginal opening.
If an infection develops, pus may collect inside and a Bartholin abscess forms. The lump then usually becomes very painful, swollen and tender. It may make walking, sitting down and intercourse difficult.
Not every cyst needs a procedure. A small, symptom-free lesion can be observed. For a large, recurrent or infected cyst, on the other hand, methods are used that allow the contents to drain, e.g. incision and drainage, insertion of a Word catheter or marsupialisation. The doctor chooses the specific method according to the clinical picture.
A sebaceous cyst is a different lesion - it forms in the skin as a result of a blocked gland or follicle opening. It can usually be felt as a well-defined lump and can also become infected.
Spots and irritation after hair removal or chafing
The skin of the vulva is exposed to moisture, friction and frequent contact with cosmetics. This is why a spot on the labia does not have to mean an STI.
After shaving or hair removal, the following may appear:
- small red bumps,
- folliculitis,
- ingrown hairs,
- spots containing pus,
- itching and burning,
- superficial scratches,
- post-inflammatory discolouration.
Irritation can be made worse by tight leggings and underwear, panty liners, perfumed intimate washes, hair removal products, laundry detergents or scented wet wipes.
With a single lesion that appears immediately after hair removal, observation and avoiding further irritation of the skin are often enough. If, however, the lump grows, fills with pus, is very painful or the lesions keep coming back, it is worth checking for another cause.
Blisters, sores and itching in the intimate area
Blisters and ulcers call for a different approach than a typical spot after hair removal.
Genital herpes, caused by HSV-1 or HSV-2, may involve painful blisters that burst and leave superficial erosions or sores. The infection does not look typical in everyone, however, so a diagnosis based on appearance alone may be wrong. If a fresh blister or ulcer is present, a sample can be taken from it for molecular HSV testing.
Sores in the intimate area may also have other causes - from mechanical injuries and chronic scratching to syphilis and non-infectious skin conditions. The CDC stresses that the medical history and examination alone may not be enough to reliably determine the cause of genital ulcers.
Chronic itching without blisters, on the other hand, may occur, among others, with thrush, contact allergy, dermatitis, lichen sclerosus or other vulval dermatoses.
Vulval lesions and HPV, genital warts and STIs
Genital warts may take the form of small, skin-coloured or pink bumps. They can be single or form clusters with an uneven surface.
They are most often associated with infection with certain types of HPV. The HPV types that cause typical genital warts are essentially different from the high-risk types responsible for most precancerous lesions and cancers. The appearance of a wart does not, however, allow the patient to establish the type of virus.
An HPV test is not routinely performed on every wart to confirm genital warts. Typical warts are most often diagnosed clinically, while a biopsy may be indicated for atypical lesions.
Not every lesion in the intimate area is an STI. A spot after shaving, a Bartholin cyst or contact dermatitis have a different background. On the other hand, painful blisters, ulcers, warts or lesions appearing after a new sexual contact may be a reason to extend diagnostics with STI tests.
How are lesions on the labia diagnosed?
The first step is taking a medical history. For the doctor, the following matter, among others:
- when the lesion appeared,
- whether it is getting bigger,
- whether it hurts, itches or bleeds,
- whether it has appeared in the same place before,
- whether it appeared after hair removal or an injury,
- whether it is accompanied by discharge or other signs of infection,
- whether there has been a new sexual contact recently,
- whether an antibiotic, antifungal drug or topical preparation has already been used.
The doctor then examines the vulva and the lesion itself. They can assess its size, colour, surface, consistency, tenderness, the presence of fluid or pus and the condition of the surrounding skin.
Depending on the picture, diagnostics may include:
- a gynaecological examination,
- a bacteriological or mycological swab,
- molecular STI tests,
- a swab from a blister or ulcer,
- blood tests when specific STIs are suspected,
- an ultrasound scan for a deeper lesion,
- a biopsy,
- histopathological examination of the removed lesion.
Not every patient needs all of these tests. Diagnostics for typical folliculitis look different from those for a chronic ulcer or multiple warts.
Lesions on the labia in pregnancy
Cysts, infections, vulval varicose veins, swelling, irritation and skin lesions can also occur in pregnancy. This does not automatically mean a threat to the pregnancy, but the way diagnostics and treatment are carried out should take its stage into account.
It is particularly worth reporting to the doctor:
- a painful or rapidly growing lump,
- a lesion containing pus,
- blisters or an ulcer,
- fever,
- severe swelling,
- bleeding from a lesion,
- suspected genital herpes,
- a lesion appearing for the first time in pregnancy.
Do not pierce a cyst yourself or use randomly chosen ointments, antibiotics or antifungal drugs.
Does a lesion on the labia have to be removed?
No. The appearance of a lump or wart does not in itself mean automatic referral for a procedure.
Observation may be sufficient, among others, for a small, benign-looking lesion that causes no complaints.
Treatment of the cause instead of removal is used, for example, for some infections and skin conditions.
A procedure is considered more often when the lesion:
- is regularly irritated,
- causes pain,
- gets in the way during intercourse or activity,
- bleeds,
- keeps coming back,
- becomes inflamed often,
- is getting bigger,
- has an ambiguous appearance,
- requires a histopathological diagnosis.
For suspicious lesions, the priority is not the cosmetic result but obtaining the correct diagnosis.
Methods of treating lesions in the intimate area
Treatment depends on the cause.
With irritation or contact allergy, the basis is to eliminate the irritant and choose local treatment suited to the condition of the skin.
For a bacterial infection, the doctor may use local or general treatment, depending on the extent of the lesions and the symptoms.
Genital herpes is treated with antiviral drugs. They are most important during the first episode and with frequent recurrences.
A Bartholin cyst without symptoms may not require active treatment. An abscess or a large symptomatic cyst may need to be emptied and further drainage of secretions ensured.
Genital warts can be treated with medication or removed surgically. The choice of method depends, among other things, on the number, size and location of the lesions.
For chronic skin conditions of the vulva, such as lichen sclerosus, dermatological or gynaecological treatment and further follow-up are needed.
Removal of skin lesions in the intimate area
Lesions qualified for a procedure can be removed using various techniques. Depending on the diagnosis, the location and the equipment available, these include:
- surgical excision of the lesion,
- electrocoagulation,
- CO₂ laser,
- cryosurgery,
- curettage,
- incision and drainage for lesions containing pus.
Not all methods are suitable for every type of lesion. For example, a suspicious lesion that requires histopathological assessment should not be destroyed by a method that makes later examination of the tissue under a microscope impossible.
Small superficial procedures can often be performed under local anaesthesia. For larger lesions or procedures involving the Bartholin gland, the type of anaesthesia and further management are chosen individually.
Histopathological examination of a lesion - when is it needed?
Histopathological examination involves a pathologist assessing a fragment or the whole of the removed tissue under a microscope.
It is particularly important when the lesion:
- has an unusual appearance,
- is getting bigger,
- is hard or irregular,
- has ulcerated,
- keeps coming back,
- bleeds for no obvious reason,
- does not heal despite treatment,
- differs from the other lesions,
- requires a cancerous lesion to be ruled out.
A biopsy does not automatically mean that cancer is suspected. It is a method that makes it possible to determine more clearly what tissue the lesion is made of. With an abnormal area of the vulva, the doctor can take a small fragment under local anaesthesia and send it to the laboratory.
Vulval cancers are rare diseases, and most lumps and lesions have other causes. However, persistent ulcers, lumps, chronic itching, bleeding and red, white or dark areas of skin with a changed texture in particular require checking.
Price of consultation and treatment of lesions on the labia
The cost depends on whether only a consultation is needed, additional tests or also a procedure.
The total cost may include, among others:
- a gynaecological consultation,
- a bacteriological or mycological swab,
- PCR tests for STIs,
- a biopsy of the lesion,
- histopathological examination,
- removal of the lesion,
- a follow-up visit after the procedure.
For a procedure, the price also depends on the number, size and location of the lesions and the method used.
The current price of the consultation and available procedures can be checked in the OpenMed price list or confirmed when booking and by phone on 22 100 45 20
Discreet diagnosis of intimate lesions at OpenMed
The OpenMed Gynaecology and Obstetrics clinic is located at ul. Wschowska 8 in the Wola district of Warsaw.
The consultation on vulval lesions takes place in conditions that ensure privacy. The doctor asks only for information that may matter for the diagnosis - e.g. when the lesion appeared, how it has developed, previous treatment, hair removal, signs of infection or any sexual exposure.
There is no need to wait until the lesion becomes very painful or large. An earlier consultation often makes it possible to identify a benign problem and reduce unnecessary worry, and in the case of lesions that need treatment - to start the right management sooner.
Frequently asked questions about lesions on the labia
Possible causes include folliculitis, an ingrown hair, a sebaceous cyst, a cyst, an abscess or a Bartholin cyst. Less often, a lump may have another dermatological background or require histopathological diagnostics. Its exact location, tenderness, size and how long it persists all matter.
Yes. On the hair-bearing part of the labia majora, folliculitis and lesions resembling pimples can occur, especially after shaving or hair removal. If, however, the lesion is very painful, is growing, keeps coming back or does not go away, it should be checked.
It is most often a lump on one side, located at the vaginal opening. A small cyst may be practically painless. If it becomes infected and an abscess forms, the lesion may grow quickly, be very painful and red, and make walking or sitting difficult.
No. Piercing or squeezing a cyst yourself increases the risk of injury and infection. If the lesion hurts, is growing or keeps coming back, the method of treatment should be decided by a doctor.
They may, but not every blister means HSV. With herpes, painful blisters often appear and then turn into erosions or ulcers. A fresh lesion can be tested by taking a sample from it for a molecular test.
Not every raised lesion is a genital wart. Physiological bumps, fibromas and other benign lesions can also occur on the vulva. Warts associated with HPV have a characteristic appearance, but if in doubt, the diagnosis should be confirmed by a doctor.
Not always. Itching can occur with candidiasis, but also with allergy and irritation, contact eczema, lichen sclerosus and other skin conditions of the vulva. Chronic itching in particular should not be treated on your own with antifungal preparations for months without establishing the cause.
Most lesions have benign causes, but lumps and ulcers that persist, grow, bleed or do not heal in particular require a consultation. Chronic itching and a marked change in the colour or texture of the skin of the vulva also need to be checked.
No. Some lesions resolve on their own, some require treatment with medication, and others can simply be observed. Removal is considered, among others, for lesions that cause complaints, keep coming back, are mechanically irritated or require histopathological examination.
It depends on the type of lesion and how it was removed. Histopathology is particularly important for atypical, ambiguous, rapidly growing, ulcerated or bleeding lesions, or those whose nature cannot be reliably determined during the examination.
Yes. An external lesion of the vulva can also be assessed during a period. However, if additional swabs or other tests are planned, the doctor may recommend doing them at another time. With a painful lump, an abscess or a rapidly developing lesion, it is not worth postponing the consultation just because of bleeding.
A more urgent consultation is needed in particular for a lump that grows quickly within hours or a few days, is very painful, red, hot, discharges pus or is accompanied by fever. Such a picture may correspond, among others, to a Bartholin abscess.
Price list for the diagnosis and treatment of vulval lesions
Service available at the following clinics:
- Warsaw Wola - price list
Have questions? Contact us - 22 100 45 20.