Vulval lumps, bumps and what to do

When women discover a change to their vulva, it’s common for them to worry. Younger women often think they’ve got an STI, whereas older women tend to assume it’s cancer – then you’ve got all the other worries that fall in between.

As a dermatologist, I’ve seen shame, embarrassment or fear of the worst stop many women from seeking help early. But it’s important to remember that vulval changes happen. Many are treatable, some are completely normal and a lump doesn’t always mean cancer.

If you’ve noticed a change to your vulva, that’s a good thing. It means you know what is and isn’t normal for your body and you can do something about it.

What is the vulva?

The vulva is the external part of the female genitals that you can see. It includes the outer and inner labia and vaginal entrance. Get to know the different parts of the vulva with this diagram.

What could that vulval change be?

The list of vulval lumps, bumps and changes is long. Here are some of the more common, but less serious ones you may find.

Skin tags

Skin tags are small flaps of skin. They can occur on the inner and outer labia and near the vaginal entrance. They don’t need treatment unless they are bothering you.

Cysts

Cysts are common on the outer labia, especially as you age. They look like closed pimples and can vary in size. Cysts can also form on the inner labia and at the vaginal entrance. While cysts are usually harmless, it’s a good idea to get them checked, especially if they get bigger, become painful or cause you concern.

Age spots, freckles and moles

If you don’t look at your vulva often, you may not notice these because they are usually quite flat. They most often occur on the outer labia.

Angiokeratomas

Angiokeratomas are black, blue, purple or red non-cancerous bumps. They usually occur on the outer labia when blood vessels get bigger or break. The bumps can feel rough. They can also be frightening because people often mistake them for skin cancer (melanoma).

Abscesses near the vaginal entrance

Abscesses are infected pockets of pus that are usually red and painful. Sometimes they burst and heal by themselves. Other times you may need medical treatment, such as antibiotics.

Hymenal remnants

These are small amounts of extra tissue near the vaginal entrance. For most women, these don’t cause any problems but for some, they can be irritating or uncomfortable. Hymenal remnants often feel soft to start with but as you age and your hormone levels change, they can harden.

Genital warts

These skin-coloured lumps usually feel firm and rough but can also be flat. You mainly get them through sexual contact with someone who has the virus that causes genital warts. Having these warts can be uncomfortable and distressing. If needed, there are good treatments for genital warts while your body fights the virus.

What else can impact your vulva?

As you age, hormonal changes can affect your vulval skin. This is especially the case around puberty and menopause. You may get harmless lumps and bumps, like you do elsewhere on your body. What makes them special is that you can’t see them easily. Around puberty and in the teenage years, some birth marks can become more noticeable too, again thanks to hormonal changes.

Skin conditions, like eczema, can also impact the vulva. So can ingrown hairs or allergies. You may find yourself allergic to condoms, for example.

Then there’s pregnancy. During a vaginal delivery, stretching of the vulva can cause noticeable changes.

What to do if you spot a change to your vulva

It’s a good idea to visit your doctor if you notice a vulval change, especially if it’s new, persistent, sore, itchy or swollen. The change may be normal, it could be something minor that’s easy to treat, or it could be serious. It’s impossible to be sure unless you get it checked.

Many people find vulval health hard to talk about – even some doctors. Try to find someone with an interest in women’s health that you feel comfortable with. You can also use our tips in How to talk to your doctor about vulval changes to help prepare for your appointment.

Once you find out what the vulva change is, it can be treated, or left alone if it’s harmless. Either way, don’t put off getting it checked.