Vulvar skin disorders

What is the vulva?


What is folliculitis?

Folliculitis appears as small, red, and sometimes painful bumps caused by bacteria that infect a hair follicle. It can occur on the labia majora. This can happen because of shaving, waxing, or even friction. Folliculitis often goes away by itself. Attention to hygiene, wearing loose clothing, and warm compresses applied to the area can help speed up the healing process. If the bumps do not go away or they get bigger, see your health care provider. You may need additional treatment.

What is contact dermatitis?

Contact dermatitis is caused by irritation of the skin by things such as soaps, fabrics, or perfumes. Signs and symptoms can include extreme itching, rawness, stinging, burning, and pain. Treatment involves avoidance of the source of irritation and stopping the itching so that the skin can heal. Ice packs or cold compresses can reduce irritation. A thin layer of plain petroleum jelly can be applied to protect the skin. Medication may be needed for severe cases.

What is lichen simplex chronicus?

Lichen simplex chronicus may be a result of contact dermatitis or other skin disorder that has been present for a long time. Thickened, scaly areas called “plaques” appear on the vulvar skin. These plaques cause intense itching that may interfere with sleep. Treatment involves stopping the “itch-scratch” cycle so that the skin can heal. Steroid creams often are used for this purpose. The underlying condition should be treated as well.

What is lichen sclerosus?

Lichen sclerosus is a skin disorder that can cause itching, burning, pain during sex, and tears in the skin. The vulvar skin may appear thin, white, and crinkled. White bumps may be present with dark purple coloring. A steroid cream is used to treat lichen sclerosus.

What is lichen planus?

Lichen planus is a skin disorder that most commonly occurs on the mucous membranes of the mouth. Occasionally, it also affects the skin of the genitals. Itching, soreness, burning, and abnormal discharge may occur. The appearance of lichen planus is varied. There may be white streaks on the vulvar skin, or the entire surface may be white. There may be bumps that are dark pink in color.

Treatment of lichen planus may include medicated creams or ointments, vaginal tablets, prescription pills, or injections. This condition is difficult to treat and usually involves long-term treatment and follow-up.

What is vulvodynia?

Vulvodynia means “vulvar pain.” The pain can occur when the area is touched or it can occur without touch. There are two types of vulvodynia: generalized and localized (see FAQ127 “Vulvodynia”). With generalized vulvodynia, the pain occurs over a large area of the vulva. With localized vulvodynia, the pain is felt on a smaller area, such as the vestibule. Vulvodynia usually is described as burning, stinging, irritation, or rawness. The skin of the vulva usually looks normal. A variety of methods are used to treat vulvodynia, including self-care measures, medications, dietary changes, biofeedback training, physical therapy, sexual counseling, or surgery.

What is genitourinary syndrome of menopause?

Genitourinary syndrome of menopause is a group of signs and symptoms caused by the decreased estrogen levels that occur in perimenopause and menopause. Signs and symptoms include soreness, irritation, and dryness. Pain may occur during sexual intercourse. The vulva becomes more sensitive to irritants. Infections may occur more easily. In severe cases, vulvar skin may crack and bleed. This condition is treated with medications containing estrogen that are applied to the skin or inserted into the vagina.

What is vulvar intraepithelial neoplasia (VIN)?

Vulvar intraepithelial neoplasia (VIN) is the presence of abnormal vulvar cells that are not yet cancer. VIN often is caused by human papillomavirus (HPV) infection. Signs and symptoms include itching, burning, or abnormal skin that may be bumpy, smooth, or a different color like white, brown, or red. VIN should be treated to prevent the development of cancer. VIN can be treated with a cream that is applied to the skin, laser treatment, or surgery. The HPV vaccine that protects against four types of HPV and the HPV vaccine that protects against nine types of HPV can help prevent VIN caused by these HPV types.

What causes vulvar cancer?

Vulvar cancer can be caused by infection with HPV. Other forms of cancer that can affect the vulva include melanoma (skin cancer) or Paget disease. Paget disease of the vulva may be a sign of cancer in another area of the body, such as the breast or colon. Signs and symptoms may include itching, burning, inflammation, or pain. Other symptoms of cancer include a lump or sore on the vulva, changes in the skin color, or a bump in the groin. The type of treatment depends on the stage of cancer. Surgery often is needed to remove all cancerous tissue. Radiation therapy and chemotherapy also may be needed in addition to surgery.

What self-care measures can help prevent or clear up vulvar problems?

Keep your vulva clean by rinsing with warm water and gently patting, not rubbing, it dry.

Do not wear tight-fitting pants or underwear. Wear only cotton underwear.

Do not wear pantyhose (unless they have a cotton crotch).

Do not use pads or tampons that contain a deodorant or a plastic coating.

Do not use perfumed soap or scented toilet paper.

Do not douche or use feminine sprays or talcum powders.