Vulvar Sore

Overview

Vulvar sores are lesions, ulcers, or blisters that develop on the vulva (external female genitalia). These sores can be painful or painless, single or multiple, and may indicate various conditions ranging from minor irritations to serious infections. Prompt medical evaluation is important for proper diagnosis and treatment.

Common Causes

Infectious Causes

  • Herpes simplex virus (HSV): Painful blisters that rupture into ulcers
  • Syphilis: Painless ulcer (chancre) in primary stage
  • Chancroid: Painful, soft ulcers
  • Granuloma inguinale: Beefy red, painless ulcers
  • Lymphogranuloma venereum: Small painless ulcer
  • HPV (genital warts): Raised lesions
  • Yeast infection: Can cause cracks and sores
  • Bacterial infections: Folliculitis, impetigo

Non-Infectious Causes

  • Aphthous ulcers: Canker sore-like lesions
  • Behçet's disease: Recurrent painful ulcers
  • Contact dermatitis: Allergic or irritant reactions
  • Lichen sclerosus: White patches that can ulcerate
  • Lichen planus: Erosive form causes sores
  • Psoriasis: Red, scaly patches
  • Trauma: From scratching, tight clothing, or sexual activity
  • Bartholin's cyst: Can become infected and form abscess
  • Vulvar cancer: Non-healing ulcer (rare)
  • Drug reactions: Fixed drug eruption

Associated Symptoms

  • Pain or burning sensation
  • Itching or irritation
  • Abnormal vaginal discharge
  • Bleeding from sores
  • Painful urination (dysuria)
  • Swollen lymph nodes in groin
  • Fever (with some infections)
  • Pain during intercourse
  • Flu-like symptoms (with initial herpes outbreak)

Diagnosis

  • Visual examination: Appearance and location of sores
  • Medical history: Sexual history, symptoms, medications
  • Viral culture: Swab of sore for HSV
  • PCR testing: For various STIs
  • Blood tests: For syphilis, HIV, HSV antibodies
  • Biopsy: If cancer suspected or diagnosis unclear
  • Dark field microscopy: For syphilis
  • Tzanck smear: For herpes diagnosis

Treatment Options

  • Antiviral medications: Acyclovir, valacyclovir for herpes
  • Antibiotics: For bacterial STIs and infections
  • Topical corticosteroids: For inflammatory conditions
  • Pain management: Topical anesthetics, oral pain relievers
  • Sitz baths: Warm water soaks for comfort
  • Avoid irritants: Fragrance-free products
  • Immunosuppressants: For autoimmune conditions
  • Surgical drainage: For abscesses

Prevention

  • Practice safe sex with barrier methods
  • Limit number of sexual partners
  • Regular STI screening
  • HPV vaccination
  • Avoid irritating products
  • Wear breathable cotton underwear
  • Maintain good hygiene
  • Manage chronic skin conditions

When to Seek Medical Care

See a healthcare provider promptly for:

  • Any new vulvar sore or ulcer
  • Painful blisters or ulcers
  • Sores that don't heal within 2 weeks
  • Multiple or recurring sores
  • Sores with fever or flu-like symptoms
  • Enlarged lymph nodes in groin
  • Recent unprotected sexual contact
  • Partner with known STI
  • Sores that bleed or have unusual appearance

Important: All sexual partners should be informed and evaluated if an STI is diagnosed.