Vaginal Bumps: Causes and Treatments

Vaginal pimples and other bumps can often appear around the outer part of the female genitalia (the vulva). They can be caused by ingrown hairs, infected hair follicles, cysts, some sexually transmitted infections, and other health conditions.

Some vaginal bumps can be treated with home remedies and good hygiene practices, while others may need medical treatment.

This article discusses the various causes of vaginal bumps, including vaginal pimples, and how they're diagnosed, treated, and prevented.

Causes of Vaginal Pimples

Pimples occur when pores get clogged. This can be caused by hormonal changes. It can also be caused by external factors.

Vaginal pimples are formed when dirt, sweat, and/or bacteria build up inside a pore, causing inflammation. Poor hygiene (even hanging around in sweaty clothes after working out) can increase your risk of vaginal pimples. So can irritation from lubricant or other body fluids.

True vaginal pimples are just like pimples anywhere else on the body. They're usually small, red bumps, often with a white dot at the tip. Sometimes they can be dark at the tip or red all the way through. Some vaginal pimples may be full of pus, or swollen and painful.

Causes of Other Vaginal Bumps

Several other conditions cause bumps or lesions near the genitals that can easily be mistaken for pimples. They're not always painful, but that doesn't mean they shouldn't be taken seriously.

In some cases, pimple-like bumps are caused by infections that can spread to other people if left untreated. They can also be indicators of another condition that requires medical attention.

Ingrown Hairs

Shaving, waxing, and plucking pubic hair is a common cause of ingrown hairs. In fact, one study reported that 32.7% of women who removed their pubic hair had ingrown hairs at some point or another.

An ingrown hair develops when the hair follicle curves downward, forcing the tip of the hair to curl into the skin. This leads to a "foreign body reaction" characterized by inflammation, itchy papules and pustules, and hyperpigmentation (skin darkening).

Aside from how you groom your hair, certain genetic factors may make you more susceptible. People with thick hair or tight curls are more prone to developing ingrown hairs.

When an ingrown hair develops, the first thing you should do is stop shaving. Usually, this will resolve the irritation within a few days.

If it doesn't, you may need to see a healthcare provider, gynecologist, or dermatologist. They may recommend a topical or oral antibiotic to soothe inflammation and prevent infection.

Left untreated, recurrent ingrown hairs can become chronic (long-lasting) and develop into an infection of the hair follicles known as folliculitis. The symptoms often look similar to other pimples and are treated similarly. Folliculitis can also be caused by tight clothing or sweat irritation.

Vulvar Cysts

Cysts are pocket-like structures filled with fluid that can grow almost anywhere on the body. The majority of cysts aren't cause for worry, but occasionally they can be cancerous or precancerous. It's always a good idea to have them checked by a medical professional.

Bartholin's gland cysts are noncancerous masses that form on either side of the labia. An estimated 2% of women develop at least one in their lifetime. They are most common among women in their 20s.

This type of cyst occurs when a Bartholin's gland—which is responsible for sexual lubrication—becomes clogged. This is frequently a result of injury or E.coli infection.

Because they grow very slowly and are often painless, you may not notice you have a Bartholin's cyst until several years have passed. Some women report experiencing mild discomfort or difficulty urinating.

A range of treatment options are available, depending on how far the cyst has progressed. Your healthcare provider may prescribe antibiotics for smaller cysts. Larger cysts may require surgical drainage. Sometimes, a full excision, or surgical removal, of the gland may be needed to prevent the cyst from growing back.

Other common, noncancerous cysts that can form on the vulva include:

• Milia: Small, harmless cysts that look like whiteheads and tend to heal on their own
• Epidermoid cyst: Hard, painless, and slow-growing cysts also known as sebaceous or keratin cysts
• Lipoma: Painless and slow-growing cysts that are soft to the touch
• Pyogenic granuloma: A red papule that grows rapidly, bleeds easily, and may be crusty or smooth

Vaginal Cysts

At least one in every 200 people with a vagina will develop a vaginal cyst at some point in their lives. The true number is likely higher, though, as many vaginal cysts aren't reported.

Cysts can form as a result of injury to the vaginal walls during childbirth or surgery. They can also occur from a gland that's clogged or a noncancerous tumor in the vaginal lining. Sometimes the cause can't be pinpointed.

Around 10% of benign vaginal cysts are Gartner duct cysts. This is a congenital (present at birth) cyst that commonly goes undetected until later in life. Usually, it's discovered when you visit a healthcare provider or gynecologist for a routine checkup. These cysts have their origin in embryonic development.

Other noncancerous vaginal cysts include:

• Müllerian cyst: Another cyst resulting from leftover embryonic material that can be asymptomatic but can also lead to vaginal bleeding or urinary difficulty later in life
• Inclusion cyst: Small, painless cysts that develop on the back of the vaginal wall, typically caused by injury to the lining during surgery or childbirth

The majority of Gartner duct cysts, Müllerian cysts, and inclusion cysts remain small and painless and require no treatment.

If a cyst is detected during a pelvic exam, your healthcare provider may order an ultrasound or MRI to diagnose it. A biopsy may also be ordered to rule out cancer.

Molluscum Contagiosum

Molluscum contagiosum (MC) is a viral infection that can cause small, raised papules to grow anywhere on the body. There may be just one or a whole cluster. While they're usually painless, they can become quite itchy.

MC papules tend to be smooth and firm with a dimple in the center. They can be pink, white, or flesh-colored in appearance. The infection spreads through sexual or non-sexual skin-to-skin contact. It's most commonly seen in children, sexually active adults, and people who are immunocompromised.

Fortunately, MC infections usually resolve within six to nine months. There are several treatment options to aid with the healing process:

• Cryotherapy, involves treating the MC papules with extreme cold. One study found weekly cryotherapy cleared papules in 70% of patients after three weeks and 100% of patients after 16 weeks. However, it has received some criticism due to the risk of blisters, scars, or hyperpigmentation (darkening of the skin).
• Cutterage, a type of non-invasive, surgical scraping, is also effective at physically removing papules. However, this may cause scarring as well.
• Topical treatments for MC often include such ingredients as cantharidin, potassium hydroxide, imiquimod, iodine, and salicylic acid.
• Immunomodulatory treatments to boost the immune system and antiviral treatments to fight the viral infection may also be considered. As always, treatment should be directed by a healthcare provider.

Varicose Veins

Varicose veins are a common condition in adults. They typically affect superficial (near the surface of the skin) veins in the body's lower extremities.

The condition occurs when there is increased blood pressure in a weak or damaged vein. This causes the vein to become twisted and enlarged and to bulge from the skin.

Varicose veins of the vulva are most prevalent in pregnant and postpartum women. An estimated 18% to 22% of pregnant women have them. As blood pools in the vulvar veins, bumps can form on the outer surface of the labia.

Varicose veins of the vulva can occasionally be misdiagnosed as a Bartholin's gland cyst or a hernia.

While some women do not experience symptoms, others report:

• Swelling of the labia
• Pressure in the vulvar area
• Fatigue
• A painful, burning, or itching sensation

Pregnancy causes an increase of blood flow in the pelvis and genitalia that generally subsides after delivery. Within six weeks, varicose vulvar veins usually go away as well, but if they don't (or they continue to grow), they can be treated with surgery.

The most common procedure is minimally-invasive embolization, in which the varicose vein is blocked to prevent further congestion.

Another option is sclerotherapy. This procedure involves injecting the vein with a solution to close it off. This causes the blood to reroute to other veins.

Genital Warts

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States, affecting tens of millions of people each year.

There are at least 100 different kinds of HPV. Most are considered relatively harmless. Others can cause more serious health problems, such as cervical cancer or genital warts.

The first HPV vaccine was approved by the FDA in 2006. In 2014, a newer version of the vaccine, Gardasil 9, was approved for use in males and females. It has shown to be 88% effective in protecting against nine strains of cancer-causing HPV.

Among those who have not been vaccinated for HPV, only 10% will develop genital warts. If you are infected with a strain of HPV that causes them, warts may not develop for several months. In some cases, they develop years later. When they do develop, they sometimes go unnoticed. They can form in or around the vulva, vagina, or cervix.

Genital warts can vary quite a bit in appearance. They can be raised or flat, smooth or cauliflower-like in texture. They can be flesh-colored or lighter, dark purple or brown. There may just be one or there may be a cluster. While some people experience no symptoms at all, others can have warts that itch or bleed.

In most cases, genital warts will eventually resolve on their own. Available treatment options include:

• Cryotherapy, a procedure that uses extreme cold to remove the warts
• Surgical removal of warts by tangential scissor excision, tangential shave excision, curettage, laser, or electrosurgery
• Antimitotics (podofilox), a solution or gel applied topically to get rid of the warts
• Imiquimod (3.7%) cream, a topical treatment applied at bedtime for up to eight weeks

These may reduce flare-ups, but treatment can't get rid of HPV in the body. Only time can resolve HPV entirely.

Genital Herpes

There are two types of herpes simplex virus (HSV), which are referred to as HSV type 1 and HSV type 2.

In 2016, 47.8% of people between the ages of 14 and 49 were living with HSV type 1 in the United States. That year, 11.9% of people had HSV type 2 as well, making genital herpes one of the most common sexually transmitted infections.

HSV is a lifelong infection with no known cure. Numbers are on the rise, with more women affected than men.

HSV type 1 is usually spread by oral-to-oral contact (cold sores), although oral-to-genital transmission is growing in prevalence.

Genital herpes is mostly caused by HSV type 2 and transmitted via penetrative sex. This type is characterized by recurring herpes sores that come and go at the infection site and are not always symptomatic. Therefore, the infection can easily be spread between two sexual partners without either party realizing it.

Women may develop a genital herpes rash on the vulva, inside the vagina, or on the cervix. Sores tend to be small, clear, filled with fluid, and surrounded by red, irritated skin. They may pop and ooze with green or yellow discharge and can be painful and itchy, accompanied by a burning sensation while urinating.

If the rash develops inside the vagina or on the cervix, it can be misdiagnosed as pelvic inflammatory disease or a urinary tract infection. Approximately 70% of women also report fever, headache, and malaise (feeling unwell) during an outbreak.

Fox-Fordyce Disease

Fox-Fordyce disease is an uncommon disorder that causes chronic inflammation of the apocrine sweat glands. These are glands found in areas with abundant hair follicles, particularly the groin, armpits, and around the nipples.

During a flare-up, the apocrine glands become enlarged and inflamed with intensely itchy papules. Women with this condition often develop multiple, small, firm, and flesh-colored papules on their labia. Scratching them can result in a secondary infection of the hair follicles.

Over 90% of those with Fox-Fordyce disease are women. Researchers aren't sure what causes the condition. However, it's clear that hormones and genetics play a role in its development.

Because the apocrine glands are responsible for producing stress-related perspiration, flare-ups can be caused by emotional stress and consequent hormonal changes. Research also suggests that laser hair removal may trigger the condition in some people.

Treatment options are available, but their success can be limited since they don't prevent stress or perspiration. Your healthcare provider may recommend:

• A topical corticosteroid or retinoid treatment
• Topical clindamycin or benzoyl peroxide
• An oral retinoid, antibiotic, or contraceptive
• Surgical excision of the affected apocrine glands

Vaginal Skin Tags

Skin tags (or "polyps") are painless growths that can form anywhere on the skin. They are usually benign, although postmenopausal women have a higher risk of developing polyps that are malignant (cancerous).

In women, genital polyps can form in the uterus (endometrial polyps), on the cervix or, less commonly, in the vagina. A variety of factors may contribute to their development. They include:

• Obesity
• Diabetes
• Hypertension
• Age
• Changes in steroid sex hormones

Healthcare providers or gynecologists may not detect a polyp unless an ultrasound or a hysteroscopy is ordered.

Their appearances vary. Polyps range in color from reddish-purple to gray or white. The size of the growth also varies. They tend to look like a stem with a bulb on the end.

A range of symptoms have been reported, such as vaginal discharge and bleeding between periods or after sexual intercourse.

Treatment may not be required for polyps that are small or do not cause symptoms. Your healthcare provider may recommend surgical removal of larger or potentially malignant polyps.

Small polyps may be removed in-office using liquid nitrogen. Larger polyps may require hysteroscopic surgery—a procedure that entails being put under anesthesia.

Diagnosis

To diagnose vaginal pimples, your healthcare provider will probably want to examine the pimples. They may be able to diagnose them based on their appearance. You should also let your healthcare provider know:

• When you noticed the pimple(s)
• If the pimples have produced any discharge
• If the outbreak has changed over time
• Whether the pimples are painful or itchy

If the bumps near your vagina don't appear to be pimples, your healthcare provider may also ask you about recent sexual encounters.

Most diagnoses can be made based on the history and physical exam. However, depending on the likely cause, your healthcare provider may perform additional tests (such as an HPV test) to confirm the diagnosis.

Treatment

If your healthcare provider has confirmed your vaginal pimples are pimples, you have a few options for treatment. Mostly, you'll want to focus on good hygiene and keeping your skin clean.

If the vaginal bumps are caused by another condition, your healthcare provider will discuss what types of treatment are available.

Medicine for the Underlying Condition

The skin in your genital area is more sensitive than skin elsewhere on your body, so you should always discuss your options with a healthcare provider before pursuing treatment.

Different conditions require different treatments, which can range from topical to oral medications, subcutaneous medications (injected into the skin), or surgical excision.

While learning about available medications for your condition, you may encounter:

• Oral antibiotics: for ingrown hairs, Fox-Fordyce disease, or Bartholin's gland cysts
• Oral antiviral drugs: for sexually transmitted diseases, such as MC, HPV genital warts, or genital herpes
• Imiquimod cream: for genital herpes, HPV genital warts, or infections like MC
• Oral contraceptives: for Fox-Fordyce disease or excessive acne

Warm or Cool Compress

Warm compresses are useful for soothing painful ingrown hairs or cysts. Cool compresses are better for itchiness.

If your condition is contagious or you suspect it might be, using a compress to relieve discomfort is fine. However, you should take great care to use a clean towel each time. That way, you don't reinfect yourself or spread infection.

To soothe varicose veins, consider using a cool compress, as warmth increases blood flow and causes veins to dilate. Cool compresses may also be more therapeutic for conditions that cause itchy lesions, like MC or Fox-Fordyce disease. Just make sure to dry the skin after.

Topical Treatments

Your healthcare provider may also recommend a topical treatment to help with your pimples. This might be an antibiotic, an antihistamine, or even an acne medication. Understanding the nature of your condition is critical for treating it properly.

For example, using antibiotics kills the skin's "good bacteria" in addition to the bad. For this reason, you should only apply topical antibiotic treatments when your healthcare provider advises you to do so. These treatments are not useful for skin tags or varicose veins.

Always consult with your healthcare provider before using an over-the-counter acne medication to treat vaginal pimples. If they say it's OK to use benzoyl peroxide, stick with low concentrations and only use these creams on external skin.

Prevention

Some things that may help prevent a recurrence of vaginal pimples are:

• Wearing clean, cotton underwear
• Avoiding clothing that is too tight or rubs against your genital region
• Practicing good hygiene, including showering after exercise and changing out of sweaty exercise clothes (rather than sitting in them for hours)
• Changing your menstrual products frequently when you have your period
• Trimming your pubic hair instead of shaving (if the pimples are razor bumps)

If your pimples showed up after you changed your type of soap or laundry detergent, try going back to the old product. It may be that your skin finds the new product irritating and is responding by breaking out.

Sexually Transmitted Infections

If you are sexually active, you can reduce (but not eliminate) the risk of infection by:

• Learning how to use latex condoms properly and using them every time
• Getting Pap smears and HPV tests on the schedule recommended by your healthcare provider
• Being in a mutually monogamous relationship with your sexual partner and asking them to get tested too
• Getting tested for STIs any time you have a new sexual partner

Don't forget that STIs can be transmitted even when you don't have symptoms. For lifelong diseases like genital herpes, be open with your partner and tell them if you are having a herpes flare. Discuss the risks involved and come up with a plan together to have safer sex.

Summary

Vaginal bumps could be pimples or could be caused by another medical condition. Vaginal pimples occur when the pores in your vulva get clogged. Other conditions that could cause vaginal bumps include ingrown hairs, vulvar cysts, varicose veins, and genital warts.

Your healthcare provider can usually diagnose whether a bump is a pimple or something else based on its appearance. To help prevent pimples, practice good hygiene and avoid tight clothing. Prevent bumps caused by STIs by using condoms and getting regular Pap smears and HPV tests.