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A worrier’s guide to vaginal lumps and bumps

Having a lump or bump springing up on any part of your body can be worrying, but there's something particularly stomach-churning when it erupts on or around your vagina.

It may appear to be a sinister-looking new arrival to your body, however, these things are usually fairly harmless and are almost always easy to treat. But it's good to know what to look out juuuust in case it turns out to be more serious (the more we know, the better, right?).

So, how can you tell what lumps, spots and ingrown hairs are serious, and made need medical treatment - and what aren’t? We spoke to a number of experts, including Dr Samantha Wild, Women’s Health Clinical Lead at Bupa Health Clinics, London-based gynaecologist Dr Anita Mitra, aka Gynae Geek, as well as Dr Melanie Bone, an OBGYN and member of Daye's medical board, to get to grips with the various things that can grow in your lady garden.

What's the difference between the vulva and the vagina?

First things first, we're going to give you all a quick anatomy lesson about where we're talking about. Because before you tell your doctor you've got a lump on your labia, you need to make sure you actually do have a lump on your labia. Not your vagina.

"Sometimes, people use ‘vagina’ and ‘vulva’ interchangeably, but they mean two separate things," Dr Wild explains.

So firstly, the ~vulva~ refers to the area on the outside of your genitals. "It's the external area between the top of your legs," Dr Wild continues. "It includes your labia (If we're going into detail, there's the inner and outer set of labia lips aka the labia minora and labia majora), clitoris, vaginal opening and urethra (the hole you pee from), pubis (the fleshy bit where your pubic hair grows) and your anus.

In terms of lumps and bumps in this area, they're typically pretty common and more often than not there's nothing to worry about (the main culprits are usually ingrown hairs that especially thrive amongst those of us who shave or wax, but we'll get to that in a minute. However, if you are worried, don't ignore it - make an appointment with your doctor straight away, even if it is just for peace of mind).

The ~vagina~ on the other hand, is the internal part. "The vagina is a stretchy, muscular tube that connects your vulva to your cervix and uterus," explains Dr Wild. "This is where you’re able to feel sexual pleasure, and where menstrual blood and babies pass through the body."

However, while bumps in the vagina are normally less common than vulval ones, they can also be caused by a variety of harmless things, from vaginal cysts to scarring from giving birth. FYI, just because they're not seen as frequently it doesn't mean you'll be branded as a medical anomaly. But again - if you're concerned - call your doctor.

Now we've got that straight, let's unpack some of the lumps and bumps that can develop in your genital area, and which require a trip to see your GP...

a woman in a white garment
jacoblund - Getty Images

Ingrown hairs

What are they?

Most of us are probably well acquainted with ingrown hairs. Because ingrown hairs on your vagina or genital area are totally normal. “Ingrown hairs are where the hair starts to grow back on itself so that it curls back down into the skin rather than coming out of the surface; they often form a ‘head’ like a spot does, and you can often see a hair inside,” says Dr. Anita.

“Just because it may have a white head, doesn’t necessarily mean it’s infected or full of pus. The white stuff is sebum and oil that your skin usually makes, but is now trapped underneath the skin.”

There are ways to prevent ingrown hairs, explains Dr. Wild: "When shaving, use shaving gel. Shave in the direction the hairs are growing and rinse the razor after every stroke, or you can use hair removal creams instead of shaving."

Wild adds you should "avoid scratching, picking, or squeezing ingrown hairs" to prevent scarring and infections.

Does it require a doctor’s visit?

“If the ingrown hair is very large and very, very painful with red sore skin around or, in some rare cases, you can start to feel unwell with high fever - pop some paracetamol and ibuprofen and call your GP. You may need some antibiotic cream/tablets," Dr Anita says.

“Folliculitis is a slightly more serious condition that can result from hair removal; rather than just one isolated hair being affected, large clusters of hair follicles may be red, inflamed, bumpy and can look like acne or a rash. It’s often caused by a bacterial Staphylococcus infection and needs to be seen by a doctor, and may need antibiotic/anti-fungal or steroid treatment.”

How are they treated?

Dr Bone explains if ingrown hairs do develop: “They can often be treated with warm compresses and gentle exfoliation. Remember to not squeeze or irritate the ingrown hair as this can lead to redness and swelling, infection, and possibly permanent scarring.”

Rashes (itchy or non-itchy)

What are they?

If you suffer from eczema or psoriasis, you’ll probably recognise it if it’s spread to your nether regions. “These can both affect the vulval area and tend to be very itchy with their own characteristic appearance,” says Dr. Anita.

“Lichen planus is another kind of itchy rash which can also be red and inflamed to start with but can cause white, scarred areas which can eventually narrow the entrance to the vagina. Lichen sclerosis is a less common skin condition, which may or may not itch, and causes a pearly white discolouration of the vulval skin.

Thrush (also known as vulvovaginal candidiasis) is the most common cause of vaginal itching, but doesn't often cause a rash.”

Dr Wild added that vulvitis, an inflammation of the vulva, and vaginitis, an inflammation of the vagina may result in rash.

Dr Bone warns of bacterial vaginosis, which does not cause a rash but can also cause itchiness.

Sometimes, though, it can be something as simple as your washing detergent, she explains.

“In addition, wearing tight clothes or sweaty workout gear can also cause rashes and itchiness. Occasionally, rashes and itchiness are related to laundry soap or softeners, especially scented varieties. Treatment depends on the cause and may involve keeping the area clean and dry, using unscented, hypoallergenic laundry detergents, using topical creams, or seeking medical advice.”

a woman wearing grey underwear
jacoblund - Getty Images

Does it require a doctor's visit?

“If you’re certain it's thrush or have a high suspicion, you can try and treat it with over-the-counter medication such as Canesten,” says Dr Anita. “But if that doesn’t work, and there is a definite rash or something else you’re worried about, then you do need to go and see your GP to find out exactly what it is. The treatments may be subtly different, and may even require a small skin biopsy to determine the exact condition.”

How are they treated?

“Often with steroid creams, but may involve a trip to a dermatologist for a specialist treatment plan.”

Varicose veins

What are they?

We bet you thought you could only get these in your legs. Bad news: you can also get varicose veins of the vulva.

“These are known as vulvar varicosities, and they can cause swelling of the vulva, a sensation of pressure and discomfort,” Dr Wild says. “Most commonly, this condition affects you if you’re pregnant, as more blood flows to the area around your genitals and pelvis at this time.

“This also slows the blood flow from the lower part of your body back up to your heart, so there’s more chance of blood pooling in your vulvar region, which can lead to varicose veins around your vulva, and sometimes your legs, too.”

“They appear like blueish lumps, on the labia majora or minora, that are soft and will go away temporarily if you put pressure on the area, but rise up again when you take your fingers away,” says Dr. Anita. “They can be itchy and sometimes bleed, and are often accompanied by a heavy sensation.”

So what causes them in this area? “Varicose veins in the vaginal area can develop due to increased pressure on the blood vessels,” explains Dr. Bone. “This mostly happens during pregnancy, but can also happen as a result of exerting a lot of pressure in your pelvis through heavy workouts or when constipated.”

Do they require a doctor's visit?

“As with most things around the vulva, because it can be difficult for you to be sure of the diagnosis, it’s worth seeing your GP to ensure that’s exactly what they are,” Dr Anita explains.

How are they treated?

“Treatment for varicose veins in the vaginal area may include lifestyle changes, such as elevating your legs regularly and wearing compression underwear,” says Dr. Bone. “In severe cases, medical procedures like sclerotherapy or laser therapy may be necessary. Consult a healthcare provider for further guidance.”

“Usually, vulvar varicosities go away when your baby is born, without treatment,” Dr Wild adds. “They can be managed by using cold compresses, not sitting or standing for long periods at a time and changing position regularly.”

Genital warts

What are they?

There’s a lot of confusion around genital warts and what exactly causes them.

“A lot of people think they’re caused by herpes, but they're actually caused by the Human Papilloma Virus (HPV), which is in the same family of wart virus that causes cervical cancer,” says Dr. Anita.

“The types that cause warts, however, are called ‘low-risk HPV’ because they don't cause cancer, so having warts won't increase your risk. HPV warts are transmitted through sexual contact and are usually fleshy and non-painful, although they can itch, bleed and cause irritation during sex.”

Do they require a doctor's visit?

“Yes, to confirm the diagnosis. It may also be worth visiting the sexual health clinic because about 20% of people with genital warts also have another sexually transmitted infection.”

How are they treated?

“One-third of cases will go away on their own within six months; you may be offered a cream to treat them or treatment to remove them by freezing or surgery,” says Dr. Anita. “These are normally done by sexual health specialists or a dermatologist/gynaecologist at a specialist clinic for vulval skin problems.”

Herpes

What is it?

“Genital herpes is caused by Herpes Simplex Virus type 1 or 2; type 1 also causes cold sores, and the most common way for a woman to get genital herpes is through oral sex,” Dr Anita tells us. “It typically causes a tingling/itching followed by the formation of small red blisters which then pop, release a clear/yellowish fluid and then form ulcers which can scab over and disappear.

“They can cause intense pain when urinating; you may also have flu-like symptoms at the same time including aching muscles and joints, a high fever and nausea/vomiting. The first episode tends to be the worst and lasts about 2-3 weeks, while subsequent episodes may be shorter and less severe.”

woman in her underwear
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Does it require a doctor's visit?

“Yes, because it's important to be sure of the diagnosis in women in particular because outbreaks can happen in pregnancy, which requires prompt treatment. Many doctors will also give you treatment from 36 weeks of pregnancy to reduce the risk of an outbreak around the time of delivery, and therefore reduce the risk of transmission to the baby.”

How is it treated?

“With an antiviral medication called acyclovir - it’s more effective the sooner it’s taken from the onset of symptoms.”

Bartholin's cysts/abscesses

What are they?

Cysts are build-ups of fluid caused by a blockage. “The Bartholin's gland sits on the edge of the entrance to the vagina and makes a mucus-like secretion which acts as a lubricant. If this gland opening gets blocked it will cause a cyst, because the fluid is still made, but can’t escape,” says Dr. Anita. “These can range from the size of a pea to the size of a golf ball. Typically larger means more uncomfortable, but they are not dangerous.”

If they are small, you might not even know you have one, says Dr Wild: “Sometimes they’re found during cervical screening tests, or through other examinations of the area.”

However, they can lead to complications.

“These cysts can get infected by the bacteria that normally lives on your skin in that area,” continues Dr. Anita. “This is called a Bartholin’s abscess, and they can get even larger and more painful than a cyst, making it uncomfortable to walk, sit or have sex. They’re surprisingly common and some people may get recurrent cysts/abscesses. Smoking increases the risk of getting a Bartholin's abscess.”

Do they require a doctor's visit?

“These should be checked by a doctor to decide whether it’s a cyst or an abscess.”

How are they treated?

Usually, cysts won’t require any treatment. “Treatment options for Bartholin's cysts or abscesses range from home care, such as warm compresses and sitz baths, to medical procedures like drainage or marsupialisation (creating a permanent drainage window in the cyst),” says Dr. Bone. “The appropriate treatment will depend on the size and severity of the cyst or abscess. Consult a healthcare professional for a proper evaluation and treatment plan.”

Labial cysts

What are they?

“Similar to a Bartholin’s cyst, these are also blocked glands, but they don’t generally have the potential to get as big as a Bartholin’s cyst,” says Dr. Anita.

“They can also get infected, and are treated in the same way.”

Do they require a doctor's visit?

Same as above - let your doctor check whether it’s a cyst or an abscess.

How are they treated?

This one’s also the same as Bartholin’s cyst. Cysts won't require treatment, but an abscess might.

a woman poses in underwear hiding crotch
Marina Demeshko - Getty Images

Vaginal cysts

What are they?

Cysts aren’t just limited to Bartholin and Labial, guys. “These cysts are pearly white lumps around the size of a pea on the wall of the vagina,” says Dr. Anita. “They can sometimes happen after childbirth, particularly if you had a cut or a tear.”

Do they require a doctor's visit?

“It’s worth having them looked at to check that’s exactly what they are because they may be difficult for you to see yourself,” advises the expert.

How are they treated?

“They don’t usually require treatment unless they are very large or painful, and they don’t usually get infected.”

Tumours

What are they?

When we find a new growth or weird rash, it’s totally normal for our brains to jump straight to thinking it’s a lump indicating vaginal cancer.

It’s normal to panic, but as Dr. Anita explains, “vulval cancers are very rare, and vaginal cancers even more so. There are only about 1400 cases of vulval cancer and 250 cases of vaginal cancer diagnosed in the UK each year. Women with lichen sclerosis or lichen planus are slightly more likely to get a vulval cancer, but it’s still very uncommon. They are often associated with HPV, and are more common in smokers and women who have gone through the menopause.”

Do they require a doctor's visit?

For peace of mind, yes. “Any unusual lumps/bumps/thickened patches of skin that are itching/bleeding/burning, don’t go away or are associated with abnormal vaginal discharge or bleeding should prompt you to make a GP appointment,” advises Dr. Anita. “It’s more likely to be one of the things mentioned above - but that's why it’s always worth checking.”

How are they treated?

“Treatment varies depending on the type of tumour and whether it has spread.”

The moral of the story? If in doubt, go and see your doctor - to stop you wondering what it could be, and to find out what it actually is.

This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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