Genital sores - female

Definition

Sores or lesions on the female genitalia or in the vagina may have a number of possible causes.

Alternative Names

Sores on the female genitals

Considerations

Genital sores may be painful, itchy, produce a discharge, or cause no symptoms at all.

Because genital lesions or sores can have a negative affect on a person's self-image, many people do not seek proper medical care. All genital sores should be evaluated by a medical professional.

Itching, painful urination, or painful sexual intercourse often occur with genital lesions.

Common Causes

Sores or lesions on the female genitals are often caused by sexually transmitted infections (STIs). STIs that can cause these sores include:

• Chancroid
• Genital herpes
• Granuloma inguinale
• Molluscum contagiosum
• Syphilis
• Genital warts

Precancerous changes of the vulva (vulvar dysplasia) may appear as white, red, or brown patches on the vulva, and may cause itching. The vulva can also develop skin cancers such as melanoma and basal cell and squamous cell carcinomas.

Nonsexually transmitted diseases may also produce sores on the genitals. In young girls (before puberty), common causes of genital sores include:

• Atopic dermatitis
• Contact dermatitis
• Nonspecific vulvovaginitis

Less common causes include:

• Skin conditions such as lichen planus, lichen sclerosis, seborrheic dermatitis, and vitiligo
• Noncancerous (benign) cysts or abscesses of the Bartholin's or Skene's glands

Home Care

Avoid treating yourself before seeing a doctor. It can mask the symptoms and make it more difficult to diagnose the cause of the sore.

A sitz bath may help relieve itching and crusting. Moist lesions can be dried using a heat lamp.

If the sores are caused by a sexually transmitted infection, notify your sexual partner so that he or she can be treated. Stop all sexual activity until the sores are no longer infectious.

Call your health care provider if

Call your doctor if you:

• Find any unexplained genital lesion
• Have a change in a genital lesion
• Have persistent genital itching that does not go away with home care
• Think you might have a sexually transmitted infection
• Also have pelvic pain, fever, vaginal bleeding, or other new symptoms

What to expect at your health care provider's office

Your doctor will perform a physical examination and ask medical questions to identify:

• Type of lesion
  • What color is the lesion?
  • How big is it?
  • Is it painful?
  • Does it itch?
  • Is it scaly?
  • Does the border look distinct (sharp) or blurry?
• Time pattern
  • When did you first notice the lesion?
  • Have you ever had a similar lesion in the past?
• Distribution
  • Has the lesion grown larger?
  • Is there an increasing number of lesions?
  • How many lesions are there?
  • Where on the genitals is the lesion located?
• Other
  • How often do you have sexual activity?
  • What are your hygiene habits?
  • Do you have painful urination?
  • Do you have painful sexual intercourse?
  • Do you have abnormal vaginal drainage?

The physical examination will usually include a pelvic examination.

The following tests may be done:

• Complete blood count (CBC)
• Blood differential
• Skin or mucosal biopsy culture

Treatment may include medications that are applied to the skin or that are taken by mouth. The type of medication depends on the cause, but may include corticosteroids, antiviral drugs, antibiotics, or drugs to control itching.

References

Frumovitz M, Bodurka DC. Neoplastic diseases of the vulva: lichen sclerosus, intraepithelial neoplasia, Paget's disease, carcinoma. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap. 30.

Eckert L, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap. 22.