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Your health is important.
By Aly Walansky — Written on Apr 23, 2019
If we see bumps on our vagina, or in the vaginal area, we are probably assuming almost instantly that it's some sort of infection. For the sake of our vaginal health, we might begin to panic, but these vagina bumps could be so many things, from a skin irritation to ingrown hairs to a "downstairs" version of acne.
Of course, different causes are going to have different remedies, and some are a lot more serious than others. Before you become too worried, read carefully, and if you have any doubt at all, see your dermatologist or doctor immediately. Better safe than sorry!
1. Acne
Acne develops due to a combination of four factors: excess sebum production (usually hormone-related), follicular hyperkeratinization (build up of keratin in the follicles/pores), bacteria on the skin, and inflammatory response in the skin to all of the above.
According to Tsippora Shainhouse, MD, FAAD, a board-certified dermatologist, "Vulvar skin has apocrine sweat glands, but not as many sebaceous glands produce sebum, aka oil, as the scalp, face or chest. Vulvar 'acne' usually presents as folliculitis, discrete abscesses, or a more serious condition called hidradenitis suppurativa."
2. Folliculitis
This refers to inflammation of the hair follicles, aka the pores. Sometimes, skin cells and keratin build up in the follicles, clogging up the opening. This can lead to blackheads in the vulvar area.
Irritation and inflammation due to sweating, constant rubbing, or tugging due to shaving or waxing can cause pink bumps. When combined with skin bacteria or yeast, this can cause pink or pus-filled pimples around the hairs.
"Prevent this by wearing cotton-gusset underwear, which is more breathable for your skin. Change out of sweaty underwear and leggings after working out. Also, consider using an anti-bacterial or benzoyl-peroxide soap in the shower (just use in on the outside; your vagina itself is self-cleaning and prone to irritation from products). Finally, if the pimples persist, see your dermatologist for a prescription topical antibiotic," advises Dr. Shainhouse.
3. Abscess
This is fairly common, so don't be shy if you get one. You can't really prevent these, but there are certain things you can do to manage them.
Says Dr. Shainhouse, "It is a dilated, balloon-like, pus-filled, sealed-off cyst that develops in the base of the follicle. It is deep and it hurts and you can't squeeze it out until the overlying skin gets stretched thin enough to rupture. They usually resolve on their own within a few days. Apply a warm compress for comfort and help it drain if it is ready. If it persists or hurts too much to sit/walk/wear underwear, see your dermatologist to have it lanced. Sometimes you might need an oral antibiotic for a few days."
4. Hidradenitis Suppurativa
This is an inflammatory skin condition that most likely has a genetic or autoimmune component.
"It can range from mild to severe, and often presents with painful, recurrent and persistent cysts, and pus-filled or weeping acne lesions and sinus tracts in the armpits, vulva, buttocks and under/on the breasts. This is a condition that must be managed by a dermatologist, as it waxes and wanes for years, and is often present lifelong once it starts (usually after puberty).
It can be maintained with over-the-counter anti-bacterial washes, prescription topical and oral antibiotics, and injectable biologic immunomodulators. Sometimes the sinus tracts and cysts can be unroofed (cut open) and scraped out or completely excised by a surgeon," Dr. Shainhouse says.
5. Warts
Genital warts can appear as flat or raised, smooth or slightly rough bumps. They are always caused by an HPV virus. And while they are obvious on men, they don't always appear so obvious for women.
According to Dr. Felice Gersh, OB/GYN, "Genital warts can certainly develop and should be treated by a physician. Any disease of the skin can develop on the vulvar skin, including cancers, psoriasis, eczema, moles, and benign tumors. Anything of concern needs to be evaluated by a physician.”
6. Herpes
We've all heard of herpes, but we may not know what to look for when it happens. These present as single or cluster of non-follicular, painful blisters.
"They tend to erupt in the same spot (vulva, buttocks, thigh, lower back) every once in a while, and are extremely contagious through direct contact. Most people can feel the tingle of a new lesion starting. If you take your prescription antiviral medications immediately, you can actually prevent the lesion from developing. For people who get more than six episodes a year, discuss daily suppressive therapy with your dermatologist," says Dr. Shainhouse.
7. Molluscum Contagiosum
These are flesh-colored, umbilicated, non-follicular bumps present on the vulvar area and can spread by shaving over them.
"They can last six months to two years before resolving, or else they can be removed by your dermatologist. They are very contagious (hence the name) through direct skin-to-skin contact, which is why they are technically an STI (sexually transmitted infection)," Dr. Shainhouse shares.
8. Cysts
"Little cysts can form on the skin, called sebaceous cysts and epidermal inclusion cysts,” says Dr. Gersh. But there's no need to worry, because these are of no significance other than cosmetic. And they rarely can become infected.
Aly Walansky is a NY-based lifestyles writer. Her work appears in dozens of digital and print publications regularly. Visit her on Twitter or email her at alywalansky@gmail.com.