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

Sores or lesions on the female genitalia are often caused by sexually transmitted infections (STIs).

STIs that cause visible and fairly classic-appearing lesions include:

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

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

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 lesions on the genitalia. In young girls (before puberty), nonspecific vulvovaginitis, atopic dermatitis, and contact dermatitis are common causes of genital lesions. Less common causes include lichen planus, lichen sclerosis, seborrheic dermatitis, and vitiligo. Benign cysts or abscesses of the Bartholin's or Skene's glands can cause pain or swelling in areas of the vulva.

Rarely, a medical illness, such as Crohn's disease, can cause genital lesions.

Because genital lesions or sores often adversely affect a person's self-image, many individuals do not seek proper medical care. All genital sores should be evaluated by a medical professional.

Itching, painful urination, or painful sexual intercourse often accompany genital lesions.

• Benign cysts
• Cancer
• Chancroid
• Genital herpes
• Genital warts
• Gonorrhea
• Granuloma inguinale
• HPV
• Injury
• Molluscum contagiosum
• Syphilis
• Vaginal yeast infection (Candida)
• Vulvar dysplasia

Avoid self-treatment before seeing a doctor. It can mask the symptoms and make diagnosis of the cause of the sore more difficult.

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

If the sores are caused by a sexually transmitted infection, the sexual partner should be notified and treated, and all sexual activity should be discontinued until the lesions are no longer infectious.

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 measures
• Think you might have a sexually transmitted infection

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.

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.