What causes vulval skin changes?

Contact irritation from soaps, pads, laundry products, shaving, or friction can cause redness, swelling, dryness, thickening, or soreness. Lichen sclerosus may present with pale, fragile, itchy skin and can alter the normal texture of the vulva. Genital warts can appear as raised or clustered growths.

A persistent sore, lump, ulcer, patch of altered colour, or area that bleeds needs examination. Vulval cancer is uncommon, but it can present with a skin change that does not settle. A new appearance is not enough to identify the cause by looking at it yourself.

Stop fragranced products and avoid scrubbing, douching, and scratching. Wash gently, pat dry, and choose loose clothing. Take a clear note of when the change began, whether it itches or bleeds, and any new products or medicines. A clinician may recommend topical steroid treatment for vulval skin when inflammation such as lichen sclerosus is diagnosed.

Book an assessment for any persistent or changing patch, lump, ulcer, wart-like growth, bleeding, thickening, or colour change. Seek earlier review for a sore that will not heal, worsening pain, or bleeding without an obvious cause. Examination may be followed by a swab or small biopsy when the appearance is unclear.

Does this look like irritation, lichen sclerosus, genital warts, or another condition? Do I need testing or a biopsy, and which washing or treatment routine will protect the skin?