What does vulval skin changes feel like with vulval cancer?

You may notice persistent itching, burning, tenderness, or soreness while walking, sitting, washing, or having sex. The skin can look lighter, darker, red, scaly, thickened, raised, or ulcerated. A small lump, open area, or spot that bleeds after gentle contact may also occur. Vulval cancer can develop without severe pain, so a change that remains deserves attention even when it feels mild. Eczema, infection, irritation, lichen sclerosus, and benign growths can look or feel similar; an examination is needed to tell them apart.

Arrange an appointment with a GP, gynaecologist, or specialist vulval clinic if the change is new, persistent, or returning. Before the visit, note when it began, whether the area is changing, and any itching, discharge, bleeding, pain, or lump. Use lukewarm water and unscented products, avoid scratching, and do not apply steroid, antifungal, or other treatment unless advised. A clinician may inspect the skin and recommend a small biopsy if an area needs closer examination.

Seek prompt medical assessment for bleeding without a clear cause, an ulcer that does not heal, a growing lump, severe pain, spreading redness, or difficulty passing urine. Seek urgent help if heavy bleeding, rapidly increasing swelling, fever, or feeling faint occurs. These signs do not identify the cause, but they should not be left until a routine review.

Could this appearance be caused by irritation or another vulval condition? Does the area need a biopsy? How should I care for the skin while it is being assessed? What changes should prompt an earlier review?