Vulval Skin Changes

You may notice itching, soreness, burning, tenderness, dryness, or a change in sensitivity. Visible changes can include white or pale patches, redness, thickened skin, small raised bumps, cracks, blisters, ulcers, or a new area that bleeds or does not settle. Some changes cause little discomfort, while others become more noticeable with friction, urination, sex, or washing.

Vulval skin is affected by moisture, rubbing, products, hormones, and skin conditions. A new change does not identify its cause by appearance alone.

Arrange a clinical assessment if a change persists, returns, spreads, or is accompanied by ongoing itch, pain, bleeding, an ulcer, a lump, or a sore that does not heal. Seek prompt care for severe pain, rapidly increasing swelling, fever, or difficulty passing urine. These signs need assessment because infection, inflammation, and other conditions can require different treatment.

The causes below are listed alphabetically, not as a likelihood ranking. Genital warts can produce small, flesh-coloured or rough growths. Lichen sclerosus can cause pale, fragile, itchy skin and cracks. Vulval cancer can present as a persistent patch, lump, ulcer, colour change, or sore; a vulval skin change is not proof of cancer.

A clinician will ask when the change began, whether it itches or hurts, whether it has altered, and which products or treatments you use. They may inspect the vulval skin and nearby areas, and may gently examine a sore, lump, or patch. A swab can help when infection is suspected. If the appearance remains unclear or a concerning area needs checking, a small biopsy may be offered; local anaesthetic is used and the tissue is examined.

Care is matched to the finding. Genital warts may be monitored or treated with a clinician-selected medicine or procedure. Lichen sclerosus is often managed with a prescribed topical steroid and follow-up to check the skin. A suspicious or confirmed vulval cancer needs specialist assessment and an individual treatment plan. Do not apply wart products, antiseptics, or steroid creams to vulval skin unless a clinician has advised that product and how to use it.

Wash gently with lukewarm water or a mild, fragrance-free cleanser, then pat dry. Avoid scented wipes, deodorants, bubble bath, harsh scrubbing, and unnecessary antiseptics. Choose breathable underwear, change out of damp clothing, and reduce rubbing while the skin is sore. Use condoms or other barrier protection to reduce the spread of some infections, although they do not cover every area of vulval skin. Follow prescribed treatment and attend reviews if a condition can recur.

Tell the clinician about discharge, odour, pain during sex, burning when passing urine, bleeding after sex, pelvic pain, or sores. The combination and timing of symptoms can guide which examination or test is useful.

You may be reassured after an examination, given skin-care advice, or offered a swab, treatment trial, or biopsy. Persistent or changing findings may lead to referral to a gynaecology or dermatology service. Keep track of when the change started and any product, period, sexual, or treatment-related trigger.