Evaluation of vulval symptoms and skin changes

Vulval and labial conditions are common and may cause discomfort, pain, or concern. Early assessment is important for accurate diagnosis and treatment.

  • Vulval and labial lesions are changes in the appearance or texture of the vulva (the external female genital area) or labia (the lips of the vagina). These lesions can be caused by various factors, including infections, skin conditions, or even cancer. They can manifest as sores, bumps, lumps, or discoloration. 

    Common Types of Vulval and Labial Lesions:

    • Vulvar Warts - Small, flesh-coloured bumps caused by the human papillomavirus (HPV). 

    • Vulvar Squamous Intraepithelial Lesions (SILs) - Precancerous changes in the vulvar skin, classified as low-grade (LSIL) or high-grade (HSIL). 

    • Vulvar Ulcers - Sores or breaks in the skin of the vulva, often caused by STIs or other infections. 

    • Cysts - Fluid-filled sacs that can develop on the vulva, such as Bartholin's gland cysts or vestibular mucinous cysts. 

    • Skin Conditions - Conditions like eczema, psoriasis, or lichen sclerosis can cause skin changes on the vulva. 

    • Vulvar Cancer - While less common, certain types of vulvar cancer can present as lesions. 

    Symptoms:

    • Itching, burning, or stinging sensations.

    • Pain or discomfort during sexual activity.

    • Changes in skin appearance, such as redness, discoloration, or bumps.

    • Abnormal discharge or bleeding.

    • Ulcers or sores. 

    Causes:

    • Infections: STIs like herpes, HPV, or other bacterial or fungal infections. 

    • Skin Conditions: Eczema, psoriasis, lichen sclerosis, and other skin disorders. 

    • Trauma or Injury: Minor scratches or injuries can lead to sores or inflammation. 

    • Cancer: Certain types of vulvar cancer can present as lesions. 

    • Other Factors: Allergies, irritants, or certain medications can also cause vulval lesions. 

  • Vulvar and labial lesions, or sores on the vulva and labia, can be caused by a variety of factors, including sexually transmitted infections (STIs), non-sexually transmitted infections, and other skin conditions. 

    Sexually Transmitted Infections (STIs):

    • Herpes simplex virus (HSV) - Causes painful, blister-like lesions.

    • Syphilis - Can cause painless ulcers (chancres).

    • Chancroid - A small, painful bump that develops into an ulcer.

    • Genital warts - Caused by the human papillomavirus (HPV) and appear as raised, cauliflower-like growths.

    • Lymphogranuloma venereum (LGV) - Can cause painless ulcers. 

    Non-Sexually Transmitted Infections:

    • Yeast infections - Caused by the fungus Candida, leading to itching, burning, and sometimes lesions. 

    • Bacterial infections - Can cause various types of sores. 

    • Other viral infections - Like chickenpox, shingles, or hand, foot, and mouth disease, which can sometimes affect the vulva. 

    Other Causes:

    • Lichen sclerosis - A skin condition that can cause white, itchy patches on the vulva, sometimes mistaken for cancer. 

    • Vulvar intraepithelial neoplasia (VIN) - Abnormal cell changes in the vulva, often related to HPV. 

    • Vulvar cancer - A cancerous growth on the vulva, which can cause sores and lumps. 

    • Allergic reactions - Sensitivity to soaps, detergents, or personal care products can cause irritation and lesions. 

    • Contact dermatitis - Irritation from chemicals, irritants, or prolonged contact with certain substances. 

    • Trauma - Scratching, rubbing, or chafing can damage the skin and lead to sores. 

    • Autoimmune diseases - Conditions like Crohn's disease or systemic lupus erythematosus can sometimes cause vulvar sores. 

    • Ingrown hairs - Can occur after hair removal. 

    • Sebaceous or Bartholin's gland cysts - Blocked glands or ducts that can form lumps, sometimes becoming painful or infected. 

  • It's crucial to seek medical attention for any new or concerning vulval or labial changes. A doctor can properly diagnose the cause of the lesions and recommend appropriate treatment. Treatment options may include medications, creams, procedures, or surgery, depending on the underlying cause and severity of the lesions. 

    Treatment depends on the cause and may include:

    • Topical medications

    • Oral medication

    • Surgical treatment where indicated

  • https://www.healthdirect.gov.au/vulval-conditions

    RANZCOG Patient Information Resources

Frequently Asked Questions

Managing Pap Smear Abnormalities

Frequently Asked Questions

  • The Cervical Screening Test is a quick and simple procedure to check the health of your cervix.

    The Cervical Screening Test replaces the two-yearly Pap test for people. If you’re aged 25 to 74 you should have your first Cervical Screening Test two years after your last Pap test.

    The Cervical Screening Test will look and feel the same as the Pap test.

    The Pap test looked for cell changes in the cervix, whereas the Cervical Screening Test looks for the human papillomavirus (known as HPV) which can lead to cell changes in the cervix.

    HPV is a common virus that can cause changes to cells in your cervix, which in rare cases can develop into cervical cancer.

    Once you have had your first Cervical Screening Test, you will only need to have one every five years instead of every two, if your results are clear.

  • An abnormal result usually indicates the presence of HPV or abnormal cervical cells. Most abnormalities do not mean cancer and are treatable when detected early.

  • The test is a quick and simple procedure to check the health of your cervix. Your cervix is the opening of the uterus (neck of the womb), and is at the top of your vagina.

    If you have ever had a Pap test before, the way your healthcare provider does the Cervical Screening Test will look and feel the same.

    The procedure might be a bit uncomfortable, but it shouldn’t hurt.

  • If you are 25 to 74 years old and have had a Pap test, you should have your first Cervical Screening Test two years after your last Pap test.

    If you have symptoms at any age, such as abnormal vaginal bleeding, pain or discharge, you should discuss these with your healthcare provider immediately.

  • Return to screen in five years

    Your results show you do not have a HPV infection. The National Cervical Screening Program will send you a reminder to have your next Cervical Screening Test in five years.

    Return to screen in 12 months

    Your results show you do not need further investigation but you should have a repeat test in 12 months.

    This is because you have a HPV infection. It is likely to be cleared by your body within the next 12 months.

    The repeat test checks if the infection has gone and if so, you are safe to return to five yearly screening.

    If the repeat test shows a HPV infection is still present, you may need further investigation from a specialist.

    If you have a HPV infection, it does not mean you have cervical cancer. It takes about 10 to 15 years for cervical cancer to develop, and cervical cancer is a rare outcome.

    Refer to a specialist

    Your results show you have:

    • A type of HPV infection that requires further investigation, or,

    • Abnormal cells were found that require treatment

    Your healthcare provider will refer you to a specialist for a follow-up test called a colposcopy test.
    Unsatisfactory test result

    An unsatisfactory test result means the laboratory cannot read your sample. This means you will need to come back for a repeat test in six weeks.

    This result might happen if the number of cells collected is too small. An unsatisfactory result does not mean there is something wrong.

  • If your healthcare provider refers you to a specialist for a follow-up test, they will perform a colposcopy test.

    A colposcopy is an examination of your cervix. During this examination, the specialist will use a device called a colposcope (which looks like a pair of binoculars on a stand) to get a magnified view of your cervix.

  • To have a colposcopy test, your specialist will ask you to lie on an examination bed with your legs supported, in a similar position to when you have a Cervical Screening Test. Like the Cervical Screening Test, the specialist will insert a speculum into your vagina. The specialist will then put a special liquid onto your cervix to highlight any abnormal cells.

    The specialist will then look through the colposcope to carefully examine your cervix. The colposcope itself does not enter your body.

    This examination usually takes 10 to 15 minutes and most people do not experience any pain. However, you may have some discomfort from having the speculum inside your vagina.

  • If areas of your cervix appear abnormal during a colposcopy test, the specialist may take a small sample of tissue to send to a laboratory for testing. This is a biopsy.

    If you have a biopsy, you may have some pain for a short time.

    It may take up to two weeks for the results of your biopsy to come back to your healthcare provider. When the results are back, you should make an appointment with your healthcare provider to discuss the findings and talk about treatment, if needed.

  • If abnormal cells are found during your colposcopy, further treatment may be required.

    Treatment options may include:

    Wire loop excision

    During this procedure, the abnormal cells are removed from your cervix with a wire loop. The procedure takes 15 to 30 minutes.

    Cone biopsy

    In this minor operation, a cone-shaped section of the cervix which contains the abnormal cells is removed. A general anaesthetic is normally needed and a day or overnight hospital stay for recovery may also be required.

  • https://ranzcog.edu.au/womens-health/patient-information/