A vulvar lump or bump may be caused by an STI, skin infection, swollen lymph node, benign cyst, or, rarely, a tumor. Because these conditions can be difficult to distinguish by appearance alone, an OB-GYN examination and additional testing may be needed for an accurate diagnosis.

What should you do if you suddenly notice a lump or bump on your vulva?

Many patients visit our clinic saying:

“Doctor, I found a lump on my vulva!”

“I think there’s some kind of bump down there!”

Today, I’d like to explain the possible causes of vulvar lumps and how they are evaluated.

The vulva can be difficult to see clearly. Sometimes, a lump is discovered unexpectedly while showering or using the bathroom. 

Other patients visit the clinic after suddenly experiencing pain while sitting, walking, or moving.

Various conditions can develop on the vulvar skin, but it is usually difficult to identify the exact cause on your own.

When you feel something unusual, it is natural to search for it on Naver or Google. 

However, many search results seem to suggest that almost every vulvar lesion is a sexually transmitted infection.

Some patients become so frightened that they arrive at the clinic in tears. Others come in after arguing with their partners.

Rather than assuming the cause, it is best to visit an OB-GYN. During the examination, we check when the lesion first appeared, where it is located, how large it is, and what it looks and feels like.

What Can Cause a Lump on the Vulva?

A vulvar lump or bump can have many possible causes.

It may be associated with a viral infection, skin infection, swollen lymph node, benign cyst, blocked gland, or another type of skin growth. In rare cases, a vulvar lesion may require further evaluation to rule out precancerous or cancerous changes.

The appearance of the lesion alone may not always be enough to determine the cause. Its location, size, color, shape, texture, associated pain, and how long it has been present are all important.

Let’s look at some of the more common conditions.

Could It Be a Sexually Transmitted Infection?

One of the first concerns many patients have is whether the lesion could be a sexually transmitted infection.

Common viral infections that may cause lesions around the vulva include genital herpes, condyloma, and molluscum contagiosum.

Genital Herpes

Genital herpes often begins as small, raised blisters.

There are two types of herpes simplex virus: HSV-1 and HSV-2. HSV-1 is commonly associated with oral herpes, while HSV-2 is more commonly associated with genital herpes.

However, the distinction is not always clear. Either type can affect the genital area.

Some patients are surprised when HSV-1 is detected in a genital test and ask:

“Why was type 1 found down there?”

This can occur because herpes may be transmitted through oral sexual contact as well as genital contact.

Testing can determine whether the infection is caused by HSV-1 or HSV-2. However, treatment is generally similar and may include oral antiviral medication and, when appropriate, topical treatment.

Condyloma, or Genital Warts

Another possibility is condyloma, commonly known as genital warts.

Genital warts are caused by certain types of human papillomavirus, or HPV. Raised growths may develop on the genital skin, around the anus, or on the mucosal tissues.

They may resemble small cauliflower-like or comb-shaped projections. They can cause itching or bleeding, although some people have no noticeable symptoms.

Some genital warts have a characteristic pointed appearance, while others may be flatter and more difficult to identify through visual examination alone.

Because not every lesion can be diagnosed with complete certainty by appearance, an HPV test or biopsy may sometimes be necessary to confirm the diagnosis.

Molluscum Contagiosum

Molluscum contagiosum can also cause multiple small bumps around the genital area.

These lesions can spread easily. Instead of appearing in only one or two places, they may develop across a wider area.

Depending on the number, size, and location of the lesions, treatment such as laser cauterization may be considered. In severe cases, dozens of lesions may need to be treated individually.

Could It Be an Infection or Swollen Lymph Node?

Not every painful vulvar lump is caused by an STI.

A boil, skin infection, or swollen lymph node can also produce a tender or noticeable lump around the vulva or groin.

Boils and Skin Infections

A lump may be a boil caused by an infected wound, hair follicle, or damaged area of skin.

A small lesion may remain relatively mild. However, if the infection spreads into the surrounding soft tissue,

 a longer course of antibiotics may be necessary.

Some patients arrive with such severe swelling that they can barely sit, stand, or walk comfortably.

Others develop a tense, painful lump containing pus.

Treatment may include antibiotics and drainage. 

When the surrounding tissue is extremely red and swollen, appropriate antibiotic treatment can often help improve the symptoms within several days.

Swollen Lymph Nodes

A swollen lymph node may also feel like a boil or lump.

There are many lymph nodes in the groin. Just as the tonsils may swell when you have a cold, the lymph nodes in the groin can become enlarged when inflammation or infection is present elsewhere in the body.

These lumps may recur, particularly when you are tired, stressed, or in poor physical condition.

Common Benign Vulvar Lumps

There are also many benign, noncancerous lumps and growths that can develop on the vulva.

These lesions are not necessarily caused by an infection or sexually transmitted disease.

Skin Tags

One common example is a skin tag.

Skin tags are generally harmless and do not usually cause inflammation. 

If they become irritated, uncomfortable, or cosmetically concerning, they may be removed.

They can also occur more frequently in areas exposed to friction.

Sebaceous and Mucous Cysts

A vulvar lump may also be a sebaceous cyst.

Depending on the material contained inside, it may instead be a mucous cyst. These lesions should be evaluated according to their appearance, location, size, and associated symptoms.

Treatment may not always be necessary, but painful, enlarging, inflamed, or recurrent cysts should be examined.

Bartholin Cysts and Abscesses

Another condition we examine carefully is a Bartholin cyst.

A Bartholin cyst develops when the duct of the Bartholin gland becomes blocked. 

Because of its location near the vaginal opening, it may cause noticeable discomfort while sitting, walking, or moving.

When fluid remains trapped inside and becomes infected, the cyst can develop into a painful Bartholin abscess.

A Bartholin cyst or abscess may be treated with a procedure called marsupialization. 

This is a relatively simple procedure that can often be performed under local anesthesia.

The cyst is opened in a way that allows the fluid to continue draining rather than collecting again—

similar to opening a small pouch and keeping the opening from sealing shut.

The appropriate treatment depends on the size of the cyst, the degree of pain, 

whether an infection is present, and whether the condition has occurred repeatedly.

Could a Vulvar Lump Be Cancerous?

Most vulvar lumps are caused by infections or benign conditions. 

However, concerning tumors can occasionally develop.

Conditions that require particular attention include malignant melanoma and vulvar cancer.

Some suspicious lesions can be identified relatively easily by their appearance, 

while others are much more difficult to distinguish from benign lesions.

A lesion may look like nothing more than a slightly raised mole, a discolored area, 

or a firm patch of skin. However, testing may reveal precancerous changes or a tumor.

If a lesion has an unusual color or shape, becomes firmer or larger, bleeds, develops an ulcer, 

or does not heal, a biopsy may be necessary.

That is why certain vulvar lesions should not be diagnosed by appearance alone.

When Should You See an OB-GYN?

It is very difficult to diagnose a vulvar lesion on your own.

Please visit an OB-GYN if you notice a new or unfamiliar lump, especially if it:

• Causes pain, itching, or burning
• Becomes red, swollen, or warm
• Contains fluid or pus
• Bleeds or develops an ulcer
• Increases in size or number
• Repeatedly disappears and returns
• Does not improve or heal
• Has an unusual color, shape, or texture

During the examination, the doctor will evaluate the lesion’s location, size, appearance, and associated symptoms.

Depending on the findings, you may need a bacterial test, viral test, HPV test, or, in some cases, a biopsy.

Treatment varies according to the diagnosis, so identifying the exact cause is the first and most important step.

If you have discovered an unfamiliar lump on your vulva, 

try not to assume that it must be an STI or another serious condition based only on an online search.

Please have the lesion properly examined so you can receive an accurate diagnosis and the appropriate treatment.