Sores or lesions on the external female genitalia, or in the vagina, may have a number of possible causes.

Sores or lesions on the female genitalia are often caused by sexually transmitted infections (STIs). Venereal warts, syphilis, genital herpes, chancroid, molluscum contagiosum, and granuloma inguinale are STIs that cause visible and fairly classic-appearing lesions.

Precancerous changes of the vulva (vulvar dysplasia) may appear as white, red, or brown patches on the vulva, and are often accompanied by itching. The vulva can also develop skin cancers such as melanoma and squamous cell carcinoma.

Non-sexually transmitted diseases may also produce lesions on the genitalia. In young girls (before puberty), nonspecific vulvovaginitis, atopic dermatitis, and contact dermatitis are common causes of genital lesions. Other common disorders of the skin, such as lichen planus, seborrheic dermatitis, and vitiligo are less common causes. Rarely, a medical illness can cause genital lesions as one of its symptoms, as in Crohn's disease.

Because genital lesions or sores often adversely affect a person's self-image, many individuals do not seek proper medical care. These lesions may be caused by a malignancy or a sexually transmitted disease, and in every case should be evaluated by a medical professional.

Itching, painful urination, or painful sexual intercourse often accompany genital lesions.

• Benign cysts
• Genital warts
• Vaginal yeast infection (Candida)
• Genital herpes
• Gonorrhea
• Syphilis
• Injury
• Chancroid
• Granuloma inguinale
• Molluscum contagiosum

Avoid self-treatment before seeing a doctor. It can mask the symptoms and make diagnosis of the cause of the sore more difficult.

A sitz bath may be recommended to relieve itching and crusting. Moist lesions can be dried by using a heat lamp.

If the sores are caused by a sexually transmitted disease, the sexual partner should be notified and treated, and all sexual activity should be discontinued until the lesions are no longer infectious.

• You find any unexplained genital lesions.
• You suspect a sexually transmitted disease.
• There is any change in the lesion.

Your doctor will perform a physical examination and ask medical questions to identify:

• Type of lesion
  • Pustule
  • Papule
  • Nodule
  • Open areas (ulcer)
  • Pinpoint red or purple spots (petechiae)
  • Larger red or purple splotch (purpura)
  • Bruise (ecchymosis)
  • Hives or blisters
  • What color is the lesion?
  • How big is it?
  • Is it painful?
  • Does it itch?
  • Is it scaly?
  • Does the border look distinct (sharp) or blurry?
• Time pattern
  • When did you first notice the lesion?
  • How long have you had it?
  • Have you ever had a similar lesion in the past?
• Distribution
  • Has the lesion increased in size?
  • Is there an increasing number of lesions?
  • Is there one lesion or multiple lesions
  • Exactly where on the genitals is the lesion located?
• Other
  • What is the amount and type of sexual activity?
  • What are the hygiene habits?
  • Is there painful urination?
  • Is there painful sexual intercourse?
  • Is there abnormal vaginal drainage?

The physical examination will probably include a pelvic examination.

Diagnostic tests that may be performed include:

• Blood tests such as CBC or blood differential
• Culture and biopsy (skin or mucosal biopsy culture) of the lesions

Treatment may include medications that are applied to the skin or that are taken internally. The type of medication varies depending on the cause, but may include corticosteroids, antiviral drugs, antibiotics, or drugs to control itching.

AFTER SEEING YOUR HEALTH CARE PROVIDER

If you have been diagnosed with a sexually transmitted infection, you are urged to undergo further testing for all other STIs and to notify your sexual partner to undergo testing and treatment.