Genital sores - female

• Alternative Names

  Sores on the female genitals

• Considerations

  Genital sores may be painful, itchy, produce a discharge, or cause no symptoms at all.

  Because genital lesions or sores can have a negative affect on a person's self-image, many people do not seek proper medical care. All genital sores should be evaluated by a medical professional.

  Itching, painful urination, or painful sexual intercourse often occur with genital lesions.

• Common Causes

  Sores or lesions on the female genitals are often caused by sexually transmitted infections (STIs). STIs that can cause these sores include:

  • Chancroid
  • Genital herpes
  • Granuloma inguinale
  • Molluscum contagiosum
  • Syphilis
  • Genital warts

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

  Nonsexually transmitted diseases may also produce sores on the genitals. In young girls (before puberty), common causes of genital sores include:

  • Atopic dermatitis
  • Contact dermatitis
  • Nonspecific vulvovaginitis

  Less common causes include:

  • Skin conditions such as lichen planus, lichen sclerosis, seborrheic dermatitis, and vitiligo
  • Noncancerous (benign) cysts or abscesses of the Bartholin's or Skene's glands
• Home Care

  Avoid treating yourself before seeing a doctor. It can mask the symptoms and make it more difficult to diagnose the cause of the sore.

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

  If the sores are caused by a sexually transmitted infection, notify your sexual partner so that he or she can be treated. Stop all sexual activity until the sores are no longer infectious.

• Call your health care provider if

  Call your doctor if you:

  • Find any unexplained genital lesion
  • Have a change in a genital lesion
  • Have persistent genital itching that does not go away with home care
  • Think you might have a sexually transmitted infection
  • Also have pelvic pain, fever, vaginal bleeding, or other new symptoms
• What to expect at your health care provider's office

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

  • Type of lesion
    • 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?
    • Have you ever had a similar lesion in the past?
  • Distribution
    • Has the lesion grown larger?
    • Is there an increasing number of lesions?
    • How many lesions are there?
    • Where on the genitals is the lesion located?
  • Other
    • How often do you have sexual activity?
    • What are your hygiene habits?
    • Do you have painful urination?
    • Do you have painful sexual intercourse?
    • Do you have abnormal vaginal drainage?

  The physical examination will usually include a pelvic examination.

  The following tests may be done:

  • Complete blood count (CBC)
  • Blood differential
  • Skin or mucosal biopsy culture

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

• References

  Frumovitz M, Bodurka DC. Neoplastic diseases of the vulva: lichen sclerosus, intraepithelial neoplasia, Paget's disease, carcinoma. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap. 30.

  Eckert L, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap. 22.

Review Date: 12/14/2009

Reviewed By: Daniel N. Sacks, MD, FACOG, Obstetrics & Gynecology in Private Practice, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.