A lump in the vaginal area can be very distressing. Here’s a look at why some happen and how to treat them.

Vulval or vaginal lumps come in different shapes, forms and sizes – all of them important.

Quick biology class reminder that the vagina is an elastic tube which extends from the vulva to the first part of the womb or cervix.

The vulva is that part of the woman’s genitals found between the thighs and beginning from the mons pubis or pubic hair area.

It covers the entrance to the bladder and vagina. 

It’s also made of fleshy tissues, including the labia or the lips of the vagina and some glands. 

Vulval (Vaginal) Milia

Let’s begin with vulval milia.

The word milia is the plural of the term milium, which refers to milium cyst. A group of milum cysts is known as milia.

A milium cyst is a small bump that develops on the skin. 

It can be whitish, yellow or pale compared to the rest of the skin and, in most cases, develops due to hard skin protein Keratin being trapped under the skin. This is known as primary milia.

They are most commonly found in babies but also affect adults and are located on the skin around the face, lips, eyelids, and cheeks. They can also affect the genitals.

The skin around the vulva is the same as the skin everywhere else on the body, changing slightly as it approaches the internal organs. 

Imagine how the skin changes from your jaw as it approaches your mouth and lips.

So vulval milia usually present as tiny multiple lumps sized 1-2mm developing around the vulva.

They are mainly benign, i.e. harmless, painless and usually do not grow very large. 

Vulval milia may disappear in a few weeks or last for several months.

While primary milia develop from the trapped keratin under the skin, there can be other causes, usually leading to something blocking the skin ducts that lead to the skin surface.

These are secondary milia and may be caused by certain skin conditions or trauma to the area of skin affected, including burns and skin irritation.

Some skin creams or make-up products can rarely lead to milia forming – hence, avoid products containing the following:

• Lanolin,
• liquid paraffin,
• liquid petroleum,
• paraffin oil/ liquid, and
• petroleum oil/liquid, etc.

Milia could also develop as we age and at a time when the skin can no longer exfoliate itself effectively.

Treating Vulval Milia

 Most times, vulval milial cysts do not need treatments.

 They will go away by themselves – though they could take some weeks or months. 

At home, you could try simple exfoliation to see if they will go away with that treatment. These can include washing the vulva area with gentle exfoliating scrubs (such as jojoba beads, sugar, or finely ground oatmeal) or mild chemical exfoliants like salicylic acid or glycolic acid and soft washcloths or exfoliating gloves with fragrance-free, mild soaps.

We usually advise you not to pop any lumps – in the case of milia, they are made of hard Keratin protein or blocked ducts, which are hard to pop. While trying, you may increase the chance of a skin infection in the area.

However, if they make you uncomfortable and do not get better, you can remove them using different techniques, best under the care of a dermatologist, given that the vulval skin is sensitive.

Depending on the extent or size, your options may be creams to help with skin exfoliation, laser treatment, surgical removal or extraction and so on.

Vulval or Vaginal Pimples

These are benign bumps that develop on the skin of the vulva, commonly on or around the labia. They look red and inflamed – with a whitehead at the tip and are often painful. 

Vulval pimples (also known as vaginal acne) develop from a mix of excess oil produced from the skin and clogging the pores, bacteria and other material.

They appear similar to milia but are not the same:

Milia and pimples are different. Pimples contain a soft core of dead skin cells, skin oil (sebum), and bacteria. If popped, fluid flows from the pore. Milia contain a plug of hardened (keratinised) dead skin cells, and you cannot pop them.

Apart from excess oil clogging the skin pores, other causes of pimples are irritation or contact dermatitis caused by different triggers:

• Condoms or lubricant.
• Douche applicators or fluid.
• Feminine wipes.
• Laundry detergent.
• Scented bath products.
• Semen.
• Sweat.
• Tampons or sanitary pads.
• Urine.
• Vaginal discharge.

Another way vaginal pimples could develop is from folliculitis, when the hair follicles of the pubic hair become infected or inflamed.

You may develop folliculitis from:

• Razor burn.
• Shaving.
• Tight-fitting clothes.
• Unclean water in a bathtub, hot tub or swimming pool.
• Ingrown hairs.

Treating Vulval Pimples

If you have vulval pimples, here are ways you can manage them:

1. Maintain Good Hygiene: Clean the area with a mild, fragrance-free soap and warm water. Avoid harsh or scented products that can irritate the skin.
2. Exfoliation: Exfoliate the area regularly to help prevent ingrown hairs. Be gentle to avoid further irritation. Gentle exfoliation can help prevent the buildup of dead skin cells and debris that may contribute to clogged pores or ingrown hairs. You can use gentle exfoliating products specifically designed for sensitive areas. However, it’s essential to be careful and gentle because excess exfoliation or using harsh products can cause irritation or further skin issues. I’ve said gentle like 5 times? You get the point. Always opt for mild exfoliants and gentle techniques to avoid aggravating the sensitive skin in this area.
3. Loose Clothing: Wear loose-fitting, breathable underwear to reduce friction and irritation.
4. Avoid Tight Clothing: Tight clothing can increase friction and irritation, making ingrown hairs more likely. Opt for loose, cotton underwear.
5. Topical Treatments: Over-the-counter creams with salicylic acid or glycolic acid may help. A warm compress can also soothe irritated areas.
6. Avoid Picking: Refrain from squeezing or picking at pimples, which can lead to infection or scarring.
7. Medical Evaluation: If you have persistent or severe issues, consult a healthcare professional or dermatologist for proper evaluation and treatment.

Vulval Ingrown Hair

This brings us to discussing the topic of ingrown hairs in the vulva.

Ingrown hair around the vulva and vagina can look like red, brown or purple discoloured bumps on the skin – they happen because a strand of hair grows back into the skin after shaving, tweezing or waxing.

They are common, especially around the genitals, and can be painful and itchy.

They are also known as razor bumps, shave bumps or barber bumps.

Anyone who shaves, waxes or removes their pubic hair with tweezers is at risk of ingrown hairs, but they are more common with thick, coarse, or curly hair or in black people.

Why do they happen, though?

Each hair follicle is like a tube or pore within which grows a strand of hair and its root.

When you shave, wax or tweeze your pubic hair, you are removing the hair strand only and not the hair follicle or root. As new hair grows, it may curl back into the skin, leading to ingrown hairs. 

An ingrown hair will usually appear as raised bumps which are sore and itchy, but if they become infected, the bumps will grow into larger and more painful boils containing pus and may lead to abscesses developing.

This is different from the condition Hidradenitis suppurativa, which can also look like boils on the skin of the genitals or armpits and which I will be covering in a separate video.

Treating Vulval Ingrown Hair

So, if you have ingrown hairs – how are they treated?

First, some essential factors to consider are:

How often do you wax, tweeze, or shave, and what type of tools (razors or waxing creams) do you use, as excessive shaving and certain equipment can increase your risk of ingrown hairs?

Additionally, how do you prepare your skin before you shave/wax or tweeze?

So the following suggestions may help prevent this condition for those who shave:

• Avoid shaving dry skin – ensure the skin is prepped first with a gentle wash with a mild soap and warm water.
• Use a clean, sharp razor and always work in the direction of the hair growth, not against it, to reduce the risk of ingrown hairs. You may consider other hair removal methods, like an electric shaver, laser or electrolysis, or depilatory creams to remove hair without shaving. 

If you have ingrown hairs already:

• Stop any more shaving/waxing, or tweezing and allow the hair to grow.
• Use warm compresses on your affected skin for 10 to 15 minutes at a time to open your pores and make it easier for ingrown hairs to release.

If these measures don’t help, your clinician or dermatologist may need to prescribe medications that reduce inflammation and treat infections.

Rarely, they may need to cut into the skin, drain any pus and remove the ingrown hair. 

Importantly, avoid picking at, scratching or trying to pop your ingrown hairs to prevent infection and scarring.

In Summary…

So we’ve successfully analysed these 3 common potentially troublesome vulval skin conditions; don’t sit on a lump in the vaginal area. If you’re not sure, ask your doctor to make sure it’s nothing too serious.

More Reading

• What is an Allergy??
• How Effective Are Acne (Pimple) Patches Spot Treatments Compared to Creams?
• Don’t Panic! Exploring 7 Common Causes of Vaginal Lumps and Bumps
• 5 Reasons to Use CeraVe Foaming Cleanser for Normal to Oily Skin
• 7 Causes and Compelling Reasons You Should Never Ignore Vaginal Lumps

Editing by AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of healthcare conditions to provide evidence-based guidance and to help promote quality healthcare. 

The advice in our material is not meant to replace the management of your specific condition by a qualified healthcare practitioner.
To discuss your condition, don’t hesitate to get in touch with a health practitioner or reach us directly.

Image Credits: Canva