Here, we speak to London-based gynaecologist Dr Anita Mitra (aka the Gynae Geek) to get to grips with the various things that can grow in and around your genitals, and which particular lumps and bumps require a trip to see the doctor.
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Atsushi Yamada
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Ingrown hairs
What are they?
This is one we probably all can (and do) recognise. Dr Anita says:
"Ingrown hairs are where the hair starts to grow back on itself so that it curls back down into the skin rather than coming out of the surface; they often form a 'head' like a spot does, and you can often see a hair inside... Just because it may have a white head, doesn't necessarily mean it's infected or full of pus. The white stuff is sebum and oil that your skin usually makes, but is now trapped underneath the skin."
How are they treated?
These can be treated at home with DIY methods; by exfoliating with a hot flannel or a hot compress to ease the hair out.
Does it require a doctor's visit?
"If
it's very large and very, very painful with red sore skin around or, in
some rare cases, you can start to feel unwell with high fever – pop
some paracetamol and ibuprofen and call your GP. You may need some
antibiotic cream/tablets.
"Folliculitis
is a slightly more serious condition that can result from hair removal;
rather than just one isolated hair being affected, large clusters of
hair follicles may be red, inflamed, bumpy and can look like acne, or a
rash. It's often caused by a bacterial Staphylococcus infection and
needs to be seen by a doctor, and may need antibiotic/anti-fungal or
steroid treatment."
Rashes (itchy or non-itchy)
What are they?
If you suffer with eczema or psoriasis, you'll probably recognise it if it's spread to your nether regions. Dr Anita says:
"These can both affect the vulval area and tend to be very itchy with their own characteristic appearance. Lichen planus is another kind of itchy rash which can also be red and inflamed to start with, but can cause white, scarred areas which can eventually narrow the entrance to the vagina. Lichen sclerosis is a less common skin condition, which may or may not itch, and causes a pearly white discolouration of the vulval skin."
She adds:
"Thrush (also known as vulvovaginal candidiasis) is the most common cause of vaginal itching, but doesn't often cause a rash."
Does it require a doctors visit?
"If
you're certain it's thrush or have a high suspicion, you can try and
treat it with over-the-counter medication such as Canesten. But if that
doesn't work, and there is a definite rash or something else you're
worried about, then you do need to go and see your GP to find out exactly what it is. The treatments may be subtly different, and may even require a small skin biopsy to determine the exact condition."
How are they treated?
"Often with steroid creams, but may involve a trip to a dermatologist for a specialist treatment plan."
Varicose veins
What are they?
It's
a common misconception that varicose veins only appear on a person's
legs, but in reality you can also get varicose veins of the vulva. Dr
Anita explains:
"They appear like blueish lumps on the labia majora or minora, that are soft and will go away temporarily if you put pressure on the area, but rise up again when you take your fingers away... They can be itchy and sometimes bleed, and are often accompanied by a heavy sensation."
Do they require a doctors visit?
"As
with most things around the vulva, because it can be difficult for you
to be sure of the diagnosis, its worth seeing your GP to ensure that's
exactly what they are."
How are they treated?
"They rarely need surgical treatment," Dr Anita adds, "compression underwear is the most common way to manage them."
Genital warts
What are they?
There's a lot of confusion around genital warts and what exactly causes them. Dr Anita says;
"A lot of people think they're caused by Herpes, but they're actually caused by the Human Papilloma Virus (HPV), which is in the same family of wart virus that causes cervical cancer... The types that cause warts, however, are called 'low-risk HPV' because they don't cause cancer, so having warts won't increase your risk. HPV warts are transmitted through sexual contact and are usually fleshy and non-painful, although they can itch, bleed and cause irritation during sex."
Do they require a doctors visit?
"Yes,
to confirm the diagnosis. It may also be worth visiting the sexual
health clinic, because about 20% of people with genital warts also have
another sexually transmitted infection."
How are they treated?
"One-third
of cases will go away on their own within 6 months; you may be offered a
cream to treat them or treatment to remove them by freezing or
surgery," says Dr. Anita. "These are normally done by sexual health
specialists, or a dermatologist/gynaecologist at a specialist clinic for
vulval skin problems."
Herpes
What is it?
"Genital herpes is caused by Herpes Simplex Virus type 1 or 2; type 1 causes cold sores, and the most common way for a woman to get genital herpes is through oral sex," Dr Anita tells us.
"It typically causes a tingling/itching followed by formation of small red blisters which then pop, release a clear/yellowish fluid and then form ulcers which can scab over and disappear... They can cause intense pain when urinating; you may also have flu-like symptoms at the same time including aching muscles and joints, a high fever and nausea/vomiting. The first episode tends to be the worst and lasts about 2-3 weeks, while susbsequent episodes may be shorter and less severe."
Do they require a doctors visit?
"Yes, because it's important to be sure of the diagnosis in women in particular because outbreaks can happen in pregnancy,
which require prompt treatment. Many doctors will also give you
treatment from 36 weeks of pregnancy to reduce risk of an outbreak
around the time of delivery, and therefore reduce the risk of
transmission to the baby."
How are they treated?
"With an antiviral medication called acyclovir – it's more effective the sooner its taken from the onset of symptoms."
Bartholin's cysts/abscesses
What are they?
Cysts
are build-ups of fluid caused by a blockage. "The Bartholins gland sits
on the edge of the entrance to the vagina and makes a mucus-like
secretion which acts as a lubricant. If this gland opening gets blocked it will cause a cyst, because the fluid is still made, but can't escape," says Dr. Anita.
"These can range from the size of a pea to the size of a golf ball. Typically larger means more uncomfortable, but they are not dangerous. They can, however, get infected by the bacteria that normally lives on your skin in that area. This is called a Bartholin's abscess, and they can get even larger and more painful than a cyst, making it uncomfortable to walk, sit or have sex. They're surprisingly common and some people may get recurrent cysts/abscesses. Smoking increases the risk of having a Bartholin's abscess."
Do they require a doctors visit?
"These should be checked by a doctor to decide whether it's a cyst or an abscess."
How are they treated?
Usually,
cysts won't require any treatment. "You can try and do a sitz bath
yourself (hot bath several times a day) or a hot flannel compress to see
if it will burst of its own accord," says Dr. Anita. "An abscess may
require antibiotics and, if it doesn't improve, some people need a small
operation to drain it. Some gynaecologists prefer to treat them with
antibiotics where possible, as many report vaginal dryness after an
operation if it's necessary to remove the gland."
Labial cysts
What are they?
"Similar
to a Bartholin's cyst, these are also blocked glands, but they don't
generally have the potential to get as big as a Bartholin's cyst," says
Dr. Anita. "They can also get infected, and are treated the same way."
Do they require a doctors visit?
Same as above - let your doctor check whether it's a cyst or an abscess.
How are they treated?
This one's also the same as Bartholin's cyst. Cysts won't require treatment, but an abscess might.
Vaginal cysts
What are they?
Cysts aren't just limited to Bartholin and Labial, according to Dr Anita.
"These cysts are are pearly white lumps around the size of a pea on the wall of the vagina. They can sometimes happen after childbirth, particularly if you had a cut or a tear."
Do they require a doctors visit?
"It's worth having them looked at to check that's exactly what they are because they may be difficult for you to see yourself," advises the expert.
How are they treated?
"They don't usually require treatment unless they are very large or painful, and they don't usually get infected."
Tumours
What are they?
When we find a new growth or weird rash, it's only natural to start questioning whether or not it could be cancer. "Vulval cancers are very rare, and vaginal cancers even more so," Dr. Anita says.
"There are only about 1400 cases of vulval cancer and 250 cases of vaginal cancer diagnosed in the UK each year. Women with lichen sclerosis or lichen planus are slightly more likely to get a vulval cancer, but it's still very uncommon. They are often associated with HPV, and are more common in smokers and women who have gone through the menopause."
Do they require a doctors visit?
For
peace of mind, yes. "Any unusual lumps/bumps/thickened patches of skin
that are itching/bleeding/burning, don't go away or are associated with
abnormal vaginal discharge or bleeding should prompt you to make a GP
appointment," advises Dr. Anita. "It's more likely to be one of the
things mentioned above – but that's why its always worth checking."
How are they treated?
"Treatment varies depending on the type of tumour and whether it has spread."
The moral of the story? If in doubt, go and see your doctor – to stop you wondering what it could be, and to find out what it actually is.
For more info, visit our women's health collection.
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