Vaginal Bumps: Main Causes and What to Do About Them

• Most vulvar and vaginal bumps are benign — normal anatomical variants, cysts, ingrown hairs, or folliculitis. STIs account for a minority.
• Many 'new' bumps are normal structures (vestibular papillae, Fordyce spots, hymenal remnants) you only notice once you start looking closely.
• A Bartholin cyst is a soft swelling on one side of the vaginal opening; small ones settle with sitz baths, while an infected one (abscess) becomes red, hot, and very painful.
• Painless does not mean harmless — some serious conditions, including vulvar cancer, can present as a painless lump, especially after age 50.
• See a gynaecologist for any bump that persists beyond 2–3 weeks, grows, ulcerates, bleeds, or follows recent unprotected sex.

The vulva and vaginal opening have several normal structures that can look or feel like an abnormal bump the first time you notice them — often when you start examining yourself because something else has made you anxious. Knowing what is simply a variant of normal saves a lot of worry.

Vulvar vestibular papillae (vestibular papillomatosis) are small, soft, finger-like or smooth projections arranged symmetrically on the inner labia minora and around the vaginal opening. They are a normal variant, smooth rather than rough, the same colour as the surrounding mucosa, soft, and present on both sides. They need no treatment and are not contagious. Because they are sometimes mistaken for genital warts, a gynaecologist can usually tell them apart on simple inspection — warts are firmer, rougher, and not symmetrical.

Fordyce spots are tiny (1–3 mm) pale yellow or skin-coloured papules — ectopic (out-of-place) sebaceous glands. They appear on the lips, inner cheeks, and genital skin including the labia, and are extremely common and completely harmless. No treatment is needed.

Hymenal remnants (carunculae hymenales) are small soft skin tags left behind from the hymen, often more noticeable after using tampons, having sex, or giving birth. They are normal.

Normal folds and asymmetry: labia minora and majora vary widely between women — some are larger, some asymmetric. This is normal anatomy, not a bump, and needs no intervention unless it causes real physical or emotional distress.

Glands you may feel: Skene's glands sit near the urethral opening and Bartholin glands at the 4 and 8 o'clock positions of the vaginal opening. When healthy they are usually not visible, but a blocked Bartholin gland can swell into a noticeable lump (covered below).

If you are unsure whether something is new, compare it with the rest of your anatomy using a mirror in good light. Most normal variants can be confirmed by a gynaecologist on inspection alone — a biopsy is rarely needed for typical findings.

Cysts — fluid- or material-filled sacs under the skin — are one of the most common reasons women notice a vulval lump.

Bartholin cyst and abscess is the most clinically important. The two Bartholin glands sit deep in the labia majora at the 4 and 8 o'clock positions of the vaginal opening and produce lubricating fluid. If a duct gets blocked, fluid backs up into a cyst. A simple Bartholin cyst is usually a soft, painless or mildly tender swelling on one side, anywhere from pea-sized to a few centimetres. Small symptom-free ones often need nothing more than warm sitz baths. If it becomes infected — a Bartholin abscess — it turns red, hot, swollen, and increasingly painful, sometimes with fever, and sitting, walking, or sex can become very uncomfortable.

Treatment depends on size and symptoms:

• Sitz baths (sitting in warm water for 10–15 minutes a few times a day) for small, symptom-free cysts.
• Incision and drainage — a quick office procedure to release pus from an abscess.
• Word catheter — a tiny balloon catheter placed through a small incision to keep the duct open for a few weeks so a new drainage tract forms and lowers the chance of recurrence.
• Marsupialisation — minor surgery that creates a permanent opening, used for cysts that keep coming back.
• Gland excision — complete removal, reserved for recurrent or refractory cases.

The hair-bearing skin of the labia majora and mons pubis is prone to the same follicle problems as skin anywhere else — and grooming makes them more common.

Folliculitis is inflamed or infected hair follicles: small red bumps around hair shafts, sometimes with a central pustule. Common triggers are bacteria (often Staphylococcus aureus), fungi, shaving or waxing, friction, and tight clothing. Most cases are mild and settle with warm compresses, gentle cleaning, loose cotton underwear, and avoiding irritating products; topical antibacterials (mupirocin) or antifungals (clotrimazole) help when a specific organism is to blame. Our detailed guide to pubic and vaginal folliculitis covers prevention after hair removal.

Ingrown hairs (pseudofolliculitis) happen when a hair curls back into the skin instead of growing out, leaving a red bump and sometimes a pustule — especially after shaving or waxing curly hair. They usually clear on their own with warm compresses, gentle exfoliation, and a break from shaving. Picking or squeezing makes them worse. Learn how to prevent them in our guide to ingrown pubic hair.

Boils (furuncles) are deeper follicle infections, usually staphylococcal — painful, red, swollen nodules that may form a head and drain. Warm compresses encourage drainage; larger or persistent boils need antibiotics. Carbuncles (clustered boils) need medical care.

Hidradenitis suppurativa (HS) is a chronic inflammatory condition of sweat-gland-rich areas (groin, armpits, under the breasts) with recurrent painful nodules, abscesses, sinus tracts, and scarring. It usually starts in young adulthood, is more common in women, and has genetic and hormonal links. Management includes weight and smoking changes, antibiotics, hormonal therapy, biologics for severe disease, and sometimes surgery — a dermatologist should be involved.

Molluscum contagiosum is a viral (poxvirus) infection: small dome-shaped, flesh-coloured papules with a central dimple. In adults it can spread sexually. Most cases clear on their own over months; treatment options include cryotherapy, curettage, and topical agents. See our guide to molluscum contagiosum on the genitals.

Lichen sclerosus is an autoimmune skin condition causing thin, white, fragile, itchy vulval skin that, untreated, can distort the normal architecture and slightly raise vulvar cancer risk. It needs specialist assessment and long-term topical steroids — see lichen sclerosus. Lichen planus and inverse psoriasis can also affect the vulva and need a dermatologist or gynaecologist.

Genital warts (condylomata acuminata) are caused by the human papillomavirus, mainly the low-risk types HPV 6 and 11 — these cause warts but not cancer. They are one of the most common STIs worldwide.

Warts appear as soft, flesh-coloured, pink, or grey growths on genital skin and mucosa. They can be single small papules, larger cauliflower-like clusters, flat plaques, or stalk-like lesions, and commonly turn up on the vulva, vagina, cervix, perineum, perianal area, and groin folds. Most cause no symptoms beyond their appearance, though some itch or feel irritated, and pregnancy can make them enlarge. A doctor usually diagnoses them by sight; magnification (colposcopy) helps for cervical or tiny lesions, and biopsy is reserved for atypical or treatment-resistant ones.

Treatment options include:

• Provider-applied: cryotherapy (freezing), trichloroacetic acid, surgical excision, laser, or electrocautery.
• Self-applied: imiquimod cream, podophyllotoxin solution or gel, or sinecatechins ointment.

Some genital bumps are actually blisters or ulcers caused by sexually transmitted infections, which behave differently from warts and cysts.

Genital herpes is caused by herpes simplex virus — historically HSV-2, but increasingly HSV-1 (the usual cause of cold sores). A first (primary) outbreak often starts with tingling, itching, or burning, followed by clusters of small fluid-filled blisters that break into painful ulcers, then crust and heal over 2–3 weeks. The first episode is usually the worst, sometimes with fever, swollen lymph nodes, and painful urination. Recurrences are milder, shorter (5–10 days), and can be triggered by stress, illness, or hormonal changes. Many people have few or no symptoms yet still shed the virus, which is how it spreads unknowingly — explained in can you get herpes without an outbreak.

Herpes is diagnosed clinically, often confirmed with a PCR swab of a lesion. Antivirals (acyclovir, valacyclovir, famciclovir) shorten outbreaks and, taken daily as suppressive therapy, reduce both recurrences and transmission. The virus stays in the nerve roots for life, but for most people the long-term course is mild and manageable.

Other infections to know about:

• Syphilis can begin as a painless ulcer (chancre) that heals on its own even though the infection persists and progresses if untreated. It is curable with penicillin — see syphilis in Indian women.
• Chancroid causes painful ulcers with tender swollen lymph nodes and is treatable with antibiotics.
• Lymphogranuloma venereum (LGV), a form of chlamydia, causes a small painless ulcer followed by tender lymph nodes, treated with doxycycline.
• Pubic lice (crabs) can cause itchy bumps and visible nits at the hair base.

Most vulvar bumps are benign, but a few features should prompt prompt evaluation. Vulvar cancer is uncommon (about 4 percent of gynaecological cancers), but the risk rises with age, especially after 60.

Risk factors include older age, high-risk HPV infection, smoking, vulvar intraepithelial neoplasia (VIN), lichen sclerosus, a weakened immune system (HIV, transplant), and a history of cervical or vaginal precancer.

VIN is a precancerous change in vulvar skin, appearing as flat or raised white, red, pigmented, or skin-coloured patches, often itchy. It is diagnosed by biopsy and treated with topical imiquimod, excision, or laser ablation.

Vulvar squamous cell carcinoma (about 90 percent of vulvar cancers) usually shows up as a persistent lump, a non-healing ulcer, or an area of changed skin — with itching that won't settle, a palpable mass, bleeding, or a colour or texture change. Vulvar melanoma is rarer; any new, changing, asymmetric, or multi-coloured pigmented spot needs assessment using the ABCDE rule.

Red flags that warrant prompt gynaecological review:

• A new lump or mass that persists
• An ulcer or sore that does not heal within 4–6 weeks
• Bleeding from a vulvar lesion
• Persistent itching that does not respond to usual treatment
• A change in colour, texture, or size of an existing spot
• A swollen lymph node in the groin
• Any worrying skin change, especially over age 50

Knowing what you can safely manage at home — and what needs a professional — helps you respond calmly.

Reasonable to watch at home: clearly identifiable normal variants (vestibular papillae, Fordyce spots, hymenal remnants), a small uncomplicated ingrown hair, mild folliculitis, and a small symptom-free Bartholin cyst.

Helpful self-care measures:

• Warm sitz baths (10–15 minutes, 2–3 times a day) for inflamed or infected lesions
• Gentle cleaning with plain water — no harsh soaps, douches, or scented wipes
• Cotton underwear and loose clothing to reduce friction and moisture
• Avoiding scented soaps, perfumed pads, and douches
• An over-the-counter antifungal (clotrimazole, miconazole) for a suspected mild fungal problem
• Giving minor issues time to settle on their own

• ACOG — Disorders of the Vulva: Common Causes of Vulvar Pain, Burning, and Itching
• ACOG — Bartholin Gland Cysts (Practice information)
• NHS — Vaginal lumps and skin changes
• WHO — Human papillomavirus (HPV) and cervical cancer-and-cervical-cancer)
• WHO — Herpes simplex virus
• CDC — Genital Warts (STI Treatment Guidelines)
• FOGSI — Federation of Obstetric and Gynaecological Societies of India