What's Normal

Lumps and Bumps

The vulva is one of the lumpiest and bumpiest parts of the body, and these normal lumps and bumps tend to increase in both number and /or size with age.

Lots of cysts are caused by sweat glands which have been blocked: the sweat then can’t escape and a cyst forms. These tend to occur along lines of friction, especially where trousers rub. Don’t pick or squeeze these cysts: you might cause an abscess!

“Fordyce spots”

These are small white or yellow lumps, 1-3mm in diameter on the labia minora. They are painless. They are slightly enlarged sebaceous(oil) glands, completely harmless. They often become more easily seen at puberty and with pregnancy and hormone treatment. They can occur on the penis in men too, but are not transmitted from person to person.You can find them in the lining of your mouth. They are a normal variant, and it is not known why they are more prominent in some people than others.

Vestibular papillomatosis

This is a condition where the surface of the vestibule(entrance of the vagina) and inner labia minora becomes a bit thicker and folded, under hormone stimulation following puberty. This gives a very fine, frond-like, slightly warty appearance to the skin, so it can be mistaken for warts. It is common in pregnancy. This is normal for some people though and doesn’t need or respond to treatment.

Angiokeratomas

These are tiny clusters of dilated blood vessels with a scaly top, seen after puberty usually on the labia majora. They tend to become more numerous in older age. They are bright red initially but can become darker, almost black. Very occasionally they can bleed slightly if knocked. Other than that they don’t cause symptoms and are harmless.If they are causing problems they can easily be removed in the doctors office.

Hymenal remnants

It is common to have irregular protrusions around the area of the hymen, the outer ring of the vagina. Minor surgery can remove any lumps here that are annoying.

Seborrhoeic keratoses

These are harmless warty lesions found all over the skin in increasing numbers in people as they age (senile warts!) They are found on the labia majora in women from the thirties onwards. They are often dark in colour 2-5mm in diameter or larger. They can be solitary or multiple. They can cause alarm because of the colour, confused with melanomas. They are not anything to worry about with no potential to turn cancerous.

Pigmentation of the inner vulva: vulval melanosis

Colour changes such as brown flat patches are very common in the inner labia minora, especially in darker skinned women. In most cases the dark areas are completely harmless, but there are rare cases of melanoma of the vulva. It’s not easy to tell which dark spots could be precancerous, so it’s best to have them checked by a doctor. Sometimes it may be necessary to take a test from the skin or photograph the dark area of skin for follow up.

Cysts of the labia majora

‘Sebaceous’ or epidermoid cysts are fairly common on the labia majora in older women. They appear as raised white or yellow lumps, 2-5mm in diameter. Sometimes they get infected, and are sore and red. Usually they don’t need to be removed.

Cysts of the inner vulva

Mucous cysts can occur in the vestibule region too. They appear as a painless soft lump. They can be ignored or removed with minor surgery.

“Varicose veins” of the vulva

Varicose veins are very common, especially after childbirth. They can give the vulva a purple look, and may cause vulval aching, especially at the end of the day. The veins in the labia majora or minora can become enlarged and tortuous, sometimes due to pregnancy. They rarely cause problems with delivery of the baby and will often shrink back after delivery.