An Overview of Vaginal Pimples

Many vaginal pimples are just what they sound like: pimples that appear on or around the vulva. The vulva consists of the external parts of the female genitalia. The vagina is the internal canal. However, people often refer to the entire female genitalia as the vagina.

True vaginal pimples are formed when dirt, sweat, and/or bacteria build up inside a pore, causing inflammation. They're just like pimples on any other part of your body.

However, not all bumps and lumps in the genital area are vaginal pimples. There are a number of other conditions, infectious and otherwise, that may be mistaken for vaginal pimples.

Causes of Vaginal Pimples

Pimples occur when pores get clogged. This can be caused by hormonal changes. It can also be caused by external factors. Poor hygiene (even hanging around in sweaty clothes after working out) can increase your risk of vaginal pimples. So can irritation from lubricant or other body fluids.

True vaginal pimples are just like pimples anywhere else on the body. They're usually small, red bumps, often with a white dot at the tip. Sometimes they can be dark at the tip or red all the way through. Some vaginal pimples may be full of pus, or swollen and painful.

Several other conditions cause bumps or lesions near the genitals that can easily be mistaken for pimples. They're not always painful, but that doesn't mean they shouldn't be taken seriously. In some cases, pimple-like bumps are caused by infections that can spread to other people if left untreated. They can also be indicators of another condition that requires medical attention.

Ingrown Hairs

Shaving, waxing, and plucking pubic hair is a common cause of ingrown hairs. In fact, one study reported that 32.7% of women who removed their pubic hair had ingrown hairs at some point or another.

An ingrown hair develops when the hair follicle curves downward, forcing the tip of the hair to curl into the skin. This leads to a "foreign body reaction" characterized by inflammation, itchy papules and postules, and hyperpigmentation (skin darkening). Aside from how you groom your hair, certain genetic factors may make you more susceptible; people with thick hair or tight curls are more prone to developing ingrown hairs.

When an ingrown hair develops, the first thing you should do is stop shaving. Usually, this will resolve the irritation within a few days. If it doesn't, you may need to see a gynecologist or dermatologist who may recommend a topical or oral antibiotic to soothe inflammation and prevent infection.

Left untreated, recurrent ingrown hairs can become chronic and develop into an infection of the hair follicles known as folliculitis. The symptoms often look similar to other pimples and are treated similarly. Folliculitis can also be caused by tight clothing or sweat irritation.

Vulvar Cysts

Cysts are pocket-like structures filled with fluid that can grow almost anywhere on the body. The majority of cysts aren't cause for worry, but occasionally they can be cancerous or precancerous, so it's always a good idea to have them checked by a medical professional.

Bartholin's gland cysts are noncancerous masses that form on either side of the labia. An estimated 2% of women develop at least one in their lifetime, and they are most prevalent among women in their 20s.

This type of cyst occurs when a Bartholin's gland—glands that are responsible for sexual lubrication—becomes clogged, frequently as a result of injury or E.coli infection. Because they grow very slowly and are often painless, you may not notice that you have a Bartholin's cyst until several years have passed. Some women report experiencing mild discomfort or difficulty urinating.

A range of treatment options are available, depending on how far the cyst has progressed. Your doctor may prescribe antibiotics for smaller cysts. Larger cysts may require surgical drainage, and sometimes, a full excision of the gland may be needed to prevent the cyst from growing back.

Other common, noncancerous cysts that can form on the vulva include:

• Milia: small, harmless cysts that look like whiteheads and tend to heal on their own
• Epidermoid cyst: hard, painless, and slow-growing cysts also known as sebaceous or keratin cysts
• Lipoma: painless and slow-growing cysts that are soft to the touch
• Pyogenic granuloma: a red papule that grows rapidly, bleeds easily, and may be crusty or smooth

Vaginal Cysts

Approximately 1% to 2% of women develop a vaginal cyst at some point in their lives. These cysts can form as a result of injury to the vaginal walls during childbirth or surgery, a gland that is clogged, or a noncancerous tumor in the vaginal lining. Sometimes the cause can't be pinpointed.

Around 10% of benign vaginal cysts are Gartner duct cysts—a congenital (present at birth) cyst that commonly goes undetected until later in life when a woman visits a gynecologist for a routine checkup. These cysts have their origin in embryonic development.

Other noncancerous vaginal cysts include:

• Müllerian cyst: another cyst resulting from leftover embryonic material that can be asymptomatic but can also lead to vaginal bleeding or urinary difficulty later in life
• Inclusion cyst: small, painless cysts that develop on the back of the vaginal wall, typically caused by injury to the lining during surgery or childbirth

The majority of Gartner duct cysts, Müllerian cysts, and inclusion cysts remain small and painless, and require no treatment. If a cyst is detected during a pelvic exam, your doctor may order an ultrasound or MRI to diagnose it. A biopsy may also be ordered to rule out cancer. Vaginal cysts that are enlarged, inflamed, or that cause problematic symptoms must be excised with surgery to prevent them from recurring.

Molluscum Contagiosum

Molluscum contagiosum (MC) is a viral infection that can can cause small, raised papules to grow anywhere on the body. There may be just one or a whole cluster, and while they're usually painless, they can become quite itchy.

MC papules tend to be smooth and firm with a dimple in the center, and can be pink, white, or flesh-colored in appearance. The infection spreads through sexual or non-sexual skin-to-skin contact and is most commonly seen in children, sexually-active adults, and people who are immunocompromised.

Fortunately, MC infections usually resolve within six to nine months, and there are several treatment options to aid with the healing process. Cryotherapy is considered one of the more effective therapies, although it has received some criticism due to the risk of blisters, scars, or hyperpigmentation (darkening of the skin). A type of non-invasive, surgical scraping—otherwise known as curettage—is also effective at physically removing papules, though this may cause scarring as well.

Topical treatments for MC often include such ingredients as cantharidin, postassium hydroxide, imiquimod, iodine, and salicylic acid. Immunomodulatory and antiviral treatments may also be considered. As always, treatment should be directed by a physician.

Varicosities

Varicose veins are a common condition in adults, typically affecting superficial (near the surface of the skin) veins in the lower extremities of the body. The condition occurs when there is increased blood pressure in a vein that is weak or damaged, causing the vein to become twisted and enlarged, and to bulge from the skin.

Varicose veins of the vulva are most prevalent in pregnant and postpartum women, and an estimated 18% to 22% of pregnant women have them. As blood pools in the vulvar veins, bumps can form on the outer surface of the labia and can occasionally be misdiagnosed as a Bartholin's gland cyst or a hernia. While some women do not experience symptoms, others report swelling of the labia, pressure in the vulvar area, fatigue, and a painful, burning, or itching sensation.

Pregnancy causes an increase of blood flow in the pelvis and genitalia that generally subsides after delivery. Within six weeks, varicose vulvar veins usually go away as well, but if they don't (or they continue to grow), they can be treated with surgery. The most common procedure is minimally-invasive embolization, in which the varicose vein is blocked to prevent further congestion. Another option is sclerotherapy—a procedure that involves injecting the vein with a solution to close it off, causing the blood to reroute to other veins.

Genital Warts

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States, affecting tens of millions of people each year. There are at least 100 different kinds of HPV, and while most are considered relatively harmless, others can cause more serious health problems, such as cervical cancer or genital warts.

The first HPV vaccine was approved by the FDA in 2006, but it was discontinued due to reports of adverse side effects. In 2014, a newer version of the vaccine, Gardasil 9, was approved for use in males and females, and has shown to be 88% effective in protecting against nine strains of cancer-causing HPV.

Among those who have not been vaccinated for HPV, only 10% will develop genital warts. If you are infected with a strain of HPV that causes them, warts may not develop for several months (2.9 months is the median length of time in women). When they do develop, they often go unnoticed. They can form in or around the vulva, vagina, or cervix.

Genital warts can vary quite a bit in appearance. They can be raised or flat, smooth or cauliflower-like in texture. They can be flesh-colored or lighter, dark purple or brown. There may just be one or there may be a cluster. And while some people experience no symptoms at all, others can have warts that itch or bleed.

In most cases, genital warts will eventually resolve on their own. Available treatment options include cryotherapy, surgery, antimitotics (podofilox), and a formulation of imiquimod (3.7%) cream. These may reduce flare-ups, but only time can resolve HPV entirely.

Genital Herpes

There are two types of herpes simplex virus (HSV), which are referred to as HSV type 1 and HSV type 2. In 2016, 47.8% of people between the ages of 14 and 49 were living with HSV type 1 in the United States. That year, 11.9% of people were living with HSV type 2 as well, making genital herpes one of the most common sexually transmitted infections. HSV is a lifelong infection with no known cure and numbers are on the rise, with more women affected than men.

HSV type 1 is usually spread by oral-to-oral contact (cold sores), although oral-to-genital transmission is growing in prevalence. Genital herpes is mostly caused by HSV type 2 and transmitted via penetrative sex. This type is characterized by recurring herpes sores that come and go at the infection site and are not always symptomatic. Consequently, the infection can easily be spread between two sexual partners without either party realizing it.

Women may develop a genital herpes rash on the vulva, inside the vagina, or on the cervix. Sores tend to be small, clear, filled with fluid, and surrounded by red, irritated skin. They may pop and ooze with green or yellow discharge and can be painful and itchy, accompanied by a burning sensation while urinating. If the rash develops inside the vagina or on the cervix, it can be misdiagnosed as pelvic inflammatory disease or a urinary tract infection. Approximately 70% of women also report fever, headache, and malaise during an outbreak.

Fordyce Spots

Fox-Fordyce disease is an uncommon disorder that causes chronic inflammation of the apocrine sweat glands—glands found in areas with abundant hair follicles, particularly the groin, armpits, and around the nipples. During a flare-up, the apocrine glands become enlarged and inflamed with intensely itchy papules. Women with this condition often develop multiple, small, firm, and flesh-colored papules on their labia, and itching them can result in a secondary infection of the hair follicles.

Over 90% of those with Fox-Fordyce disease are women; researchers aren't sure what causes the condition, although it's clear that hormones and genetics play a role in its development. Because the apocrine glands are responsible for producing stress-related perspiration, flare-ups are commonly induced by emotional stress and consequent hormonal changes. Research also suggests that laser hair removal may trigger the condition in some people.

A variety of treatment options are available, but the success of treatment can be limited since the options available do not prevent stress or perspiration. Your doctor may recommend:

• A topical corticosteroid or retinoid treatment
• Topical clindamycin or benzoyl peroxide
• An oral retinoid, antibiotic, or contraceptive
• Surgical excision of the affected apocrine glands

Vaginal Skin Tags

Skin tags (or "polyps") are painless growths that can form anywhere on the skin. They are usually benign, although postmenopausal women have a higher risk of developing polyps that are malignant. In women, 50% of genital polyps form in the uterus (endometrial polyps), but they can also form on the cervix or, less commonly, the vagina. A variety of factors may contribute to their development, including obesity, diabetes, hypertension, age, or changes in steroid sex hormones.

Gynecologists may not detect a polyp unless an ultrasound or a hysteroscopy is ordered. Their appearances vary; polyps range in color from reddish-purple to gray or white. The size of the growth also varies, and they tend to look like a stem with a bulb on the end. A range of symptoms have been reported, such as vaginal discharge and bleeding between periods or after sexual intercourse.

Endometrial polyps may cause infertility, although shortly after the polyp is removed, women often become spontaneously pregnant.

Treatment may not be required for polyps that are small or do not cause symptoms. Your doctor may recommend surgical removal of larger or potentially malignant polyps. Small polyps may be removed in-office using liquid nitrogen, while larger polyps may require hysteroscopic surgery—a procedure that entails being put under anesthesia.

Diagnosis

To diagnose vaginal pimples, your doctor will probably want to examine the pimples. They may be able to diagnose them based on their appearance. You should also let your doctor know:

• When you noticed the pimple(s)
• If the pimples have produced any discharge
• If the outbreak has changed over time
• Whether the pimples are painful or itchy

If the bumps near your vagina do not appear to be pimples, your doctor may also ask you about recent sexual encounters.

Most diagnoses can be made based on the history and physical exam. However, depending on the likely cause, your doctor may perform additional tests (such as an HPV test) to confirm the diagnosis.

Treatment

If your doctor has confirmed your vaginal pimples are pimples, you have a few options for treatment. Mostly, you'll want to focus on good hygiene and keeping your skin clean.

Medicine for the Underlying Condition

The skin in your genital area is more sensitive than skin elsewhere on your body, so you should always discuss your options with a doctor before pursuing a treatment. Different conditions require different treatments, which can range from topical to oral medications, subcutaneous medications (injected into the skin), or surgical excision. While learning about available medications for your condition, you may encounter:

• Oral antibiotics: for ingrown hairs, Fordyce spots, or Bartholin's gland cysts
• Oral antiviral drugs: for sexually transmitted diseases, such as MC, HPV genital warts, or genital herpes
• Imiquimod cream: for genital herpes, HPV genital warts, or infections like molluscum contagiosum
• Oral contraceptives: for Fordyce spots or excessive acne

Warm Compress

Warm compresses are useful for soothing painful ingrown hairs or cysts, while cool compresses are better for itchiness. If your condition is contagious or you suspect it might be, using a compress to relieve discomfort is fine. However, you should take great care to use a clean towel each time so that you do not reinfect yourself or spread infection via fomites.

To soothe varicose veins, consider using a cool compress, as warmth increases blood flow and causes veins to dilate. Cool compresses may also be more therapeutic for conditions that cause itchy lesions, like MC or Fox-Fordyce disease. Just make sure to dry the skin after.

Topical Treatments

Your doctor may also recommend a topical treatment to help with your pimples. This might be an antibiotic, an antihistamine, or even an acne medication. Understanding the nature of your condition is critical for treating it properly.

For example, using antibiotics kills the skin's "good bacteria" in addition to the bad. For this reason, you should only apply topical antibiotic treatments when your doctor advises you to do so. These treatments are not useful for skin tags or varicose veins.

Always consult with your doctor before using an over-the-counter acne medication to treat vaginal pimples. If you do use products such as benzoyl peroxide, you should stick with low concentrations and only use these creams on external skin.

Prevention

Some things that may help prevent a recurrence of vaginal pimples are:

• Wearing clean, cotton underwear
• Avoiding clothing that is too tight or rubs against your genital region
• Practicing good hygiene, including showering after exercise and changing out of sweaty exercise clothes (rather than sitting in them for hours)
• Changing your menstrual products frequently when you have your period
• Trimming your pubic hair instead of shaving (if the pimples are related to razor use)

In addition, if your pimples showed up after you changed your type of soap or laundry detergent, try going back to the old product. It may be that your skin finds the new product irritating and is responding by breaking out.

Sexually Transmitted Infections

If you are sexually active, you can reduce (but not eliminate) the risk of infection by:

• Learning how to use latex condoms properly and using them every time
• Getting Pap smears and HPV tests on the schedule recommended by your doctor
• Being in a mutually monogamous relationship with your sexual partner and asking them to get tested too
• Getting tested for STIs any time you have a new sexual parter

Don't forget, STIs can be transmitted even when you don't have symptoms. For lifelong diseases like genital herpes, it's important to be open with your partner and to tell them if you are having a herpes flare. Discuss the risks involved and come up with a plan together to have safer sex.

Coping

If your pimples are caused by an STI, understand that contracting an STI is not the end of the world, even when it's a type that will never go away. At least 1 in 6 people are living with genital herpes, according to the CDC.On top of that, millions of people have or will have HPV at some point in their lives. In other words, you're not alone, and you certainly don't have to stop enjoying your life or connecting with other people.

Take this as an opportunity to strengthen your communication skills with romantic and sexual partners. Reach out to a psychologist if you need help coping with the diagnosis. If you're not in a relationship, and you're worried your condition will prevent you from finding a partner, know that there are several dating apps for people who have herpes, HPV, and other STIs.

Learning that you have an STI can be frightening, but you might just find that through learning to cope, new doors will open for you. Prioritize your health and managing your condition with the help of your doctor, and trust that the rest will fall in place. What you have is not who you are. Remember that.

A Word From Verywell

When in doubt about any bumps or irritations that appear on your genitals (or anywhere else on your body), talk to a doctor. If they are not vaginal pimples, you may need to be checked for infection. Be cautious if you are sexually active and make sure you are using safe practices.

If the bumps are painful, are releasing pus, or have any other sort of discharge, it is best to speak to a doctor right away. That way, if the bumps aren't simple pimples, they can be treated appropriately.