Experiencing a painful lesion on the private area? It may be a vulvar ulcer. An injury, infection, or STD may result in vulvar ulcers or sores. The treatment is usually cause-specific.
The causes and symptoms of vulvar ulcers are discussed in this blog. It also explores their prevalence, potential complications, and medical practitioners’ strategies to recognize and treat vulvar ulcers.
What are Vulvar Ulcers?
Open sores or lesions known as vulvar ulcers can develop on the labia, clitoris, or vaginal opening of females and affect their external genitalia. Sexually transmitted diseases like herpes or syphilis, autoimmune diseases like Behçet’s illness, or skin issues are possible causes of vulvar ulcers (such as psoriasis or lichen planus).
The infected area may experience discomfort, itching, burning, or tenderness as vulvar ulcer symptoms. Depending on the underlying cause of the ulcers, several treatment options are available, including drugs (such as antivirals or corticosteroids), topical ointments, or surgery in rare instances.
What are the Causes of Vulval Ulcers?
The multiple causes of vulvar ulcers are listed below:
Sexually transmitted Diseases (STDs)
Ulcers on the genitals are commonly caused by STDs such as herpes simplex virus (HSV), syphilis, chancroid, and lymphogranuloma venereum (LGV). These infections are usually spread through sexual contact and can cause rashes, erosions, fluid-filled blisters, or painful sores on the vulva or around the anus. Other symptoms like fever, headache, and swollen lymph nodes can accompany these ulcers. Treatment for STI-related vulvar ulcers typically involves antiviral or antibiotic medications, depending on the specific infection.
Certain autoimmune diseases, such as Behçet’s, lupus, and pemphigus vulgaris, can cause vulvar ulcers. In these conditions, the immune system attacks healthy tissue, leading to inflammation and ulceration in the vulvar area. Women with autoimmune disorders may also experience joint pain, rashes, and fatigue symptoms. Treatment for vulvar ulcers related to autoimmune diseases typically involves medications to suppress the immune system and reduce inflammation.
Skin conditions like lichen planus, psoriasis, and erythema multiforme can cause vulvar ulcers. In these conditions, the skin on the vulva becomes inflamed and irritated, forming ulcers or blisters. Women with skin-related vulvar ulcers may also experience itching, burning, or pain in the affected area. Treatment for vulvar ulcers related to skin conditions may involve topical or oral medications to reduce inflammation and promote healing.
Trauma or injury
This can cause ulcers to form. This can occur during childbirth, sexual activity, or other trauma like falls or accidents. In some cases, vulvar ulcers caused by trauma may heal on their own, while in other cases, treatment may be needed to promote healing and prevent infection.
An allergic reaction to products like soaps, detergents, or condoms can cause vulvar ulcers. In these cases, the skin on the vulva becomes inflamed and irritated, forming ulcers. Treatment for vulvar ulcers caused by allergic reactions may involve avoiding the allergen and using medications to reduce inflammation and promote healing.
Vulvar cancer can cause ulcers to form. This is a rare cause of vulvar ulcers, but women with vulvar cancer may experience other symptoms like bleeding, itching, and pain in the vulvar area. Treatment for vulvar cancer typically involves surgery to remove the cancerous tissue, followed by chemotherapy or radiation therapy.
Reactions to medications
Some medications can cause a reaction that leads to ulcers on the vulva. Medicines associated with vulvar ulcers include nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, chemotherapy, and immunosuppressive drugs.
Inflammatory bowel disease
Inflammatory bowel diseases (IBD), such as ulcerative colitis or Crohn’s disease, can sometimes affect the vulvar area and cause ulcers.
Exposure to certain chemicals can cause a burn on the vulvar area, leading to the formation of ulcers.
Changes in hormones, such as those that occur during menopause, can cause the vulvar tissue to become thinner and more susceptible to ulcers.
Infections not sexually transmitted, such as bacterial infections, can cause vulvar ulcers. Bacterial infections such as staphylococcus aureus, streptococcus pyogenes, and Clostridium perfringens can cause ulcers on the vulvar area. These infections are usually treated with antibiotics.
Yeast infections, such as candida, can also cause vulvar ulcers. These infections can be treated with antifungal medications, either topical or oral.
Other types of infections, such as viral infections and parasitic infections, may also lead to the formation of vulvar ulcers. Treatment for these infections will depend on the specific type of infection.
This rare disorder can cause inflammation throughout the body, including in the vulva, leading to the formation of ulcers.
One other potential cause of vulvar ulcers is vasculitis, which is a condition that causes inflammation in the blood vessels. This inflammation can cause damage to the blood vessels in the vulvar area, leading to the formation of ulcers. Vasculitis can occur due to an underlying autoimmune disorder or infection, or a medication reaction can cause it. Treatment for vulvar ulcers related to vasculitis typically involves medications to suppress the immune system and reduce inflammation.
Other medical conditions
Medical conditions like tuberculosis can also cause vulvar ulcers. The ulcers may be accompanied by other symptoms like abdominal pain, diarrhea, and fever in these conditions. Treatment for vulvar ulcers related to other medical conditions may involve treating the underlying disease and using medications to reduce inflammation and promote healing in the vulvar area.
Types of Vulvar Ulcer
Several types of vulvar ulcers can occur, each with specific characteristics and causes. Here are a few common types
Small and shallow, with a white or yellowish center and a red border. They are typically painful and can be caused by an autoimmune disorder or an allergic reaction.
Herpes simplex virus (HSV) can cause painful, fluid-filled blisters on the vulva that can burst and leave ulcers. Other symptoms like itching, burning, and tingling typically accompany these ulcers.
Behcet’s disease is a rare autoimmune disorder that can cause ulcers in various body areas, including the vulva. The ulcers are typically large and painful with a raised border.
Trauma or injury to the vulvar area, such as sexual activity or an accident, can cause ulcers. These ulcers may be painful or not painful depending on the severity of the trauma.
Vulvar cancer can cause ulcers to form on the vulva. Other symptoms like itching, bleeding, and discharge may accompany these ulcers.
Erosive lichen planus ulcers
Lichen planus is an autoimmune disorder that can cause erosive ulcers on the vulva. These ulcers may be painful and are typically accompanied by other symptoms like itching and burning.
Sexually Acquired Vs. Non-Sexually Acquired vulvar ulcers.
Vulvar ulcers can be sexually or non-sexually acquired. Sexually acquired vulvar ulcers are caused by sexually transmitted infections (STIs) such as herpes, syphilis, chancroid, and lymphogranuloma venereum. Non-sexually acquired vulvar ulcers can be caused by autoimmune diseases such as Behçet’s or inflammatory bowel disease, infections such as tuberculosis or fungal infections, or trauma.
The most typical reason why vulvar sores develop during sexual activity is herpes. It is brought on by the herpes simplex virus (HSV) and is spread through sex-related skin-to-skin contact.
Another STI that can result in vulvar sores is syphilis, which is brought on by the bacterium Treponema pallidum. Chancroid is a bacterial infection that spreads during intercourse and results in painful ulcers. Some strains of the bacteria Chlamydia trachomatis can cause the uncommon STI lymphogranuloma venereum (LGV), which can result in genital ulcers.
Many diseases can lead to vulvar sores that are not sexually transmitted.
An uncommon autoimmune condition, Behçet’s disease, can result in oral and vaginal ulcers. Vulvar ulcers can be brought on by inflammatory bowel disease, including ulcerative colitis (UC) and Chron’s colitis. Aside from sexually transmitted diseases, trauma, fungal infections, and tuberculosis can also result in vulvar ulcers.
A patient’s sexual history and associated symptoms can help differentiate between sexually and non-sexually acquired vulvar ulcers.
How are Vulvar Ulcers Diagnosed?
Diagnosing vulvar ulcers involves a thorough medical history, physical examination, and laboratory tests.
Medical history of vulvar ulcers
The history of the patient’s symptoms, including the onset, duration, and associated symptoms, such as fever or rash, is essential. The patient’s sexual history and other medical conditions that may be contributing factors are also investigated.
Some common medical history questions for vulvar ulcers include:
- When did you first notice the ulcers?
- Any other symptoms, such as fever, rash, or joint pain?
- Have you had similar ulcers in the past?
- Are the ulcers painful or itchy?
- Do you have any discharge or bleeding?
- Have you had sexual contact with a new partner or partners recently?
- Past diagnosis of a sexually transmitted infection?
- Are you currently taking any medications, or have you recently taken any drugs?
- Any known medical conditions, such as autoimmune diseases, inflammatory bowel disease, or tuberculosis?
- Have you experienced any recent trauma or injury to the vulvar area?
Physical exam of vulvar ulcer
During the physical exam, the healthcare provider will examine the vulvar area for any signs of ulcers, such as redness, swelling, or crusting. They may also examine the vaginal area and cervix to rule out other possible causes of ulcers.
Investigations for vulvar ulcers
Laboratory tests may also be ordered to confirm the diagnosis and determine the underlying cause of the ulcers. These may include:
Blood tests can detect the presence of antibodies to certain infections, such as herpes or syphilis.
A viral culture involves collecting a fluid sample from a blister or ulcer and testing it for the presence of the herpes simplex virus.
It involves taking a small tissue sample from the ulcer and examining it using a microscope to find signs of inflammation or infection.
Polymerase chain reaction (PCR) testing
PCR testing involves amplifying the genetic material of a virus or bacteria to detect its presence in a sample.
This involves testing the blood to detect the presence of antibodies to certain infections.
Ultrasound, CT scan, or MRI may be ordered if there is a concern for deep tissue involvement.
The specific tests ordered will depend on the suspected cause of the ulcers. Once a diagnosis is made, appropriate treatment can be initiated to manage the ulcers and any underlying conditions.
Treatment Options For Vulvar Ulcers
The treatment for vulvar ulcers depends on the underlying cause of the ulcers. Treatment may involve medication, lifestyle changes, or other interventions. Some standard treatment options for vulvar ulcers include:
If the vulvar ulcers are due to a viral infection such as herpes, your doctor may prescribe antiviral drugs to reduce the severity and frequency of outbreaks.
If the vulvar ulcers are due to a bacterial infection such as syphilis, chancroid, or LGV, your provider may prescribe antibiotics to eliminate the disease.
Your provider may prescribe immunosuppressant medications to reduce inflammation and control symptoms if the vulvar ulcers occur due to an autoimmune disorder such as Behcet’s disease or pemphigus vulgaris.
Your doctor may recommend over-the-counter( OTC) pain relievers such as acetaminophen or ibuprofen to manage pain associated with vulvar ulcers.
Topical creams may help relieve itching and promote the healing of the ulcers.
Patients with vulvar ulcers should avoid sexual contact until the ulcers have healed completely to prevent transmission of infections. Patients may also advise to avoid tight-fitting clothing and irritating fabrics and practice good hygiene.
Surgery may be necessary in rare cases to remove ulcers or damaged tissue.
Sexual or non-sexual factors can cause vulvar ulcers. Various causes and treatment options depend on the underlying condition. Medical history questions and physical examination are essential to diagnose the disease; laboratory tests may also require confirming the diagnosis. Treatment options include medication, lifestyle changes, pain management, and surgery in rare cases. It is crucial to seek medical care promptly and follow the recommended treatment plan to promote healing and prevent complications.
FAQs about Vulvar Ulcer Answered by Your Doctors Online Team.
A vulvar ulcer can have different appearances depending on its underlying cause. It may appear as a painful open sore, a blister or vesicle filled with fluid, or a raised bump with a crust. The ulcer may be red or white and surrounded by a ring of inflammation or swollen tissue.
The duration of vulvar ulcers varies depending on the underlying cause and treatment. Some ulcers may heal within a few days, while others may take weeks or months. Herpes simplex virus (HSV) ulcers, for example, typically last 7-10 days but can recur. Syphilis ulcers may last several weeks but eventually heal with appropriate treatment.
Vulvar ulcers can occur due to sexually transmitted infections (STIs), but not all vulvar ulcers are related to STIs. STIs that can cause vulvar ulcers include herpes, syphilis, chancroid, lymphogranuloma venereum (LGV), and donovanosis. However, other conditions, such as autoimmune diseases, inflammatory bowel disease, and trauma, can also cause vulvar ulcers. Safe sex practices can help prevent STIs that cause vulvar ulcers.
While infections or other non-cancerous conditions often cause vulvar ulcers, there is a slight chance they could be cancerous. Vulvar cancer can cause symptoms such as itching, pain, bleeding, and the development of ulcers. However, cancerous ulcers on the vulva are usually slow-growing and do not heal, unlike ulcers caused by infections or injuries. Biopsy of the ulcer can be helpful in diagnosis.