Ulcers Vulva: Symptoms, Causes, Diagnosis, Treatment, And More

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10 Causes of Vulvar Ulcers and How to Treat Them

Medically reviewed by Holly Ernst, PA-C — Written by Julie Marks — Updated on February 8, 2023

Symptoms
Types
Causes
Incidence
Diagnosis
Treatment

Vulvar ulcers or lesions can occur due to an STI or another infection. Treatment can depend on the cause.

What are vulvar ulcers?

The vulva is the outer part of a woman’s genitals. Vulvar ulcers are sores that appear in this area. Vulvar ulcers can be extremely painful and, in some cases, they may not hurt at all.

Most of the time these lesions are caused by sexually transmitted infections (STIs) but many other issues can trigger an ulcer. There are several effective treatment options for these sores.

Read on to learn more about what causes vulvar ulcers and how to treat them.

Symptoms

Vulvar ulcers might start out looking like bumps or a rash. Or, the sores might appear as breaks in your skin that expose tissue.

Symptoms of vulvar ulcers vary, but may include:

pain or discomfort
itchiness
leaky fluid or discharge
painful or difficult urination
enlarged lymph nodes
fever

Sometimes, vulvar ulcers don’t cause any symptoms.

Types of vulvar ulcers

Generally, vulvar ulcers are classified as being sexually acquired or nonsexually acquired.

A sexually acquired vulvar ulcer means the lesion is the result of sexual contact. This is the most common type of genital ulcer.

Nonsexually acquired ulcers are also called acute genital ulcers. These are more common in young women who aren’t sexually active.

Possible causes

There are many possible reasons vulvar ulcers develop, including:

1. STIs

The most common cause of genital ulcers in the United States is the herpes simplex virus (HSV), followed by syphilis. Other STIs can lead to ulcers, including:

chancroid
chlamydia
donovanosis

Additionally, some women with HIV may develop ulcers on their genitals.

STIs are more common that you might think. According to the American Sexual Health Association, 1 in 2 people who are sexually active will contract an STI by age 25.

2. Fungal infections

Vulvovaginal candidiasis, also known as vaginal yeast infection, is the most common fungal infection that causes vulvar ulcers or erosions. Other symptoms of yeast infections include:

burning during sex and urination
itching
increased vaginal discharge

3. Viral infections

Certain viruses can cause vulvar ulcers to form:

Epstein-Barr virus
cytomegalovirus
varicella zoster, the virus that causes chickenpox and shingles

4. Bacterial infections

Infections caused by bacteria, such as Group A Streptococcus and mycoplasma, can trigger sores on the vulva. Bacterial infections are usually treated with antibiotics.

5. Inflammatory diseases

Several types of inflammatory and autoimmune diseases can cause lesions to form around the vulva. Depending on how severe these are, they may appear like ulcerations. Some of these include:

Crohn’s disease
Behcet’s disease
Stevens-Johnson syndrome
Darier disease
erosive lichen planus
pyoderma gangrenosum
hidradenitis suppurativa

6. Trauma

Chronic rubbing or scratching of the vulva can lead to skin irritation and ulcers.

7. Other illnesses

Sometimes, common conditions like tonsillitis, upper respiratory infections, or a virus that causes diarrhea can cause genital ulcers, especially in adolescent girls.

8. Drug reactions

Medicines like nonsteroidal anti-inflammatory drugs (NSAIDs), sulfonamides, and certain antibiotics can cause a reaction that triggers ulcers.

9. Cancer

Vulvar cancer can cause ulcerlike lesions around the vagina. This type of cancer is more common in older women.

10. Skin reactions

Sometimes, a bad reaction to skin care products can cause a genital ulcer. You might want to switch to soaps and lotions for sensitive skin if this happens.

Incidence

Worldwide, about 20 million people develop some type of genital ulcer condition each year.

HSV types 1 and 2 are the most common causes of genital ulcers in the United States. 1 in 5 women and 1 in 9 men ages 14 to 49 has genital HSV type 2 infection.

What tests are used to diagnose the cause of vulvar ulcers?

Your doctor will probably perform a physical exam and explore your health history to determine what’s causing your vulvar ulcers. You might be asked about your sex life, number of sexual partners, and what medications you take.

Additionally, your physician will need to look at the ulcer or ulcers to get a better idea as to what could be causing them.

Your doctor may recommend one or more of the following tests:

blood test
bacterial or viral swab test
urine test

You may also need a biopsy. A biopsy is a procedure that involves removing a sample of the ulcer and sending it to a lab for further examination.

Treatment

Your treatment approach will depend on what’s causing your ulcers. Some vulvar ulcers may go away on their own, but others will require prompt therapy so they don’t lead to infection.

Your doctor might recommend several types of therapies to treat your condition.

STIs are typically treated with antibiotic and antiviral medicines, given as either a pill or a shot.

Vulvar ulcers that aren’t caused by infections may be treated with:

corticosteroids
antihistamines
immunomodulatory drugs, such as methotrexate

Your healthcare provider might show you how to effectively clean your ulcer until it heals. You might also need special dressings to cover and protect the area.

Sometimes, home remedies may be used to relieve the pain and discomfort of vulvar ulcers. Popular methods include:

Epsom salt baths
oral pain relievers, such as acetaminophen (Tylenol)
cool compresses to the affected area
topical anesthetics, such as lidocaine
barrier ointments, such as petroleum and zinc oxide
avoiding irritants, such as harsh soaps, douches, or tight-fitting clothing

Shop for epsom salt, acetaminophen, topical anesthetics, and petroleum jelly.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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Genital ulcers: What causes them? (2012).https://www.aafp.org/afp/2012/0201/p269.html
Janz-Robinson E, et al. (2017). Differential diagnosisof vulval ulcers.https://www.dermnetnz.org/topics/differential-diagnosis-of-vulval-ulcers
MayoClinic Staff. (2017). Vulvar cancer.https://www.mayoclinic.org/diseases-conditions/vulvar-cancer/symptoms-causes/syc-20368051
Oakley A. (2010). Non-sexually acquired genitalulceration.https://www.dermnetnz.org/topics/non-sexually-acquired-genital-ulceration
Riskfactors for vulvar cancer. (2018).https://www.cancer.org/cancer/vulvar-cancer/causes-risks-prevention/risk-factors.html
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Statistics. (n.d.).http://www.ashasexualhealth.org/stdsstis/statistics/
Syphilis [Fact sheet]. (n.d.).https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm
Vulvar ulcers. (n.d.).https://www.rch.org.au/clinicalguide/guideline_index/Vulval_ulcers/

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Medically reviewed by Holly Ernst, PA-C — Written by Julie Marks — Updated on February 8, 2023

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