Dr Vinatha Puli, Senior Consultant – Gynaecologist & Obstetrician at Cloudnine Group of Hospitals, Hyderabad, explains that ulcers can also cause burning, discharge or discomfort while urinating.
Importantly, not every vulvar ulcer is sexually transmitted. Several non-infectious conditions can cause similar-looking sores.
What Causes Vulvar Ulcers?
Vulvar ulcers can have infectious as well as non-infectious causes. Some common possibilities include:- Genital herpes
- Syphilis
- Skin irritation, trauma or allergic reactions
- Aphthous ulcers
- Inflammatory or autoimmune conditions, including Behçet's disease and Crohn's disease
- Skin conditions such as lichen sclerosus
- Certain medication reactions
- Vulvar cancer or precancerous changes
What Are the Symptoms of Vulvar Ulcers?
The symptoms can vary depending on the cause. You may notice:- A sore or open area on the vulva
- Burning, stinging or tenderness
- Pain or discomfort while passing urine
- Itching or irritation
- Swelling or redness
- Blisters that break open and form sores
- Unusual discharge
- Bleeding from the affected area
- Fever, tiredness or swollen lymph nodes
- Recurrent ulcers that heal and return
How Are Vulvar Ulcers Diagnosed?
Your doctor may ask when the ulcer appeared, whether it is painful and whether you have had similar sores before. They may also ask about recent infections, medicines, skin conditions and sexual history.The vulva may then be examined to assess the ulcer and surrounding skin. Dr Vinatha explains that diagnosis is based on the ulcer's appearance, symptoms and medical and sexual history.
Depending on your symptoms, tests may include:
- A swab from the ulcer or blister
- Blood tests for infections such as syphilis or inflammatory conditions
- Other STI tests, when appropriate
- A biopsy if the ulcer is persistent or unusual
How Are Vulvar Ulcers Treated?
Treatment depends entirely on the underlying cause.- Genital herpes may require antiviral medicines, particularly when treatment starts early during an outbreak.
- Syphilis requires appropriate antibiotics. Treatment during pregnancy is especially important because syphilis can be passed to the baby and cause serious complications.
- Inflammatory or autoimmune conditions may require prescription medicines to control inflammation.
- Skin conditions such as lichen sclerosus may need specific topical treatment prescribed by a doctor.
- Medication-related ulcers may improve after the responsible medicine is identified and managed.
- Persistent or suspicious ulcers may require further investigation or treatment if abnormal or cancerous cells are found.
A vulvar ulcer that does not heal, keeps returning, becomes increasingly painful or is associated with fever or swollen lymph nodes should be medically evaluated promptly. Early diagnosis can help ensure appropriate treatment and prevent complications.
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FAQs on Vulvar Ulcers: Causes, Diagnosis, and Treatment
- Are vulvar ulcers always caused by an STI?
No. Vulvar ulcers can also result from irritation, trauma, allergic reactions, inflammatory or autoimmune conditions, skin disorders, medication reactions and other non-infectious causes. - Can vulvar ulcers occur during pregnancy?
Yes. They can occur during pregnancy for the same range of reasons as at other times. However, some infections can affect the baby and therefore require prompt assessment and treatment. - How long does a vulvar ulcer take to heal?
Healing time depends on the cause. Some ulcers may heal within days or weeks, while recurrent or persistent ulcers may continue until the underlying condition is treated.