Female genital sores have a number of causes, the most common of which are sexually transmitted infections, including herpes.

Lumps and bumps in and around the vagina may be itchy, painful, tender, or produce a discharge. Others may not cause any symptoms. The symptoms, diagnosis, treatment, and outlook depend on the cause of the sores.

Here, we examine the main causes of female genital sores, what treatments are available and how to prevent them. 

Causes: Sexually transmitted infections

Genital sores caused by sexually transmitted infections (STIs) tend to be painful and itchy and can appear as one or multiple sores. These are the most common type of sores and can be very contagious. They include:

Genital herpes

Genital herpes is an infection that causes outbreaks of blisters or ulcers on the genitals. It is the most common cause of genital sores in the United States.

It is thought that more than 50 million Americans are infected, with up to 776,000 new cases of genital herpes diagnosed every year. As approximately 90 percent of those who carry the herpes simplex viruses (HSV-1 and HSV-2) have no symptoms, the true figures may be higher still.

When someone has an outbreak of genital herpes, they develop one or more lesions around the genitals or rectum. They may not hurt, but they can burst and become painful. If they burst, the ulcers can take 2-4 weeks to heal. The first outbreak of genital herpes that a person experiences tends to be more severe and painful.

Once somebody gets genital herpes, they have it for life. It is not curable, but outbreaks can be treated, and there are medications to reduce or shorten the number of outbreaks.

Drugs called acyclic guanosine analogues shorten the duration of outbreaks. Acyclovir, valacyclovir, and famciclovir are the most commonly used and are prescribed as pills to be taken for up to 10 days.

People with genital herpes should avoid sexual contact during an outbreak to stop the virus spreading.

Chancroid

Chancroid is an STI caused by the haemophilus ducreyi bacteria. People with chancroid develop sporadic outbreaks of painful ulcers.

Once treatment has begun, symptoms tend to improve within 3 days, and the infection usually clears up within 7 days. Large ulcers may need around 2 weeks or more to heal.

Granuloma inguinale

Granuloma inguinale, is caused by the bacterium klebsiella granulomatis. People with this condition develop ulcers that are beefy-red in color and bleed. They tend to be painless.

Granuloma inguinale, which is rare in the U.S., can be treated with antibiotics, though the infection may return 6-18 months later.

Molluscum contagiosum

Molluscum contagiosum is a contagious skin infection that causes small lesions or bumps on the thighs, buttocks, groin, and lower abdomen.

The lesions can appear on the genitals and around the anus and can develop into larger sores that become itchy or tender. They can be flesh-colored, gray-white, yellow, or pink and last from 2 weeks to 4 years.

Most lesions heal naturally, although they may come back. Doctors can remove them to prevent them spreading to others.

Syphilis

Caused by the bacterium treponema pallidum, syphilis can lead to ulcers and rashes in the genital area. It can be treated with a course of intravenous penicillin G, though the course, dose, and length of treatment depend on the stage of the disease, and how it presents.

After treatment, people tend to be retested at 6 and 12 months to ensure the infection has cleared up. If it has not, further treatment will be offered.

Genital warts

Genital warts are caused by 1 of almost 100 human papillomaviruses (HPVs). HPV infection is common, but most do not result in visible lesions. The sores that result are harmless and usually resolve by themselves within a year.

Warts tend to be soft on smooth skin, but firm on hairy skin, and treatment depends on their location and size.

People with small numbers of warts can be treated with creams, such as podophyllotoxin or imiquimod. Those with larger warts may need to have them surgically removed.

Prevention

Practicing safe sex by using latex condoms is the only way to prevent STIs.

To prevent transmitting STIs, such as herpes, to sexual partners, a person should not have sex during an outbreak of one of these conditions. People with syphilis should abstain from sex until the sores or rash have subsided.

Other causes

While STIs are the cause of most genital sores, they can also be the result of non-sexually transmitted infections or skin disorders.

Non-sexually acquired genital ulceration (NSAGU)

NSAGU sores are a type of aphthous ulcer. They appear as single or multiple shallow round sores. They tend to be painful and have a creamy-white or gray film and a red halo.

These sores can be caused by underlying health conditions, such as celiac or Crohn's disease, or be triggered by vitamin deficiencies or hormonal fluctuations.

People who have NSAGU may experience flu-like symptoms before the sores develop, as well as swelling in the genital area.

Most ulcers of this kind heal by themselves within a couple of weeks, though doctors may recommend pain relief. In severe cases, steroids may be prescribed.

Contact dermatitis

Contact dermatitis is caused by an allergic reaction and can develop in response to products, such as washing detergent or bath and shower washes. Poison ivy, nickel, and perfumes can also cause this inflammatory reaction.

Avoiding the allergen is the best way to deal with contact dermatitis, but in severe cases, doctors may recommend steroid treatment.

Varicosities

Varicosities are swollen veins that can appear as blue or purple bumps around the vulva and vagina. They can cause minor discomfort, swelling, and a feeling of pressure in the affected area.

These sores are more likely to occur during pregnancy and through aging. When they occur during pregnancy, they are likely to go away without requiring treatment within 6 weeks of delivery.

Support garments and cold compresses can relieve discomfort, and activities that improve blood flow from the pelvis, such as swimming, can also help.

Diagnosis

While most causes of genital sores can be dealt with easily, if left untreated some conditions can lead to complications later on. In very rare cases, genital sores may be caused by cancer, or they may be harmless cysts that can be removed.

Because there are a variety of causes for female genital sores, it is important to visit a doctor for a diagnosis, as soon as possible. This will ensure that a person receives the right treatment.

To discover the cause of the sores, a doctor will carry out a physical examination. They may also need to perform other tests, such as taking bloods or a swab from the affected area.

Outlook

Most causes of female genital sores are easily treated with a short course of antibiotics, which can be in the form of cream or a pill.

Some conditions, such as herpes, are lifelong, and people who have the herpes virus will experience breakouts from time to time. If someone begins to experience breakouts, they should see their doctor.

Other causes, such as contact dermatitis, are self-limiting, meaning they will get better without treatment. As mentioned above, however, it is important to understand what is causing the problem, so as to know how to treat it.