White pimples, or papules, in the vaginal area are usually found unexpectedly. Often when a woman finds an abnormal lesion in her genital area it can be the source of significant anxiety, mainly because of the fear of sexually transmitted diseases (STD's) as a cause. While there are several STD's that can lead to raised papules in this area there are several other potential causes as well. Aside from STD's, raised vaginal 'bumps' can be caused by cysts, simple infections of hair follicles, or normal skin changes.

Here we'll review a few of the most common causes of raised white pimples on the vagina.

Cysts

Cysts are common and can occur anywhere on the body. They form when drainage ducts to the glands underneath the skin become clogged. There are several types and these are named based on the type of glad they affect and where in the genital area they occur. The most common are Skene's duct cysts and Bartholin's duct cysts.

Cysts can become large when they fill with fluid, they may drain thick, yellow-white fluid, and they can become tender or painful. They can occur anywhere in the genital area. Small non tender cysts can be treated by applying a warm, wet washcloth several times per day and avoiding any irritation. It's important not to squeeze a cyst because breakage in the skin may allow a bacterial infection to start. If the cyst becomes larger or more painful, it may be necessary to see a physician to have it either drained or removed.

Two separate conditions, Hidradenitis suppurativa and Fox Fordyce disease, occur when sweat glands become clogged. These conditions usually occur in other areas of the body as well and can be painful of itchy. They are usually darkly discolored.

Bacterial infections

In the same way that Cysts can become infected by bacteria, hair follicles can become infected as well. The term for an infected hair follicle is folliculitis. It generally occurs with repetitive shaving or irritation to the skin leading to pain and tenderness. Folliculitis can be very painful but generally is easily treated by stopping the source of irritation, applying warm compresses, and antibiotics if the infection is severe enough.

Viral infections

Several viral infections can cause white colored bumps in the genital area. These can all be contracted through unprotected sexual contact.

Human Papilloma virus (HPV) is the virus responsible for genital warts. Certain strains of the virus can lead to cervical cancer but these are different from the ones causing genital warts. Genital warts have a cauliflower type appearance and may occur as one lesion, or multiple lesions. They can occur anywhere in the genital area. Genital warts should be treated by a health care professional; they usually need to be removed by several treatments with liquid nitrogen or acid.

Molluscum Contagiosum can occur anywhere on the body and spreads through direct contact. The virus responsible, pox virus, creates clusters of pinhead sized, raised 'bumps' that can be skin colored or white with a small dimple in the center. They can spread to cover a large area of skin and will usually heal themselves within several months to a year. They can be treated with liquid nitrogen or acid in the same way as genital warts if desired.

Herpes Simplex Virus (HSV) is the virus responsible for herpes of the mouth or genital area. When this virus affects the skin, it causes a raised blister which then breaks down within a few days to create a painful ulcer. Herpes can spread through direct skin to skin contact. There are several medications which can either prevent the skin breakout form occurring or decrease the number of days it sticks around, but there is no cure for the virus.

Normal skin changes

Normal growths of the skin can cause irritation or may be confused with any of the other conditions causing 'bumps' in the genital area.

Skin tags, medically called acrochordon, are overgrowths of normal skin that occur in areas with regular friction. They are irregular in sizes and shapes and do not need to be treated unless they are bothersome.

Papillomatosis can be mistaken for genital warts, but they are a normal occurrence. They are small, symmetric papules found around the opening of the vagina and do not need to be treated.

Cancer

There is a precancerous lesion called vulvar intraepithelial neoplasia which can present as a single white 'bump' in the genital area. It usually occurs in older adults, but rarely can occur in younger individuals. It can progress to cancer and should be evaluated by a healthcare professional.

Because of the wide number of possible causes, abnormal raised 'bumps' in the vaginal area should be examined by a healthcare professional particularly in sexually active or older adults.