Vaginal sores are most commonly caused by sexually-transmitted infections, like syphilis, herpes or chlamydia, especially if they present with other symptoms. However, they can also occur with friction or irritation (from certain fabrics, sex or hygiene products).
In some cases, vaginal sores can also be a result of an auto-immune disease, like Behçet's disease or Crohn's disease. These conditions will usually present with other system symptoms, like abdominal pain or joint pain.
Vaginal sores that do not resolve rapidly or present with other symptoms, like itchiness, pain, discharge or bleeding should be assessed by a doctor. Once the underlying cause is diagnosed, appropriate treatment can be initiated.
What causes sores on the vagina?
The main causes of vaginal sores include:
1. Friction or irritation
Wounds in the vagina or vulva can happen due to friction from tight-fitting underwear or sexual intercourse, or due to pubic hair removal. Irritation from underwear fabric or sanitary pads can also lead to sores, as one of the symptoms related to the allergy is itchiness in the genital area, which can cause wounds.
Learn about other causes of vaginal itching and how to treat it.
How to treat: In these cases, wounds usually heal on their own after a few days. However, to promote healing it’s important to use comfortable clothes and cotton underwear, as well as avoid hair removal and sexual intercourse while the wound present. If no improvement is noted after a few days, we recommend you visit a doctor or gynecologist to see if you should apply an ointment that will help the wound to heal.
2. Granuloma inguinale
Granuloma inguinale, also known as donovanosis, is a sexually-transmitted disease that can cause swelling within 3 days of initial sexual contact with an infected partner. If left untreated, the swelling may turn into a wound that bleeds easily, but is typically painless.
How to treat: Treatment for donovanosis involves 3 weeks of antibiotics, like ceftriaxone, aminoglycosides, fluoroquinolones or chloramphenicol. When taken as prescribed, this infection can be completely cured. You should avoid sexual contact during treatment, until your symptoms have totally disappeared.
3. Syphilis
Syphilis is an STI that is caused by Treponema pallidum bacteria. This infection typically emerges about 21 to 90 days after sexual contact with an infected partner, and leads to wounds on the outer or inner vagina. The wounds are firm and have raised borders. They can range in size and have a reddened color. These genital sores look like a crusted canker sore, and are typically painless and disappear within a few day. Learn more about syphilis symptoms and how they present.
How to treat: Treatment consists of antibiotic injections (usually penicillin). Medication dose and duration is prescribed by a doctor depending on test results.
4. Genital herpes
Genital herpes is an STI caused by the herpes simplex virus. This virus caused fluid-filled blisters that rupture 4 to 7 days after initial contact. The genital sores can be painful, and can last for up to 15 days. This infection is characterized by periods of worsening and improvement, with the flare-ups triggered by times of stress or menstruation. Read more about the symptoms of genital herpes and how these are managed.
How to treat: Although there is no cure, symptoms of genital herpes can be managed with antiviral medications taken for 7 days. These medications can help to heal the sores and prevent the emergence of new ones.
5. Chlamydia
Chlamydia is an infection caused by Chlamydia trachomatis bacteria, which is transmitted through unprotected sex with an infected partner. Vaginal sores from chlamydia are associated with genital swelling that is left untreated, which can lead to sores that rupture and emit blood and pus. In some cases, patients may also experience joint pain, fever and general malaise.
How to treat: Treatment for chlamydia involves antibiotics, which can be taken as a single.dose or taken over 7 days. Adequate treatment can lead to a total cure.
6. Chancroid
Chancroid, which is caused by Haemophilus ducreyi bacteria, is a sexually transmitted infection that is associated with genital sores. These sores can appear 3 to 10 days after initial contact with an infected partner, and can be painful and expel discharge. Some people may also palpate swollen lymph nodes in their groin as a result.
How to treat: Treatment involves antibiotics, like azithromycin, ceftriaxone and erythromycin, which can be taken as a single dose or over 7 days. In some cases, this condition required an IM injection of antibiotics.
7. Lipschutz ulcers
Lipshutz ulcers are genital sores that are not sexually transmitted. They are more common in young women and adolescents who are not sexually active. Generally, they occur with flu-like symptoms, like coughing, fever and body aches. These sores can be painful and cause swelling and pain with urination.
How to treat: Lipshutz ulcers tend to resolve on their own, with no specific interventions. Patients are advised to keep the area clean, to perform sitz baths and apply topical anesthetics to relieve pain. For more severe cases, the doctor may recommend corticosteroid ointments, analgesics and anti-inflammatories.
8. Crohn‘s disease
Crohn’s disease can affect the vulva and cause sores and wounds that swell, itch, and cause pain and discharge during sex. Other common symptoms of this condition include abdominal pain, fever and bloody stool.
How to treat: Treatment for genital sores secondary to Crohn’s typically involves antibiotics (like metronidazole) and corticosteroids. However, these genital sores can take longer to heal by nature, even with medical interventions.
9. Behçet's disease
Behçet's disease is a condition that causes inflammation of the blood vessels in the body as well as genital sores. These sores can be recurring and painful, and particularly affect the vulva. Other common symptoms of this condition include joint pain, skin redness, eye redness and abdominal pain.
How to treat: Genital sores will typically resolve with corticosteroid ointments. Immunosuppressants may be prescribed when other measures have not been effective.
10. Hidradenitis suppurativa
Hidradenitis suppurativa (HS) is a condition that affects hair follicles. It can lead to the formation of genital sores around the vulva and is commonly diagnosed in adolescent or young adult women. Some patients may also experience skin nodules and abscesses on the groin, near the tops of the thighs, in the armpits and on the groin.
How to treat: Generally, treatment for HS involves the use of antibiotics like clindamycin or doxycycline. Serious cases may require surgical treatment.
11. Vulvar cancer
Sometimes, genital sores or wounds are related to vulvar cancer. Generally, these sores are difficult to heal and can be painless, itchy and bleeding. This cancer may also cause swollen lymph nodes to appear near the sores.
How to treat: Treatment depends on the type of cancer diagnosed and the stage it is on, Treatment may involve surgical removal of the sores, radiation therapy and chemotherapy.
