Lumps on the labia majora can be caused by ingrown hairs, bartholinitis, genital herpes, genital warts, or even vulvar cancer. They may be accompanied by symptoms like pain, itching, burning, sensitivity to the touch, redness, heat in the area or skin lesions.
The labia majora are folds of adipose and connective tissue, which form the lateral edges of the vulva, where the pubic hair is found. They typically start up near the pubic mound, also called the mons pubis, and go to the perineum, covering the labia minora, clitoris, the Bartholin glands Skene glands, and the vaginal opening. The functional of the external labia are to protect the genitals, however bumps or lumps may appear on them.
It is important to consult a gynecologist if you notice a lump on the labia, particularly if the bump/s present with other symptoms. The doctor will identify the underlying cause to help guide the most appropriate treatment.
Why do I have a lump on my labia?
The main causes of lumps and bumps on the labia majora are:
1. Ingrown hair
An ingrown hair, or folliculitis is inflammation of the hair follicle, which is the structure in the skin where the hair roots are located. When it becomes inflamed, it difficult for the hair to penetrate the surface of the skin, and this can lead to the appearance of symptoms like a reddish lump on the labia, small bumps that may contain pus, itching or burning sensation.
Ingrown hairs are is a relatively common condition, and are usually caused by skin rubbing when wearing tight clothing. These bumps can also appear after shaving or waxing, or they can appear as a result of a bacterial of fungal infection.
What to do: Apply a warm water compress about 3 times a day to the affected area, and cleanse the area daily with warm water and mild soap. This helps to dilate the skin pores and keep the skin clean. If the bumps do not resolve with these measures, you should consult a gynecologist for assessment, as treatment with ointments may be necessary.
2. Bartholinitis
Bartholinitis is the inflammation of the Bartholin glands, which are located near the opening of the vaginal canal, between the labia minora and labia majora. These are necessary to keep the vagina lubricated, which can lead to the appearance of a lump, soreness of labia majora (usually just on once side, and a pus-filled bump that can make sitting or walking uncomfortable.
The Bartholin gland can become inflamed due to bacterial infections, generally caused by poor hygiene, multiple sexual partners and not using a condom during sexual intercourse..
What to do: You should consult a gynecologist who may recommend treatment with the use of anti-inflammatories or antibiotics to treat the infection. A minor procedure may be necessary to drain the pus, while severe cases may require surgical removal of the Bartholin gland. After surgery, it is recommended to avoid intimate contact for approximately 15 to 20 days, as per medical advice, to promote healing.
3. Boil
A boil is a lump filled with pus that can grow over time, causing pain, increased heat in the area, redness and sensitivity to touch. They are most common to occur in the labia majora.
The boil can arise due to inflammation at the root of the hair, obstruction of a sebaceous gland or a wound in the vulva region, and is in most cases associated with infection by the bacteria Staphylococcus aureus. This bacteria can be found naturally in mucous membranes and skin. .
What to do: Apply a warm water compress to the boil 3 times a day, and cleanse the area well with warm water and mild soap. You should never squeeze the boil, as this can worsen inflammation and the infection, making it more difficult to treat. In some cases, the gynecologist may recommend draining the abscess, which consists of removing the pus, followed bu antibiotics to treat the infection.
4. Genital herpes
Genital herpes is a sexually transmitted infection (STI) caused by the herpes simplex virus. This virus can be transmitted through contact with a partner's blisters through unprotected sex.
A herpes infection can lead to the appearance of blisters or lumps on the labia majora or minora, or around the opening of the vagina, which can rupture and form itchy and painful sores. Herpes sores can also appear in the perianal region or anus. Learn more about the symptoms of genital herpes and what the sores look like.
What to do: You should consult a gynecologist to confirm a diagnosis of genital herpes, and start the most appropriate treatment. Treatment usually involves the use of antiviral medicines such as acyclovir, valacyclovir or famciclovir for about 7 days. These help to prevent the virus from multiplying, allowing the skin to heal appearance of new sores.
5. Genital warts
Genital warts appear due to HPV infection and are characterized by a red or pink lump, with a smooth or rough texture. These lumps often have a cauliflower appearance, and develop in any region of the genitals, such as the labia majora, labia minora, perineum or, in some cases, the cervix and anal region.
HPV infection is transmitted through unprotected sex with a person infected with the virus.
What to do: HPV treatment generally involves removing genital warts, which can be through the application of medications to the warts such as acids or immunomodulators and, in some cases, surgery, for example. See all treatment options for genital warts.
6. Vulvar lipoma
A vulvar lipoma is a round, soft lump that forms under the skin and is made up of fat cells. It can appear on the labia majora or anywhere on the body where fat cells are present.
Generally, lipomas do not cause pain, however, in some cases they can grow and press on the surrounding nerves, causing pain, inflammation and redness.
What to do: Generally, no treatment is necessary for vulvar lipomas, however, when the lipoma is very large or causes discomfort, the gynecologist may surgically remove it.
7. Sebaceous cyst
A sebaceous cyst is a lump that forms under the skin, with a rounded shape, measuring a few centimeters. It can increase in size over time, and can be hard or soft. They tend to move with palpation, and can appear in the labia majora or any other region of the body.
This type of cyst is benign and is caused by an obstruction in the sebaceous gland. It is characterized by a build-up of sebum under the skin, and is generally not associated with symptoms. However, when the cyst becomes inflamed, you may notice pain, increased heat in the area, sensitivity or redness.
What to do: Specific treatment is generally not necessary, especially when the cyst is small. The gynecologist may recommend the application of a warm compress for 15 minutes on the site 3 times a day, or surgical removal for aesthetic reasons. If the cyst becomes inflamed or infected, the doctor may drain it and prescribe antibiotics.
8. Vulvar varicose veins
Varicose veins on the vulva are dilated and bluish or purplish veins that can appear on the labia majora or labia minora. They can form a lump that does not cause pain, but can cause a feeling of heaviness, as well as itching, bleeding or even discomfort during sex.
Varicose veins in the vulva are more common to appear during pregnancy, due to the excess weight of the uterus which causes pressure on the pelvis, or also due to the natural aging of the body.
What to do: Generally, when varicose veins on the vulva appear during pregnancy, no treatment is necessary, as the veins return to normal within a few weeks after giving birth. However, varicose veins caused by natural aging that present with symptoms can be surgically removed.
9. Senile hemangioma
A senile hemangioma is a type of benign tumor that is made-up of an abnormal accumulation of local blood vessels, forming one large lump or multiple small lumps. They are red or dark blue color, and are soft on palpation.
This type of lump is more common in the elderly, and is often only discovered during routine gynecological exams, as they do not present with any symptoms.
What to do: Given this lump is considered to be a benign tumor, no specific treatment is necessary. However, some women may request its removal if it causes discomfort or for aesthetic purposes.
10. Vulvar keratoacanthoma
Vulvar keratoacanthoma is a tumor that can appear as a lump on the vaginal lips with a firm appearance and an oval or round shape on the labia majora. Its color is similar to the woman's skin tone.
This type of tumor is rare and can increase in size over weeks or months, making it difficult to diagnose, as it is similar to squamous cell cancer. However, like senile hemangiomas, vulvar keratoacanthoma do not evolve into malignant lumps.
What to do: You should consult a gynecologist for diagnosis and treatment, which usually involves a minor procedure to remove the lump.
11. Vulvar cancer
Vulvar cancer is a type of malignant tumor that can cause a lump to appear in the vulva region, including the labia majora or minora, clitoris or vagina. It is associated with intense itching that does not improve, pain, bleeding, changes in the color of the skin, or open wounds.
This type of cancer is more common in elderly women, generally after the age of 65. Some factors associated with an risk for vulvar cancer include HPV infections, smoking habit, inflammatory diseases of the vulva or pelvis, radiation therapy, or a weakened immune system.
What to do: Treatment for vulvar cancer is directed by an oncologist or gynecologist, and involves surgical removal of the tumor, in addition to radiation, chemotherapy, immunotherapy or targeted therapy.
