Vulvar cancer, though relatively uncommon, can manifest with a range of symptoms that often cause apprehension. These signs might include persistent itching, discomfort, noticeable changes in skin texture or color, the presence of lumps, or unusual bleeding in the vulvar area. While such symptoms are naturally concerning and warrant attention, they are frequently attributed to conditions that are not cancerous. A variety of benign issues can closely resemble the presentation of vulvar cancer.
Common Benign Conditions
Many non-cancerous conditions frequently present with symptoms that mimic those of vulvar cancer. Common infections, such as candidiasis, often referred to as a yeast infection, can cause intense itching, redness, swelling, and a thick, white, cottage cheese-like discharge in the vulvar region. Bacterial vaginosis, another common infection, may lead to a thin, gray or white discharge with a distinct fishy odor, along with itching and burning sensations. These infections create a red and irritated appearance that can be mistaken for more serious underlying issues.
Cysts are another common cause of lumps or swellings in the vulvar area. Bartholin’s cysts, for instance, form when the ducts of the Bartholin’s glands, located on either side of the vaginal opening, become blocked, leading to a fluid-filled lump that can range from pea-sized to several centimeters. Sebaceous cysts, which arise from blocked oil glands, can also appear as small, movable lumps beneath the skin. Both types of cysts can become tender or painful if they become infected.
General irritation and allergic reactions are also frequent culprits behind vulvar discomfort. Contact dermatitis, an inflammatory skin reaction, can occur when the delicate vulvar skin comes into contact with irritants or allergens. Common triggers include harsh soaps, perfumed detergents, fabric softeners, certain feminine hygiene products, or even tight, synthetic clothing. This can result in localized redness, intense itching, burning, and sometimes even a rash or blistering.
Chronic Inflammatory and Skin Conditions
A number of chronic dermatological and inflammatory conditions can cause persistent symptoms and visible changes in the vulvar skin. Lichen sclerosus is a long-term skin condition characterized by thin, white, shiny, and crinkled patches of skin, often appearing around the clitoris and labia. Individuals frequently experience severe itching, pain, tearing, and bruising, which can lead to architectural changes in the vulva over time, including narrowing of the vaginal opening.
Lichen planus is another inflammatory condition that can affect the mucous membranes, including the vulva. This condition typically presents as shiny, purplish, flat-topped bumps or patches, and can cause painful erosions or sores. Vulvar lichen planus often leads to significant itching and burning, and in some cases, it can cause scarring and changes to the vulvar architecture.
Common skin conditions such as psoriasis and eczema can also manifest in the vulvar area. Psoriasis in the vulva typically appears as well-defined, red patches that may be itchy but often lack the characteristic silvery scales seen elsewhere on the body due to the moist environment. Eczema, or atopic dermatitis, can cause dry, red, intensely itchy patches that may become thickened or leathery over time from chronic scratching.
Precancerous Changes
Beyond benign conditions, certain changes are considered precancerous, meaning they can develop into cancer if left unaddressed. Vulvar Intraepithelial Neoplasia, known as VIN, represents a spectrum of abnormal cell changes confined to the surface layers of the vulvar skin. VIN is categorized into different grades based on the extent of these abnormal cells, with higher grades indicating more widespread changes. It is a precursor condition requiring monitoring or intervention.
Individuals with VIN may experience persistent itching, changes in skin color, or the appearance of raised or flat lesions that are often white, red, or dark brown. These lesions can be single or multiple and may not always cause symptoms. Because the visual presentation of VIN can be highly variable and often indistinguishable from early vulvar cancer or even benign skin conditions, a biopsy is often performed to accurately differentiate it. Identifying VIN early through medical evaluation allows for timely management, which can prevent progression to invasive cancer.
Seeking Professional Medical Evaluation
Self-diagnosis of vulvar conditions is not reliable. Any new or persistent vulvar symptoms, such as an unexplained lump, an unhealing sore, prolonged itching, discomfort, or noticeable discoloration that does not resolve within a few weeks, warrants a medical examination and timely consultation with a healthcare provider for accurate diagnosis.
A medical professional will conduct a thorough physical examination of the vulvar area, often followed by diagnostic procedures. A biopsy, which involves taking a small tissue sample for microscopic analysis, is the definitive method for determining the exact cause of symptoms. While discovering concerning vulvar symptoms can be unsettling, it is reassuring to know that the vast majority of vulvar issues are found to be benign following professional evaluation.