Finding an unexpected white bump on the external genitalia, or vulva, can be concerning. The skin in this area, which includes the labia, clitoris, and perineum, contains hair follicles, sweat glands, and oil glands, making it susceptible to many common skin conditions. This information provides an overview of the potential causes behind a white bump on the vulva for educational purposes. Understanding the possibilities, from harmless conditions to those requiring medical intervention, can help inform your next steps. Self-diagnosis is not a substitute for professional medical evaluation, and an accurate diagnosis from a healthcare provider is necessary for appropriate care.
Benign and Common Causes
Many white bumps in the genital region are the result of common mechanical irritation or normal anatomical features, posing no health risk. These superficial skin changes are often related to grooming habits, friction, or the natural structure of the skin. They frequently resolve on their own without medical treatment.
Ingrown hairs and folliculitis are the most common causes of localized bumps, especially in areas that are shaved, waxed, or subjected to friction. An ingrown hair occurs when the hair strand curls back and grows into the skin, causing a small, solid, sometimes painful bump. Folliculitis is the inflammation or infection of the hair follicle, often presenting as small, red, or white pus-filled bumps that resemble acne. Tight clothing, heat, and moisture can exacerbate this condition by creating an environment conducive to bacterial growth, typically caused by Staphylococcus aureus.
Fordyce spots are another frequent cause and are entirely normal anatomical variations. These manifest as tiny, painless, white or yellowish-white spots, typically 1 to 3 millimeters in diameter, most often seen on the inner labia minora. Fordyce spots are enlarged sebaceous (oil) glands that do not have an associated hair follicle and open directly onto the skin surface. They are present in a large percentage of the adult population and are not contagious or a sign of disease.
Small, pearly-white bumps known as milia can also appear on the vulva, just as they do on the face. Milia are tiny cysts filled with trapped keratin, the protein that makes up the outer layer of the skin. They are dome-shaped, firm to the touch, and usually painless, often forming after skin trauma or inflammation. Simple friction bumps or irritant contact dermatitis, caused by rubbing from tight underwear or a reaction to fragranced soaps or detergents, can also lead to localized swelling and white or red raised areas.
Cysts and Chronic Skin Conditions
Structural issues and long-term inflammatory disorders can lead to the formation of deeper, more persistent white bumps or nodules that are not infectious. These conditions involve the glands or deeper layers of the skin, often requiring professional diagnosis to distinguish them from superficial causes.
Sebaceous cysts, sometimes referred to as epidermoid cysts, form when the duct of an oil gland becomes blocked, causing sebum and dead skin cells to accumulate beneath the skin. These cysts feel like a firm, slow-growing lump beneath the skin’s surface and are usually painless unless they become infected or inflamed. They are distinct from folliculitis because they are deeper, closed sacs rather than a simple infection of the hair opening.
A Bartholin’s cyst forms near the vaginal opening, typically on one side of the labia, when the duct of one of the two Bartholin’s glands becomes obstructed. These glands normally secrete fluid for lubrication, and when blocked, the fluid builds up to form a cyst. While often painless, if the cyst becomes infected, it can quickly turn into a painful abscess, requiring medical drainage and sometimes antibiotics.
Hidradenitis Suppurativa (HS) is a chronic inflammatory disorder affecting areas with a high concentration of apocrine sweat glands, including the groin and vulva. HS typically presents as deep, painful, pus-filled nodules and abscesses that can recur, often mistaken for recurring boils or severe acne. Over time, this condition can lead to the formation of tunnels under the skin, known as sinus tracts, and significant scarring.
Infectious Causes and Transmitted Conditions
Some white bumps are signs of an infection, including those that are sexually transmitted, and these require medical treatment to resolve and prevent further spread. The appearance of these lesions is often specific, aiding in proper diagnosis.
Molluscum contagiosum is a viral skin infection caused by a poxvirus that results in small, firm, pearly-white or flesh-colored bumps. The characteristic feature of these lesions is a tiny central indentation or dimple, known as umbilication. They often appear in clusters on the vulva, groin, and inner thighs. Though usually painless, molluscum contagiosum is highly contagious through direct skin-to-skin contact, including sexual contact in adults.
Genital warts, caused by certain strains of the Human Papillomavirus (HPV), can also present as white or skin-colored bumps. These warts are typically raised, rough in texture, and may appear individually or in clusters that resemble a small piece of cauliflower. Genital warts are usually painless but may cause mild itching or irritation, and they must be diagnosed by a healthcare provider.
While genital herpes typically causes painful, fluid-filled blisters on a red base, the lesions can appear white or discolored in their early stages. As the blisters rupture and heal, they often crust over, forming a yellowish or whitish scab that may be mistaken for a bump. The presence of tingling, burning, or pain preceding the outbreak is often a distinguishing symptom.
In cases of severe vulvovaginal candidiasis, or a yeast infection, intense inflammation can lead to a thick, white, cottage cheese-like discharge or plaque-like coating on the vulva that might be mistaken for bumps. This fungal infection is accompanied by severe itching, burning, and redness of the surrounding skin. While not technically a bump, the appearance of the dense, white material can be confusing.
When to Consult a Healthcare Provider
Determining when a white bump warrants a medical visit depends on its symptoms, persistence, and changes over time. Any new or unexplained lesion on the vulva should be evaluated by a healthcare professional, such as a gynecologist, dermatologist, or primary care provider.
A medical consultation is necessary if the bump is accompanied by pain, tenderness, or a burning sensation. You should also seek care if the bump is rapidly growing, bleeding, or developing an open sore or ulcer that does not heal. These changes can be signs of more serious conditions.
Additional warning signs include systemic symptoms like fever, chills, or swollen lymph nodes in the groin, which can indicate a spreading infection. Any abnormal or foul-smelling discharge, particularly if it is bloody or pus-filled, also requires immediate attention. If a bump persists for more than a few weeks, recurs frequently, or causes anxiety, a provider can offer an accurate diagnosis and discuss treatment options.