Vulvars Ulcers

Vulva ulcers are extremely painful sores on the vulva, the outer part of a girl’s genitals. The vulva includes the opening of the vagina, the outer and inner lips, and the clitoris.

Vulvar ulcers are rare in girls and young women. Most vulvar ulcers in young girls are not sexually transmitted infections (STIs).

Patients can be seen by Texas Children's experts in Pediatric and Adolescent Gynecology.

Causes & Risk Factors

Possible causes include:

  • Canker sores
  • Infections
  • Autoimmune disorders – such as Crohn’s disease, LUPUS, or Behçet's disease
  • Reactions to certain medications
  • Skin conditions, allergies or irritants – such as lichen sclerosis, contact dermatitis or hair removal irritants

Symptoms & Types

Symptoms may include:

  • Groups of blisters or red spots on the genitals or buttocks
  • A single deep painful ulcer
  • Sores that bleed easily on contact
  • Flu-like symptoms, including fever, headache, sore throat, vomiting, diarrhea, coughing or fatigue
  • Rash on the palms of the hands and soles of the feet

Diagnosis & Tests

Diagnosis starts with a thorough medical history and physical exam, including the genital area.

Additional testing may include:

  • A pelvic exam and Pap smear 
  • Blood test
  • Testing for strep and other infections –  including sexually transmitted infections (STIs)
  • A biopsy – a sample is taken from an ulcer and examined under a microscope
  • Urinalysis and pregnancy test (in cases of sexually active young women)

Treatment & Care

Treatment depends on the individual patient and her symptoms. Treatment is typically aimed at providing pain relief and preventing scarring.

Treatment strategies include:

  • Warm baths
  • Topical ointments and steroid creams
  • Over-the-counter pain relievers
  • Antibiotics or other medications
  • Avoiding irritants to the area