Non-cancerous tumours and conditions of the vulva

Non-cancerous (benign) tumours and conditions of the skin are growths or changes to vulvar cells, but they are not cancer. They don't spread (metastasize) to other parts of the body and aren't usually life-threatening. Most of them require treatment such as surgery and topical therapy.

There are many types of non-cancerous tumours and conditions of the vulva.

Non-cancerous tumours of the vulva start in connective tissue and include:

• fibromas, fibromyomas and dermatofibromas, which start in fibrous and muscle tissue
• lipomas, which start in fatty tissue
• hemangiomas, which start in the blood vessels

An excisional biopsy is used to diagnose most non-cancerous tumours and to rule out the possibility of cancer.

Treatment for non-cancerous vulvar tumours depends on the type of tumour. They are often completely removed by surgery (excision) .

Vulvar cysts are usually non-cancerous. They are fluid-filled sacs in the vulvar tissue caused by a blockage of the ducts or glands in the vulvar area.

Bartholin cysts are the most common type of vulvar cyst. They usually appear as a painless lump next to the vaginal opening near the anus. If there is collection of pus (abscess), the lump will be painful. Bartholin cysts usually occur during reproductive age.

Skene’s gland cysts develop next to the urethral opening when the ducts to the Skene’s glands are blocked. Symptoms include pain, problems urinating and urinary tract infections (UTIs).

Some cysts disappear on their own and don’t need treatment. Other cysts may need treatments such as:

• a fine needle aspiration to drain the cyst, followed by antibiotics if an abscess develops
• inserting a small tube (catheter) into the cyst to drain it
• keeping the cyst open to let it drain and shrink gradually (called marsupialization)
• surgery to remove cysts that keep coming back
• surgery to remove cysts if there is an increased risk of vulvar cancer

Find out more about fine-needle aspiration.

Lichen sclerosus is a chronic skin condition that most often affects the vulva or the area around the anus. It causes white, itchy patches and open sores (ulcers) on the skin. The skin may also become thinner and paler, and the vulva may look abnormal. Lichen sclerosus is usually treated with corticosteroid creams.

Lichen sclerosus is more common after menopause.

Lichen planus is an inflammatory condition that can affect various parts of the body, including the skin, mouth, nails and genitals. Lichen planus of the vulva may cause loss of the top layer of skin and itching in the affected area. It’s usually treated with corticosteroid creams. Lichen planus is more common between the ages of 50 and 60.

Genital warts are growths of skin in the groin, genital and anal areas. Genital warts are caused by human papillomavirus (HPV) infection. Genital warts are usually treated with an ointment or cream. They may also be removed with laser surgery, cryosurgery or electrosurgery.

Squamous cell hyperplasia, also known as lichen simplex chronicus, is a condition inwhich the vulvar skin thickens due to an increase in the number of squamous cells. Treatments include avoiding soaps that irritate the skin and using a corticosteroid cream.