Vulvar Pimples: Causes, Differential Diagnosis, and When to Seek Care

Vulvar "pimples" (papules, pustules) have diverse etiologies. Accurate diagnosis guides treatment.

Common Causes

• Folliculitis: Bacterial (S. aureus) or fungal inflammation of hair follicles. Tender, pustular. Triggered by shaving, friction, occlusion.
• Contact Dermatitis: Irritant (soaps, detergents, pads) or allergic (fragrances, latex). Itchy, erythematous.
• Hidradenitis Suppurativa: Chronic inflammatory disease of apocrine glands; recurrent nodules/abscesses in intertriginous areas. Scarring, sinus tracts.
• Molluscum Contagiosum: Viral; umbilicated pearly papules. Sexually transmitted in adults.
• Genital Herpes (HSV): Clustered vesicles → painful ulcers. Recurrent.
• Syphilis (Chancre): Painless, indurated ulcer (primary stage).
• Vulvar Intraepithelial Neoplasia (VIN): Precancerous; pigmented or white lesions.
• Cysts: Bartholin, Skene, epidermal inclusion.

When to See a Clinician

• Lesions persist >2 weeks
• Painful, spreading, or ulcerated
• Systemic symptoms (fever, malaise)
• Sexual exposure concern
• Immunosuppression

Do not self-treat with harsh products. Biopsy or PCR/swab may be needed for definitive diagnosis.