The vulva is the external portion of the female genitalia/sex organs. If your daughter has a cyst, growth, rash, or other abnormality on or around the vulva, she should see a doctor for an examination.
In pediatric patients, common vulvar cysts and abnormalities include:
Bartholin gland cysts – cysts that form from a backup of fluid if skin grows over the opening of one of the Bartholin glands on either side of the vaginal opening, or if they become infected
Canal of Nuck cyst – a painless swelling in the vulva left over from incomplete embryonic process
Contact dermatitis – a skin condition caused by exposure to allergens and irritants that can produce vulvar itching, burning, and red or rash-like skin on the vulva
Epidermal inclusion cysts – small cysts that result from injury to the skin of the vulva
Folliculitis – small, red, painful bumps that occur when hair follicles become irritated and/or infected
Mucous cysts of vestibule – fluid-filled swellings that develop when small glands are blocked near the opening of the vagina or urethra
Sebaceous gland cyst – small cysts, which may enlarge and become infected, that develop when the ducts to sebaceous glands are blocked
Inguinal hernia – soft tissue (abdominal membrane or intestine) protruding through a weak point in the groin muscle and/or labia
Vulvar fibroma – a benign lump made up of fibrous or connective tissue
Vulvar hematoma – an area of swollen, bruised tissue usually caused by vulvar injury
Vulvar lipoma – a painless, slow-growing mass made up of fatty tissue
At her appointment, the doctor will ask about her symptoms and medical history and then examine the vulva. Some of these conditions can be diagnosed by visual inspection, location, and/or related symptoms alone, while others will require swabs to test for infection, aspiration or biopsy to rule out malignancy, and occasionally ultrasound imaging to confirm the diagnosis.
For mild, non-infected Bartholin gland cysts, your daughter’s doctor may prescribe a few days of sitz baths – during which your daughter will sit in a few inches of warm water several times a day. If her cyst is large or infected, the doctor can make a small incision to drain the fluid or insert a tube that allows fluid to drain out for several weeks. Your daughter will receive antibiotics if she has an infection.
Asymptomatic epidermal inclusion cysts don’t require treatment. Large, infected cysts may require drainage or excision and oral antibiotics.
Mucous cysts of vestibule will usually resolve on their own.
Vulvar fibromas, especially if they are large, are usually surgically removed.
Vulvar lipomas don’t require treatment unless they are large or cause pain or distress.
Canal of Nuck cysts can be treated surgically. Your doctor will prescribe antibiotics if your daughter’s cyst is infected.
Sebaceous gland cysts usually resolve on their own but may need to be drained and/or treated with antibiotics if they become large or infected.
Inguinal hernia must be repaired by surgery to prevent strangulation or incarceration, which kills the affected tissue.
Contact dermatitis will usually resolve on its own once the irritant or allergen is removed. Your doctor will recommend avoiding harsh soaps and detergents.
For folliculitis, your daughter’s doctor may prescribe antibiotic creams or pills to clear up any infection as well as warm compresses.
Vulvar cancers and other malignant lumps will be treated with a combination of surgery, chemotherapy, and/or radiation. Large hemangiomas and endometriomas – or other large, painful cysts and lumps – may require surgical removal.