Vulval guidelines

Skin conditions affecting the female genital skin are common and have a significant effect on quality of life. Although the risk is small, chronic inflammation in this area has potential to develop into neoplastic disease.


Link to Common Vulval Conditions and Treatment


Refer to Genital dermatology if


  • There is a dermatosis e.g. Lichen sclerosis, Lichen planus or eczema where primary care management has been unsuccessful


  • There is concern of an underlying Allergic Contact Dermatitis where primary care management has been unsuccessful


  • There is diagnostic uncertaintys


Refer to 2ww Gynaecology if you are significantly concerned about vulval cancer:


  • Asymmetrical lesion of unknown aetiology
  • Unexplained lump, ulceration or bleeding
  • Unexplained palpable mass or ulceration at the entrance to the vagina (not prolapse)
  • The lesion is pigmented


Refer to General Gynaecology if


  • A vaginal or labial cyst has become so large that it causes discomfort e.g. on sitting, intercourse, walking, inserting tampon. It is likely that a small catheter will be inserted as a day case, to drain the cyst. This stays in for 4-6 weeks

N.B. cystic lesions are fluctuant and soft, Bartholin’s gland tumours are hard and indurated and usually painful.


  • There is diagnostic uncertainty about a cyst


  • Consider contacting the on-call gynae registrar if a cyst has become an abscess


  • There are non-cosmetic concerns about labial injury after birth (non-acute phase)
  •  Acute tears will be dealt with by midwives


Refer to The HUB if


There are concerns about

  • STI
  • Recurrent vaginal discharge
  • Probable genital warts


Procedures of Limited Clinical Benefit

Surgery to the labia and vagina are not performed for cosmetic reasons



VULVAL DERMATOLOGYPatient information leaflets  and useful advice for treatment: https://doclibrary-rcht.cornwall.nhs.uk/RoyalCornwallHospitalsTrust/Internet/DocumentsLibrary/PatientInformation/VulvalServices.aspx


Review Date                          11/09/2019

Next Review Date                11/09/2020

Author                                   Dr Jo Parry

Contributors:                        Drs Lisa Haddon, Liz Venner, Sophia Julian, Lisa Verity RCHT


Version No.  1.0