The short answer: most itching, lumps and skin changes on the vulva (the skin outside the vagina) are not cancer; common causes are thrush and other infections, cysts and skin conditions. A lump, a sore, or a white, red or dark patch that does not settle within a few weeks, or itching that keeps coming back despite treatment, should be examined by a doctor. Vulvar cancer is uncommon and is often very treatable when found early.
In Hindi this is often searched as yoni ke bahari hisse ka cancer or yoni cancer ke lakshan (योनि कैंसर के लक्षण), and itching as private part me khujli (प्राइवेट पार्ट में खुजली).
On this page
- What Is Vulvar Cancer?
- Warning Signs of Vulvar Cancer
- The Role of Lichen Sclerosus
- Younger Women and HPV-Related Vulvar Disease
What Is Vulvar Cancer?
The vulva — the skin and tissue outside the vagina, including the outer and inner lips (labia majora and labia minora), the clitoris and the skin between the vagina and the back passage (perineum) — is the site of origin of approximately 4% of all gynaecological cancers. While uncommon, vulvar cancer is largely curable when diagnosed at an early stage. The challenge is that symptoms are often dismissed, misattributed to skin conditions, or simply not discussed with a doctor.
Squamous cell carcinoma (SCC), a cancer of the flat surface cells of the skin, accounts for 90% of vulvar cancers. There are two main pathways: HPV-related disease (more common in younger women, often preceded by a pre-cancerous skin change called vulvar intraepithelial neoplasia, or VIN) and non-HPV-related disease in older women, frequently associated with a long-term skin condition called lichen sclerosus.
Warning Signs of Vulvar Cancer
- Persistent itch (pruritus vulvae) — particularly if it has not responded to over-the-counter treatments
- A new lump, nodule, or raised area on any part of the vulva
- An ulcer or sore that does not heal within 4–6 weeks
- Skin colour or texture changes — white, red, or dark patches; thickening or scaling
- Burning or pain in the vulvar area
- Bleeding not related to menstruation
- Tenderness or swelling in the groin (can be a sign that the lymph glands in the groin are involved)
Most of these signs have harmless causes, such as thrush, eczema or a cyst. Many others come from skin changes such as lichen sclerosus or VIN, which need treatment and regular checks rather than cancer treatment. But if any of these signs lasts more than 4–6 weeks, especially after menopause, see a gynaecologist for an examination. If an area looks unusual, the doctor may suggest a small biopsy: a tiny piece of skin is removed under local anaesthetic in the clinic, and it is the only way to know for certain what the change is. The vulvar cancer page explains persistent vulvar sores or lumps needing assessment and how they are treated if cancer is found.
The Role of Lichen Sclerosus
Lichen sclerosus is a chronic inflammatory skin condition affecting the vulva and perianal area. It causes thin, white, itchy skin, scarring and gradual changes in the shape of the vulva, and is associated with an approximately 4–6% lifetime risk of developing squamous cell carcinoma. Women with lichen sclerosus should be under regular review, and a biopsy is usually advised if the appearance of any area changes.
Younger Women and HPV-Related Vulvar Disease
HPV-related vulvar intraepithelial neoplasia (VIN) affects younger women, often in their 30s and 40s. It presents as raised, warty or flat lesions, often multifocal, and carries a risk of progression to invasive carcinoma if untreated. Depending on the size and spread of the changes, treatment options include removing the affected skin with surgery, laser treatment, or a prescribed cream (imiquimod); the right choice is not the same for everyone. HPV vaccination reduces the incidence of HPV-related VIN.
Dr. Nishtha Tripathi Patel is a gynaecological oncologist in Ahmedabad specialising in all gynaecological cancers, including vulvar cancer. For a specialist assessment: +91 76988 00333.