**Category: Signs & Symptoms** Vaginal sores are lesions that appear around the vagina. Some sores can cause itching, pain, different vaginal discharge... but there are sores that may not cause any symptoms unless they worsen their appearance. Although there are also other symptoms that include pain when urinating or having sexual intercourse. Sores can be caused by a variety of skin disorders, but are most often symptoms of a sexually transmitted infection.

Sores in the vagina, what should you know?

  • These types of infections are often spread rapidly through unprotected sexual contact. For example, herpes is a common cause of the appearance of painful sores in the vagina. Genital warts can also cause sores, although there are also less common infections—chancroid, syphilis, or molluscum contagiosum—that can cause sores, itching, and pain.
  • When there are sores on the skin, skin disorders may appear with itchy and scaly eruptions. The skin turns red, hurts and there is inflammation, especially after using vaginal wipes with perfume, soaps, clothes with fabric softener, cream, etc.
  • If you think you have vaginal sores, it is best to see your doctor since a physical examination can help you determine the cause of the vaginal sores. Your doctor will perform a pelvic exam and ask you questions. In addition, you can also order tests to determine the exact cause such as a blood test or take a sample to detect the presence of bacteria. Once your doctor has determined the cause, he or she will be able to tell you exactly what treatment you need to help you find the best relief for your sores.
  • To care for vaginal sores, they must first have been checked by a doctor. But while you wait to go to your health center, you can relieve the pain with a bath in the bathtub with lukewarm water. You can add a little baking soda to the water to better relieve the pain.
## How doctors diagnose vaginal sores — step-by-step, what to expect and what to bring Accurate diagnosis matters because treatment differs dramatically between causes (antivirals for herpes, antibiotics for syphilis/chancroid, topical steroids for dermatitis, ablative therapy for warts). Below is an expert-level, practical outline of the diagnostic journey and how you can prepare. ### What the clinician will ask and why it matters - **Onset and timing.** Are the lesions acute (days), recurrent (same spot over months/years), or chronic? Acute painful clustered blisters strongly suggest HSV; single painless ulcer points to syphilis. - **Symptoms associated.** Pain, burning with urination, discharge, fever, tender lymph nodes — these clues narrow causes. - **Sexual history.** Number of partners, condom use, recent partners, oral or anal sex — critical for STI risk assessment and partner notification planning. - **Previous episodes and treatments.** Prior herpes episodes and response to antivirals guide whether suppressive therapy is appropriate. - **Pregnancy status.** Pregnancy changes management (see the pregnancy-specific section below). - **Topical products and clothing.** New soaps, wipes, tight or synthetic underwear, recent waxing — suggests contact dermatitis or folliculitis. Bring the following to your visit: - A list of current medications (birth control, supplements). - Dates of last menstrual period and any menstrual products used. - A timeline and photos of the lesion(s) if they are transient. - Contact information for recent sexual partners if comfortable (for partner notification). ### Physical exam and sampling — practical details - **Visual inspection** of the vulva and perineum, speculum exam to look inside the vagina if tolerated. - **Swab of lesion**: For suspected herpes, a swab of an active blister or ulcer for PCR is the best test — high sensitivity. Viral culture is less sensitive; PCR preferred. - **NAAT (nucleic acid amplification test)** for chlamydia and gonorrhea from urine or vaginal swab if concurrent infection suspected. - **Syphilis serology (RPR/VDRL + confirmatory treponemal test)** for suspected syphilitic ulcer. Early syphilis can be seronegative in first few weeks — if high suspicion, repeat testing in 2–4 weeks. - **Bacterial culture** if chancroid (Haemophilus ducreyi) suspected — availability varies by lab. - **Biopsy** if the lesion is atypical, persistent, or there is suspicion for lichen planus, vulvar intraepithelial neoplasia, or malignancy. - **Skin scraping or KOH prep** if fungal infection is suspected. Real example: A 28-year-old woman presents with 3 days of clustered painful vulvar blisters and low-grade fever. The clinician obtains a swab for HSV PCR and starts empiric oral antiviral therapy pending results — this is common practice to shorten symptom duration. ### When testing can be negative (and what that means) - Tests are most accurate when done on fresh lesions. If lesions have healed, PCR or culture may be negative; serology for HSV (IgG) can identify prior exposure but not necessarily current cause. - For syphilis, early single ulcers may test negative on serology — repeat testing is essential if suspicion persists. ## Treatment and home-care plan — what works, dosing examples, and practical steps Treatment depends on the cause. Below I provide clear, evidence-based, and practical regimens commonly used in gynecologic practice, plus stepwise home care you can start immediately. ### Herpes simplex virus (HSV) — first episode, recurrent, and suppression - **First clinical episode (typical dosing):** - Acyclovir 400 mg orally three times a day for 7–10 days OR - Valacyclovir 1 g orally twice a day for 7–10 days OR - Famciclovir 250 mg three times a day for 7–10 days. - **Episodic treatment for recurrent outbreaks (start within 24–48 hours of lesion onset):** - Valacyclovir 500 mg orally twice daily for 3 days OR - Acyclovir 800 mg three times a day for 2 days. - **Suppressive therapy (if ≥6 recurrences/year or recurrent disease affecting quality of life):** - Valacyclovir 500 mg daily or 1 g daily (depending on frequency) — individualized by clinician. - **Practical advice:** - Begin therapy as early as possible for best effect. - Drink plenty of water with acyclovir/valacyclovir. - If you have renal impairment, dose adjustments are necessary — bring kidney function info. - **Example:** A patient with 3-4 outbreaks per year benefited from valacyclovir 500 mg daily and reported a reduction to 1 mild outbreak annually. ### Syphilis - **Primary, secondary, or early latent syphilis:** Benzathine penicillin G 2.4 million units IM single dose. - **Penicillin allergy:** Skin testing and desensitization recommended in pregnancy; for nonpregnant patients, doxycycline 100 mg twice daily for 14 days is an alternative (not adequate in pregnancy). - **Actionable point:** Ensure partner notification and repeat serology for response at 6 and 12 months. ### Chancroid (rare in many countries) - **Treatment options:** Azithromycin 1 g orally single dose OR ceftriaxone 250 mg IM single dose OR ciprofloxacin 500 mg twice a day for 3 days. - **Practical:** Treatment generally leads to rapid improvement in 3–7 days. ### HPV genital warts - **Provider-applied treatments:** Cryotherapy, trichloroacetic acid (TCA), or surgical removal. - **Patient-applied options:** Podofilox 0.5% solution or gel, imiquimod 5% cream (useful but can cause local inflammation). - **Example:** Office cryotherapy every 2–3 weeks until clearance; many patients need 2–4 sessions. ### Molluscum contagiosum - Often self-limited but can be treated by cryotherapy or curettage in clinic. Topical treatments sometimes used. ### Contact dermatitis, lichen sclerosus, and other dermatologic causes - **Contact dermatitis:** Stop offending product; short course of topical 1% hydrocortisone cream (avoid prolonged potent steroid use on vulva). - **Lichen sclerosus:** High-potency topical steroid (clobetasol propionate 0.05% ointment) under specialist guidance. - **Actionable:** Avoid scented products, use only unscented detergent, cotton underwear, and avoid tight clothing. ### Fungal infection - **Vulvovaginal candidiasis:** Single-dose fluconazole 150 mg orally OR topical azole creams (clotrimazole, miconazole). - **Practical:** If recurrent (≥4 episodes/year), evaluate for diabetes, immune suppression, and review antibiotic use. ### Pain control and local care measures (use while awaiting test results or as adjunct) - **Sitz baths:** Warm water sitz baths 10–15 minutes several times daily provide symptomatic relief. Add 1–2 tablespoons of baking soda per liter if helpful. - **Topical anesthetic:** 2% lidocaine ointment applied sparingly for severe pain (short-term). - **Analgesia:** NSAIDs (ibuprofen) or acetaminophen for discomfort. - **Clothing:** Loose cotton underwear; avoid nylon and tight pants. - **Hygiene:** Pat dry, avoid douching, avoid bubble baths and perfumed soaps. - **Sexual activity:** Abstain from penetrative sexual activity while sores are present; use condoms consistently afterwards (they don’t fully eliminate transmission risk for HSV or HPV because of skin-to-skin spread). ### Special considerations: pregnancy and delivery - **HSV in pregnancy:** If history of recurrent genital herpes or seropositive, consider suppressive valacyclovir from 36 weeks gestation to reduce risk of active lesions at delivery. If active lesions or prodrome at labor, cesarean delivery is recommended. - **Syphilis in pregnancy:** Prompt penicillin treatment is essential; RPR titers are followed until they decline. - **Actionable:** Always inform your obstetrician immediately if you develop a new vulvar ulcer or blister in pregnancy. ### Red flags — when to seek urgent care - Fever >38°C (101°F), inability to pass urine or severe urinary retention. - Rapidly spreading redness, increasing pain, purulent drainage, or systemic signs (confusion, fainting). - Severe bleeding, rapidly enlarging lesion, or signs of sepsis. - Pregnancy with active lesions or any concern for exposure to syphilis/HSV. ## Prevention and sexual-health strategies — practical, evidence-based steps Prevention reduces the likelihood of future sores and limits transmission to partners. - **Vaccination:** HPV vaccination (Gardasil) prevents most genital warts and cervical/pre-cancerous disease caused by common high-risk HPV types. Ideal up to age 26, with some recommendations extending to 45 in shared decision-making. - **Condom use:** Consistent condom use reduces risk of many STIs but does not fully protect against HSV or HPV because they can infect uncovered skin. - **Pre-exposure discussion and testing:** If you or your partner have new sexual partners, regular STI screening (every 3–12 months depending on risk) is advisable. Discuss vaccination and testing with your provider. - **Suppressive antiviral therapy to reduce transmission:** Suppressive valacyclovir in HSV-seropositive individuals reduces (but does not eliminate) partner transmission. - **Avoiding irritants:** Use only unscented soaps, avoid vaginal douches and scented wipes, and choose fragrance-free laundry products for underwear. - **Communication with partners:** If you have an STI, timely partner notification and treatment prevent reinfection. Local health departments or clinics can assist with anonymous notification if desired. Practical example: A woman with recurrent HSV used daily valacyclovir and discussed HPV vaccination for her teenage partner. She also established routine screening for chlamydia/gonorrhea annually and switched to fragrance-free products, which resolved concurrent dermatitis. Find more on safer sex, screening schedules, and vaccination in our [related topic](/blog). To buy barrier products, gentle wash, or medicated creams, visit our [shop](/shop). ## Practical clinic-to-home checklist for patients with vaginal sores - Take photos of lesions (date-stamped on phone) to show your provider if lesions resolve before clinic visit. - Avoid sex and oral sex until a clinician confirms the cause or tells you it’s safe. - Keep lesions clean and dry; gentle patting after showers. - Start symptomatic care: warm sitz baths, NSAIDs, topical 2% lidocaine if needed (ask about over-the-counter availability). - Keep a list of recent partners and dates to facilitate partner notification if an STI is confirmed. - Record onset, symptoms, prior similar episodes, new products, and systemic symptoms to bring to your appointment. ## When to involve a specialist - Lesions that do not improve after appropriate therapy. - Recurrent or unusual lesions — consider dermatologist or vulvar clinic referral. - Suspected neoplastic changes (persistent ulcer >4 weeks without clear cause). - Pregnant patients with uncertain diagnosis or active lesions near delivery. ## FAQ ### Can vaginal sores go away on their own? Yes — some causes of vaginal sores can resolve without specific medical therapy (e.g., molluscum contagiosum in some cases, mild contact dermatitis after stopping an irritant). However, many causes (HSV, syphilis, bacterial ulcers) require medical treatment to reduce symptoms, prevent complications, and reduce transmission. If you have a new sore, **seek evaluation** rather than waiting for spontaneous resolution. ### How long after exposure do sores appear? - **HSV (genital herpes):** Typically 2–12 days after exposure for a first episode, but it can be longer. Recurrent outbreaks often occur within days to months of a known trigger. - **Syphilis:** Primary chancre appears about 10–90 days after exposure (commonly ~21 days). - **Chancroid:** Usually 4–7 days after exposure. - **Contact dermatitis:** Can appear within hours to days of exposure to the offending product. These are general ranges — individual timing varies. ### Are vaginal sores always caused by sexually transmitted infections (STIs)? No. While many vaginal sores are caused by STIs (HSV, syphilis, chancroid), non-infectious dermatologic conditions (lichen sclerosus, lichen planus), contact dermatitis, traumatic fissures, or insect bites can also lead to lesions. Proper evaluation distinguishes infectious from noninfectious causes. ### Can I have surgery or laser treatment for genital warts if I’m pregnant? Yes — provider-applied treatments like cryotherapy or surgical removal are commonly used in pregnancy for symptomatic warts. Certain patient-applied topical medications (like imiquimod or podofilox) are typically avoided during pregnancy. Always coordinate treatment with your obstetrician. ### If my partner has a sore, do I need to be treated too? You should be evaluated and tested. Management depends on the identified cause. For syphilis, **all partners** of a person with a new positive test should be notified and treated when indicated. For HSV, partner testing is of limited utility; shared decision-making about testing and counseling is recommended. Immediate evaluation and testing help prevent spread and recurrent infections. --- If you want detailed checklists for clinic visits, printable symptom trackers, or recommended gentle skin care items, see our [shop](/shop) and more educational articles in our [related topic](/blog). If you have urgent symptoms (fever, urinary retention, spreading infection), go to the nearest emergency department or contact your clinician immediately.