Dear Dr. Kate,
I recently had a few zit-like sores on my labia that I was convinced were genital herpes. I went to a nurse practitioner who looked at them and took a sample — she said she just didn’t think that was the case and I never got a call back which means all my tests came back negative. So what could they have been? Infected hair follicles? Actual zits? Infected glands (I’ve heard there are little glands and ducts down there but not sure where)?
— Bumps in the Night
If you had multiple sores that looked like chicken pox (clear bumps with a red bottom) and they hurt, it’s most likely herpes. This virus is a hard one to diagnose with tests…unless your nurse practitioner popped open a bump to swab the fluid for culture (ouch), the test may have been negative, even if the virus was there. If you want to get a diagnosis, you can ask her about the blood tests for herpes. They’re a little complicated — there’s two kinds of viruses, and they’re the same ones that cause cold sores — but it’s the definitive way to know.
Infected hair follicles can look like herpes — you’ll see those on the hair-bearing lady parts (i.e., the outer labia but not the inner). If your sores were on your mons and on the larger lips, and you’ve been waxing or shaving with an old razor, that might be all they were. (Hydrocortisone cream and time can fix them.)
The last possibility is another viral infection that also shows up down below. It’s possible to get an infection like Epstein Barr virus — with a fever and sore throat — and break out with fever blisters on your vulva. This is really uncommon, though — so unless you were pretty sick, this is not likely the reason.
If the bumps come back, get into see your nurse practitioner as soon as possible, for the best chance of a diagnosis. If it takes a few days to get an appointment, snap a picture with your camera or phone, so you can show her what the bumps looked like at their painful best.
— Dr. Kate
Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at Gynotalk.com.