Solving the Mystery of Labial Lesions

Hi Aunt Vadge,

I have a vaginal lesion in the crease between my inner and outer labia. I went to the doctor, and I have bacterial vaginosis.

They tested me for STDs and did a swab on the lesion, and it is not herpes, and it all came back negative.

The doctor told me to put an over-the-counter ointment on it until it heals. It felt healed, but since then I’ve had intercourse with my partner, and it has returned.

I got the lesion about 3 weeks ago
It doesn’t hurt or weep, but it itches
It’s skin-colored unless irritated, then it’s reddish
It’s about an inch-and-a-quarter long
The only thing that changed is it looked healed until I had intercourse on two consecutive days
It doesn’t feel much different than the other skin around it, just slightly raised
The doctor didn’t say much other than to put the ointment on and if it doesn’t help to come back in, but I don’t have insurance, so trying to figure out if I need to. The doctor told me to put bacitracin zinc [antibiotic cream] and I thought it was healed until it was irritated again today
I’m allergic to cats and some dogs, and I’m dairy sensitive and very sensitive to scented soaps and things like that – I will get razor burn and feel like I have a UTI.
I have no other diseases or conditions.
I recently moved to a new state three months ago so maybe some stress there. It was a good move, as I was ready for a change. I did get out of a 6-year relationship in January. But it was a good change.
They gave me an oral antibiotic for the BV, and it seemed like it was going away at first. But I do have problems with it reoccurring. Even when I’m taking probiotics with it.
I am not using condoms with my partner, but no semen is coming into contact, as he doesn’t ejaculate inside me.
I’m not using any other ointments on the lesion but I have used coconut oil on it.
I have been having some digestive issues. I think I’m very sensitive to dairy. And I have been having headaches, but I moved from an elevation of 3500ft to 9180ft.
I’m not aware of any autoimmune conditions in my family, but I do know my mom and sister are allergic to sulfur products.

Sincerely,
Sensitive
Age 28
Colorado, USA

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Dear Sensitive,

There are a couple of options that may explain your lesion:

Check out the lichenoid and dermatoses page and have a look online at Google Images to see what these all look like. See if any of them match your lesion and other symptoms like itching, which is a classic for any of the above lichenoid or psoriatic conditions.

Lesions can also be caused by certain types of precancerous or cancerous changes. You need to know if this is what you have. You seem to be sensitive to several things, indicating a somewhat overactive immune system (for what reason, we can’t tell from here).

This means you are susceptible to inflammatory, overactive-type health conditions, which may appear and disappear. For this reason, it would be a good idea to record all of your symptoms, keep a photo diary so you can see if the lesion changes, and find a very good gynaecologist (or dermatologist who has experience with the vulva – call ahead and ask).

Because you may be paying for this out of pocket, do your homework and see if you can find out what the problem is likely to be yourself, so you are armed with knowledge.

What to do in the meantime

Treating the BV

If you haven’t already, we recommend getting yourself a copy of our excellent book, Killing BV.

Getting examined

To be clear, we have no idea what your lesion is, only some clues as to what it could be. This means to find the true cause, you would benefit from being examined by a physician who specialised in vaginas, which doesn’t seem to necessarily be the doctor you have seen.

De-stress

While the move was three months ago, having health problems like BV and a mysterious lesion are intrinsically stressful, so be good to yourself on purpose with the express goal of reducing your stress response.

Early treatment means better outcomes. A labial lesion is not normal, so yes, you do need to go back to the doctor. If you need any more help or have any further questions, please get in touch anytime.

Warmest regards,
Aunt Vadge