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Hi Aunt Vadge,
I keep getting fissure-like cracks on my vulva – like painful little slits in all the creases. They usually heal within a night or a couple of days. They can come after sex, sometimes randomly, and often after my period. I had a PCR herpes swab that was negative, and a negative IgG blood test for HSV1 and HSV2.
I’m so worried it’s herpes – could it still be? Or could it be something else entirely?
Thanks,
N.
Age 28, UK
Dear N,
Let’s put the herpes fear to bed first: between a negative PCR swab and a negative IgG blood test for both HSV types, you can be properly confident this isn’t herpes.
It’s everyone’s first go-to fear. But your testing has covered it from two angles, so let’s spend the energy on what this actually is, because there’s always a reason – and you’ve handed me the biggest clue without realising: the timing. Cracks that flare after your period and after sex point strongly to a couple of usual suspects.
Top of the list is recurrent yeast, the single most common cause of cyclical vulval fissuring: yeast weakens the skin so it splits, and it loves to flare around your period when oestrogen dips. So the ‘after my period’ pattern fits almost perfectly.
Friction and dryness explain the ‘after sex’ ones, where there simply isn’t enough lubrication so already-fragile skin tears. And a skin condition like lichen sclerosus or eczema and contact dermatitis (from soaps, fragranced products or pads) can cause recurrent splitting too, especially if there’s any whitening or persistent fragility.
The most important practical tip is to get a swab while you actually have symptoms, not after they’ve healed, because yeast tests come back falsely negative once the skin’s settled – which is exactly how this gets missed.
From there, treat any yeast that’s found and see whether the fissures stop following your cycle, strip back irritants to plain water and fragrance-free everything with soft cotton, use plenty of lube and arousal time for the post-sex splits so the tissue is plump and resilient, and if there’s any whitening or the splitting persists, ask your doctor to check for a skin condition like lichen sclerosus.
A doctor can do those swabs and an exam. And if you keep hitting dead ends this exact kind of mystery is what we love untangling, so you can book with one of our practitioners – but my money’s on a yeast pattern, so chase that first.
Best,
Aunt Vadge
This is general information based on current research and our clinical experience, not a substitute for personalised medical advice.
