Vulval Skin Tags and Benign Bumps: Symptoms, Causes, and Treatment in the UK

Finding a new lump, bump, or skin tag in the genital area is a common experience for many women in the UK. While the discovery can be a source of anxiety, most vulval lesions are entirely benign (non-cancerous). Vulval skin tags, also known as acrochordons, are small, soft, skin-coloured growths that hang off the skin by a thin stalk.

These tags often develop in areas where skin rubs against skin or clothing, such as the groin or the folds of the labia. Unlike certain other genital conditions, skin tags are not a sexually transmitted infection (STI) and are not caused by poor hygiene. In most cases, they do not require treatment unless they become irritated, inflamed, or cause psychological distress regarding their appearance.

It is important to recognise that not every bump on the vulva is a skin tag. Several other benign conditions can present with similar symptoms:

• Sebaceous Cysts: Small, hard lumps that form under the skin when a sebaceous gland becomes blocked. They are usually painless unless they become infected.
• Fordyce Spots: Tiny, yellowish-white bumps that are actually visible oil glands. These are a normal part of human anatomy and are extremely common.
• Vulval Lipomas: Soft, fatty lumps that grow slowly under the skin. They are typically painless and move easily when pressed.
• Fibromas: Firm, slow-growing nodules made of fibrous tissue.

While these are generally harmless, any new growth in the genital area should be assessed by a healthcare professional to ensure it is not a more serious condition, such as a localized infection or, rarely, vulval malignancy.

The exact cause of skin tags is not fully understood, but several factors are known to increase the likelihood of their development. Friction is a primary driver; constant rubbing from tight underwear or skin-on-skin contact in the groin can trigger the growth of these extra cells.

Hormonal changes also play a significant role. Many women notice skin tags appearing for the first time during pregnancy or around the menopause. Additionally, there is evidence linking skin tags to insulin resistance and Type 2 diabetes, as well as a genetic predisposition. If your family members have skin tags, you may be more likely to develop them as well.

In the UK, the first step for any vulval concern is usually a consultation with a GP. Many women feel embarrassed to discuss genital symptoms in person, which is where a private online GP service can be highly beneficial. Speaking to a doctor online allows you to discuss your symptoms from the comfort and privacy of your home.

You should consider a consultation if:

• The lump has changed in size, shape, or colour.
• The growth is bleeding, oozing, or feels tender to the touch.
• The lesion is causing physical discomfort during exercise or sexual intercourse.
• You are unsure if the growth is a skin tag or a genital wart.
• The presence of the lesion is causing you significant worry or affecting your self-esteem.

An online GP can review your history and, in many cases, provide guidance on whether a physical examination or referral to a specialist clinic is necessary. This is a vital step in managing women's health and ensuring peace of mind.

One of the most common reasons patients seek medical advice is the concern that a vulval skin tag might be a genital wart. While both can appear as bumps in the genital area, they have distinct differences. Genital warts are caused by the Human Papillomavirus (HPV) and are highly contagious. They often appear in clusters, may have a 'cauliflower-like' texture, and are usually flatter or broader-based than skin tags.

In contrast, a skin tag typically sits on a narrow stalk and behaves like a small piece of loose skin. A healthcare professional can usually distinguish between the two through a visual examination. Following NHS and NICE guidance, if there is any doubt, a doctor may recommend an STI screen or a referral to a GUM (Genitourinary Medicine) clinic to rule out viral causes.

If a vulval skin tag is not causing problems, the standard clinical advice is usually to leave it alone. However, if treatment is desired for comfort or aesthetic reasons, several minor surgical options are available, typically performed by a dermatologist or a specialist GP:

• Cryotherapy: Freezing the skin tag with liquid nitrogen, causing it to fall off after a few days.
• Excision: Snapping or cutting the tag off using sterile surgical scissors or a scalpel under local anaesthesia.
• Cauterisation: Burning the skin tag off using a small electrical probe, which also seals the blood vessels to prevent bleeding.

Important Warning: You must never attempt to remove a vulval skin tag yourself using home kits, 'tag removers', or by tying it off with thread. The vulval area is highly vascular (rich in blood vessels) and sensitive. Self-removal carries a very high risk of severe bleeding, scarring, and secondary infection.