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Vestibular Papillomatosis

Vestibular papillomatosis (VP) is a benign condition of the vulva that is characterised by raised papillae (bumps) which occur on the labia minora and vestibule. These papillae are usually 1-2 mm in size and are normally flesh-coloured, light pink, or white, and are arranged in a symmetrical pattern.

It is not known what causes VP, however, It is important to understand that VP is a perfectly normal and healthy variation of the vulva and is not a sexually transmitted infection. Therefore, it cannot be transmitted to or from your partners.

Symptoms

What does vestibular papillomatosis look like?
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Vestibular papillomatosis (VP) appears as raised papillae that are found on the labia minora and vestibule of vulva. These papillae are 1-2 mm in size and are normally flesh-coloured, light pink, or white, and are arranged in a symmetrical pattern. At times, the papillae can be much larger in size and can be mistaken for Genital warts by patients and doctors who do not specialise in genital dermatology.

Due to the similar appearance of VP and other genital lesions, it is easy to misdiagnose yourself. Therefore, It is important to seek medical advice if you notice any changes in your genital area.

Who does vestibular papillomatosis affect?
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Vestibular papillomatosis (VP) is an anatomical variation of the vulva found in women who have gone through puberty.

How common is vestibular papillomatosis?
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Unfortunately, the exact prevalence rate of vestibular papillomatosis (VP) is not well reported. This is because many women with VP may not know they have it and may never be diagnosed, or they may not seek medical attention.

However, a 2014 study from The Journal of Lower Genital Tract Disease found that out of 186 women, 36% had VP. Furthermore, a 2016 study from The Journal of Obstetrics and Gynaecology Research reported that out of 101 women, 67% had VP.

These studies suggest that VP is a common variation of the vulva and can be seen in a significant proportion of women. However, more studies need to be conducted before a definite answer can be provided.

Does vestibular papillomatosis cause any symptoms?
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The majority of women with Vestibular papillomatosis (VP) do not experience any symptoms. In rare cases, some women with VP may experience itching, burning, pain, or discomfort in their genital area.

These symptoms are not typical of VP and may be indicative of other genital conditions. It is important to consult a clinician for an examination and diagnosis if you notice any of these symptoms, or any changes to your genital area.

Causes

What causes vestibular papillomatosis?
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It is not known what causes vestibular papillomatosis (VP) or why it occurs in some women and not in others.

VP is analogous with Pearly penile papules (PPP) seen in men, the cause of which is also unknown. Both conditions are completely normal variations of genital anatomy.

Is Vestibular papillomatosis an STI?
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Vestibular papillomatosis (VP) is not an STI and cannot be passed from one person to another. Furthermore, VP is not caused by viruses or bacteria, and is not related to genital warts which are caused by the Human Papillomavirus (HPV).

If you are unsure whether you have VP or warts please book in for a consultation with one of our clinicians or with your local GP.

What factors can increase the likelihood of having Vestibular papillomatosis?
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There are no factors that increase the likelihood of having Vestibular papillomatosis (VP).

It is not known whether VP is congenital (present from birth) or whether it develops during puberty and adulthood. Either way, VP is a normal variation of vulva anatomy.

What factors can lead to a more severe case of Vestibular papillomatosis (VP)?
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  • Some women may notice that their VP becomes more noticeable during pregnancy.
  • Poor hygiene may lead to the accumulation of bacteria which can exacerbate VP.
  • Friction, pressure, or other types of irritation in the vulval area can also exacerbate VP.

Diagnosis

How is Vestibular papillomatosis diagnosed?
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Many patients present themselves having self-diagnosed with Vestibular papillomatosis (VP). Often they are correct, but not always. Due to the appearance of VP, it may be difficult to differentiate VP from other genital skin conditions.

VP is best diagnosed by an examination of the vulval area. If your lesions are -2 mm in size and are normally flesh-coloured, light pink, or white, and are arranged in a symmetrical pattern, it is highly likely that you have VP.

It is important to discuss any concerns with your clinician during the appointment. If your lesions are causing you any symptoms such as burning, itching or bleeding, it is unlikely that you have VP. However, your clinician is able to take samples from your vulval area to rule out other genital skin conditions such as warts.

What factors can help to achieve an accurate diagnosis of Vestibular papillomatosis?
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  • Taking the time to listen to the patient is crucial as it provides valuable insight that can guide an accurate diagnosis.
  • High-quality pictures taken by the patient over a period of time can offer further information about the progression or stability of the lesions.
  • Conducting a thorough and unhurried examination under well-lit conditions allows clinicians to assess the skin in detail, enabling the identification of lesions that patients may have missed.

This comprehensive approach helps clinicians make informed judgments based on the clinical features of VP.

Can another skin condition be mistaken as Vestibular papillomatosis?
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Yes. It is possible for an untrained eye to mistake another skin condition, such as genital warts, for Vestibular papillomatosis (VP), and vice-versa.

Is there another way to diagnose Vestibular papillomatosis?
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The most accurate diagnosis for Vestibular papillomatosis is best made during an examination.

Treatment

As you’ve gathered by now, Vestibular papillomatosis are a perfectly normal feature of the body and treatment is not medically required.

However, we have seen many patients for whom life has come to a standstill and it is difficult to build/maintain relationships. In such an event, a simple procedure can help to regain your confidence and rebuild your life.

Prognosis

What is the long term prognosis for someone who has Vestibular papillomatosis?
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Overall, the long term prognosis for someone with Vestibular papillomatosis (VP) is excellent. Having VP will not affect your overall health or quality of life.

While it is natural to want to learn more about VP and what it looks like, it is important to avoid googling pictures and information of VP. This is because google images prioritises the most severe or unusual cases of VP (and other conditions) which can be very misleading and anxiety-inducing. If you have any questions about VP or any other condition affecting your vulva, it is best to consult a clinician who will be able to reassure and support you.

Is Vestibular papillomatosis linked to HPV?
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There is no evidence that links Vestibular papillomatosis (VP) to the Human papillomavirus (HPV).

To an untrained eye, it is easy to misdiagnose VP as genital warts (which are caused by HPV). This can cause fear and anxiety in patients. We are here to tell you that VP is a normal anatomical variation and is not caused by any type of virus or bacteria, nor is it sexually transmitted.

Is there anything I can do to prevent Vestibular papillomatosis?
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You cannot prevent Vestibular papillomatosis as it is a normal anatomical variation of the vulva.

Do I have to tell my partners I have Vestibular papillomatosis?
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There is no clinical reason to tell your partner that you have Vestibular papillomatosis (VP).

VP is a normal variation of the vulva and poses no health risks to yourself or your partner, therefore, is not something that you need to disclose with your partners. However, healthy discussions about your overall genital health with your partner may allow you to feel more comfortable with them.

Will having Vestibular papillomatosis affect pregnancy and childbirth?
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Vestibular papillomatosis (VP) will not affect you during pregnancy and childbirth.

There are several changes that occur to the vulva during pregnancy due to the increased blood flow and hormonal changes. This may cause some women to experience itching and discomfort, however, this is not related to VP.

Will my children also have Vestibular papillomatosis?
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Vestibular papillomatosis (VP) is not a hereditary condition. While it is possible that VP can occur in many members of the same family, this is not because of genetic inheritance.

It is important to consult a healthcare professional if you are concerned about your child’s vulval health and appearance.

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Page reviewed by Dr. Manoj Malu (Clinical Director)

Page written by Shannon Abraham

Last reviewed date: 13 June 2023

Next review due: 13 June 2026

Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.

References & Further Reading