Vestibular papillomatosis is characterized by small, shiny, skin-colored growths on a woman’s vulva, which is the outer part of the vagina. The growths, or papillae, occur in a line or as symmetrical patches on the labia minora — smaller inner folds — on both sides of the vulva. They can also occur in the vestibule, which is the opening of the vagina surrounded by the labia minora.
The papillae can be smooth, round bumps or finger-like projections. They’re 1-2 millimeters in diameter, slow-growing, and nontender.
Most doctors think this uncommon condition is a variation of the normal anatomy of the vulva, not an abnormality or disease.
It’s important to know that vestibular papillomatosis isn’t a sexually transmitted disease (STD). You can’t catch it from or pass it on to someone else.
There’s been a lot of debate about whether vestibular papillomatosis is caused by human papillomavirus (HPV), the virus associated with cervical cancer. But most studies now show that this isn’t true. A few doctors think you might have a higher risk of getting HPV if you have vestibular papillomatosis, but there isn’t any good evidence for this.
Vestibular papillomatosis isn’t caused by having sex or poor hygiene. However, keeping your vaginal area clean may help keep it from getting worse. If you use harsh soap or scrub the growths too hard, you may make it worse.
Because it’s a benign normal variation of your anatomy, vestibular papillomatosis is something you’re born with. It’s not something you’re at risk to get. It’s possible it may be inherited, but that hasn’t been studied.
The prevalence of vestibular papillomatosis determined in several studies varies widely, from 1 to 33 percent. It’s found most often in adult women, and it occurs in women of all ethnicities and races.
Vestibular papillomatosis is often mistaken for warts, but there’s no association between the two.
Most women have no symptoms from vestibular papillomatosis. It’s usually painless, and you may not even know you have it. Often, vestibular papillomatosis is found when you see your doctor for other unrelated symptoms, such as pain or vaginal discharge, or for a routine physical examination.
You may feel concerned if you discover bumps on your vulva. If vestibular papillomatosis is misdiagnosed as genital warts, you may feel even more worried.
A condition called vulvar vestibulitis sometimes coexists with vestibular papillomatosis. This condition can cause itching and pain around your vaginal opening. The pain can be mild or severe and can occur during intercourse or when the vestibule of your vulva is touched. You may also see redness in the vulvar vestibule. These symptoms are due to vulvar vestibulitis and not vestibular papillomatosis.
Vestibular papillomatosis can be diagnosed clinically. This means your doctor can make the diagnosis by talking to you about the bumps and performing an examination. Your doctor must know what vestibular papillomatosis is to make the correct diagnosis, but many don’t.
Often vestibular papillomatosis is misdiagnosed as genital warts. A case report from 2010 describes the characteristics that can be used to tell the difference between vestibular papillomatosis and warts.
Papillae vs. warts:
| Papillae: | Warts: |
| grow in a line and are symmetrical | spread around randomly |
| only occur on your labia minora or vulvar vestibule | can occur anywhere on the outer or inner vagina |
| are pink and shiny | can be a variety of colors and are dull |
| are soft when you touch them | are firm or hard |
| the base of each is separate from the others | the bases are all connected together |
| don’t change color when exposed to acetic acid | turn white when exposed to acetic acid |
When your doctor isn’t sure about the diagnosis, a biopsy, or little piece of one of the papillae, can be removed. When this is looked at under a microscope, it has characteristic features that confirm that it’s vestibular papillomatosis.
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