The short version
- Vulvar cancer forms in the external genitals. It is uncommon, and it is very treatable when it is found early. [1]
- The most common symptoms are a lump or growth that looks like a wart or an ulcer, and itching in the vulvar area that does not go away. [1]
- A biopsy is the only way to know. Creams and antifungals treat the symptom and delay the answer.
- Most vulvar cancer is removed surgically, often with a check of the lymph nodes in the groin.
- If you have been treated for a vulvar itch more than once without it resolving, ask directly for a biopsy.
What it is
The vulva is the external part of the female genitals, including the labia, the clitoris, and the opening of the vagina. Vulvar cancer forms there and happens when cells in the vulva start to grow out of control. [1]
Many vulvar cancers are preceded by vulvar intraepithelial neoplasia, or VIN, which is an abnormal but not yet invasive change in the skin. Finding and treating VIN is one of the reasons early evaluation matters so much here.
Signs and symptoms
The National Cancer Institute describes a lump or growth on the vulva that looks like a wart or an ulcer, and itching in the vulvar area that does not go away, along with unexpected bleeding and pain in the vulvar region. [1]
Other things women notice are a patch of skin that is a different color, thicker, or rougher than the skin around it, a sore that keeps healing and reopening, burning that does not respond to treatment, and a change in the way the vulva looks that they have been reluctant to mention.
Please mention it
A large share of vulvar cancers are found late, and the delay is usually not the doctor's. It is the months of hoping it would go away. There is nothing about this you need to be embarrassed to describe. We look at this every day.
What raises the risk
Older age, high-risk HPV infection, and having vulvar intraepithelial neoplasia are all risk factors. [1] Chronic skin conditions of the vulva are also associated with vulvar cancer, which is another reason a skin change that has been going on for a long time should be looked at rather than treated blindly.
How it is diagnosed
The diagnosis is made by biopsy, which means removing a small piece of tissue from the vulva so a pathologist can look at it under a microscope. [1] It is done in the office with numbing medicine and takes a few minutes. The relief of knowing is worth the few minutes.
How it is treated
The National Cancer Institute lists the surgical options as wide local excision, which removes the cancer with a margin of normal tissue around it; vulvectomy, which removes part or all of the vulva; sentinel lymph node biopsy, which checks the first lymph nodes the area drains into; and laser surgery, which uses a focused beam of light. Radiation therapy is also used. [1]
Modern vulvar surgery is far more conservative than it was a generation ago. The goal is to remove the cancer completely while keeping as much normal tissue and normal function as possible. Sentinel node biopsy is a large part of why: for many women it replaces removing all the lymph nodes in the groin, which greatly reduces the risk of long-term leg swelling. For what radiation involves, see chemotherapy and radiation.
Recovery
The vulva heals slowly, and it heals on its own schedule. Our written instructions for this one are deliberately not built around a fixed number of weeks. Strenuous exercise, heavy lifting over 20 pounds, and pelvic rest all continue until the surgical area has healed rather than until a date on the calendar. [2]
Two things from those instructions make more difference than anything else. Keep the area clean and completely dry, which usually means a sitz bath at least once a day and rinsing with warm water after using the bathroom. And check the area every day for redness, swelling, or the wound opening. [2]
After vulvar surgery
The printed instructions given after a vulvar procedure, including sitz baths, skin care, and the numbing slurry.
Sources
- National Cancer Institute. Vulvar Cancer Treatment (PDQ) Patient Version. Updated September 18, 2024. https://www.cancer.gov/types/vulvar/patient/vulvar-treatment-pdq
- Vasques DR. Post Vulvar Procedure Instructions. The Center for Cancer and Blood Disorders, Fort Worth, TX. Patient handout supplied by the practice. pdfs/after-vulvar-procedure.pdf
- Society of Gynecologic Oncology. Vulvar Cancer patient resources. Accessed August 21, 2026. https://www.sgo.org/patient-resources/vulvar-cancer/
Reviewed by DeEtte R. Vasques, DO, MBA · September 2026