Causes of Swollen Labia Minora

Infectious Causes

When Bartholin glands become infected, they present with swelling, erythema, and tenderness that can extend into the entire labia minora 1, 2
Any vaginal organism can cause infection, with STI pathogens including gonorrhea and chlamydia being common culprits 1, 2
Herpes simplex virus can cause vulvar swelling accompanied by painful ulcerations 1, 2
Gonorrhea and chlamydia may present with inflammation and swelling 1, 2
Syphilis can manifest as flesh-colored papules that may be confused with warts 1, 2

Labia minora piercings can develop infection, pain, bleeding, hematoma formation, or allergic reactions during the healing period 3
Multiple adverse outcomes including cyst formation and hypertrophic scarring can cause persistent swelling 3

Lichen sclerosus presents as porcelain-white papules and plaques with areas of ecchymosis affecting the interlabial sulci and labia minora 4, 5, 6, 7
Lichen sclerosus has a bimodal presentation peaks in prepubertal girls and postmenopausal women 4, 8, 6
The main symptom of lichen sclerosus is itch, but pain occurs with erosions or fissures 4, 5, 6
Lichen sclerosus may have an autoimmune etiology with associations to other autoimmune diseases 4, 8, 7, 9
Contact dermatitis and allergic reactions can cause inflammation with redness and swelling 1
Hypopigmentation changes may accompany chronic inflammation 1

Do not dismiss ecchymosis in prepubertal girls as definitively indicating sexual abuse without considering lichen sclerosus 4, 5, 6, 7
Always assess for STI pathogens when Bartholin or Skene gland infections are present 1, 2
Perform viral culture for HSV and serologic tests for syphilis when ulcers are present 1, 2