What Vulvar Melanosis, Causes, Symptoms, Diagnosis Complications, Treatments and Prevention

What is vulva melanosis or vulva melanotic macule? What causes vulva melanosis? Who is vulnerable to this condition? Can vulvar melanosis be treated? If yes, what are the treatments? In this review, we analyze the possible causes, meaning, symptoms, clinical appearance, differential diagnosis and therapy of vulva melanosis.

What is vulvar melanosis?

Vulvar melanosis is a harmless condition that clinically resembles malignant melanoma with passionately pigmented irregular macules. This is due to the extra production of pigment by melanocytes due to non-defined cause. This can be present in many locations of vulvar including the periureteral area. Vulvar is the area around the external virginal opening.

This vulva condition is characterized by the distribution of brown to black pigmentations that are multiple, flat distinct and stable. They don’t change the thickness of the skin.

Other names for vulvar melanosis

Other names used to refer to vulvar melanosis are genital melanosis, genital lentiginosis or vulvar melanotic macule. But remember vulvar melanoma is a different thing altogether.

Who gets vulvar melanosis?

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Vulva melanosis is a condition that can be experienced by females of all ages, both children and adults. Furthermore, there is no racial or ethnic prejudice for this vulvar condition.

What causes vulvar melanosis

Currently, there is no specific cause for this vulvar benign but there are some rarely linked factors. But before we proceed, we have to acknowledge that this vulva condition is not related to systemic diseases or sunlight. There are two major linked conditions. These are Genetic disorders and Lichen sclerosis. Some of the rare genetic disorders associated with this condition include the following:

  • LEOPARD syndrome
  • Peutz-Jeghers syndrome
  • NAME syndrome
  • Carney complex
  • LAMB syndrome

When numerous melanosis is diagnosed in one area, genetic syndromes are usually blamed however, when they are isolated, usually, no associated condition is discovered.

We now understand that there is no exact cause for vulva melanosis and therefore, we just presume the risk factors. If you bear such risks, it is not a guarantee that you`ll suffer vulva melanosis. On the other hand, lacking the risk factors doesn`t imply that you won’t get melanosis. Always consult your doctor about the risk conditions.

Vulvar melanosis symptoms

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There is significant confusion concerning pigmented macules of genital labia. There is no well-defined entity regarding the symptoms. Though, a good history should effectively define the onset, distribution, family history, change of the lesion among other crucial factors to be considered. Here the common clinical symptom of vulvar melanosis:

  • Pigmented vulvar skin lesions or spots
  • Presence of melanotic macules in another area such as genital tract
  • Blue-black or dark brown pigments with irregular borders
  • The macules are often singular or multiple
  • Usually, there is no change in the thickness or texture of the skin
  • The macules may persist for years and some may not be differentiated from melanoma, a skin cancer type. us confirms that “On visual inspection of the vulva, it can be difficult to differentiate melanosis from melanoma.”
  • Normally, melanosis does not have a substantial melanocytic proliferation, nesting pattern of melanocytes, or melanocyte atypia.
  • When it comes to size, the size of various types of melanosis often varies although the general range tends to be between 1 -15 millimeters in diameter.
  • They have structure less and parallel pattern in vulva location

Vulvar melanosis is a vulva skin condition that is not infectious and s cannot spread from one person to another during sex, you should not panic about that.

Can vulvar melanotic macules have complications

Right, vulva melanosis is a harmless condition that often pauses no threat but can it causes any complication? Of course, yes. When an individual notice the ugly longstanding dark spots, they may be emotionally stressed and even develop cosmetic concerns. This is evident when the pigmented spots are noticed by your sex partner. The stress can emerge more skin conditions that can be very severe than melanosis.

Again, just the appearance of pigmented macules may induce panic of melanoma and this is a type of skin cancer you know. The fear and panic can even trigger body acne breakouts among other symptoms

Lastly, complications may spring from the underlying genetic syndrome explained above. Genetic disorders may develop symptoms that may be very dreadful.

Vulvar melanosis treatment

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Though many medical studies say there is no treatment applicable for vulvar melanosis, there are some producers that can be considered as treatment in my opinion. The doctor may opt to examine the benign vulvar lesion for some time but when the successful diagnosis of melanotic macule is done, I mean when vulva melanosis is discovered, no treatment will be literally required. This is not a harmful condition, you remember?

There are also some occasions when the treatment or therapy may be required. This is when there are emotional stress and cosmetic regards. In such cases, the treatment for genetic disorders may be applied. Lichen sclerosis treatment can also be administered if it is the root.

Alternatively, an excisional vulvar biopsy may be recommended to completely get rid of the darkened small area. In the case of large darkened areas, an incisional biopsy may be carried. Some medical sources also claim that vulvar melanosis can fade following childbirth but the inevitability is not yet clear.

Your GP will be required to do persistent follow-up together with regular screening and check-ups to monitor or to prevent other possible problems such as secondary infections after biopsies.

Can vulvar melanosis be prevented?

It is not possible to currently prevent melanotic macules since there is no defined cause concerning this disorder. Medical studies are still underway to unveil more theory about this vulvar condition.


While many pigmented skin lesions have been extensively described, there is little literature about vulvar melanosis and many theories concerning this problem are under debate. Proper diagnosis should be done to be sure whether it is vulvar melanosis or vulvar melanoma. Remember melanosis is harmless but you may assume this is the case yet other serious conditions like melanoma may be the real disorder.

This is due to the fact that pigmented lesions in vulva may have almost similar symptoms. Always make sure any pigment in your genitals is diagnosis by a medical expert.