White Bumps in the Perineal Area: What You Need to Know

Small bumps in the perineal area?

Hello, doctor.
I accidentally discovered a white bump in the perineal area (the area where an episiotomy is performed during childbirth) while taking a shower.
After I pulled it off, I found it was a piece of skin (upon closer inspection, it looked similar to the skin on my fingers).
I observed it for two weeks, and the bump did not reappear, but there are small white spots on both sides of the perineum that resemble goosebumps that occur in cold weather.
They are not painful or itchy, and they feel smooth to the touch.
When I stretch the skin, the white bumps become more noticeable (they are single and separate from each other).
Could this possibly be genital warts or sebaceous gland hyperplasia? (I did some research online, but I am still very worried.) I am concerned that if I see a doctor, there might be a misdiagnosis that could make me very anxious.
I have never had the habit of examining my perineal area before, and I don't know if I am overthinking it since it's my first time looking closely...
I have been worried for several days and have not had the courage to see a gynecologist (I have never seen one before).
Thank you, doctor, for your hard work!

Xiao Qi, 20~29 year old female. Ask Date: 2017/11/28

Dr. Huang Jianzhong reply Obstetrics and Gynecology

During a shower, I accidentally discovered a white bump in the perineal area (the area where an episiotomy is performed during childbirth).
After I pulled it off, I found it was a piece of skin (upon closer inspection, it resembled the skin on my fingers).
I observed it for two weeks, and the bump did not reappear, but there are small white spots on both sides of the perineum that look similar to goosebumps that appear on hands and feet in cold weather.
They are not painful or itchy, and feel smooth to the touch.
When I stretch the skin, the small white bumps become more noticeable (each one is singular).
Could this possibly be genital warts or sebaceous gland ectopia? (I looked it up online, but I'm still very worried.) I'm concerned that if I see a doctor, they might misdiagnose me, which would make me very anxious...
I have never had the habit of examining my perineal area before, so I don't know if I'm overthinking it since it's my first time looking.

Answer: A pelvic examination is still necessary.
Don't avoid seeing a doctor due to fear of misdiagnosis.

Reply Date: 2017/11/28

More Info

Understanding white bumps in the perineal area can be concerning, especially when they appear unexpectedly. Based on your description, it sounds like you have noticed a white bump in the perineal region, which you were able to remove, and you have also observed small white spots that resemble goosebumps. It's understandable to feel anxious about these changes, especially when considering conditions like genital warts or other dermatological issues.

First, let's clarify some common causes of white bumps or spots in the perineal area:
1. Sebaceous Cysts: These are small, non-cancerous lumps that can occur when sebaceous glands become blocked. They are usually painless and can appear as white or yellowish bumps.

2. Pearly Penile Papules: These are small, harmless bumps that can appear around the head of the penis and are often mistaken for warts. They are normal anatomical variations and do not require treatment.

3. Folliculitis: This condition occurs when hair follicles become inflamed, often due to infection or irritation. It can lead to small, red or white bumps that may be itchy or painful.

4. Molluscum Contagiosum: This is a viral infection that causes small, painless bumps on the skin. They can be white or flesh-colored and may have a dimple in the center.

5. Genital Warts: Caused by the human papillomavirus (HPV), these can appear as small, flesh-colored or white bumps. They can be flat or raised and may cluster together.

6. Skin Tags: These are small, benign growths that can occur in various areas of the body, including the perineum. They are usually skin-colored or slightly darker and are not harmful.

Given that you mentioned the bumps are smooth, not painful, and have not reappeared after you removed the initial one, it is less likely that they are genital warts. However, the presence of white spots that resemble goosebumps could be related to a variety of benign conditions, including keratosis pilaris, which is a common skin condition that causes small, rough bumps.

It is important to note that self-diagnosis can often lead to unnecessary worry. While it is good to be informed, the best course of action is to consult a healthcare professional who can provide a proper examination and diagnosis. If you are concerned about potential misdiagnosis, consider seeking a second opinion if needed.
In terms of your anxiety about visiting a gynecologist, remember that healthcare providers are there to help you, and they deal with a wide range of conditions daily. It is completely normal to feel apprehensive, especially if it is your first visit. You might find it helpful to prepare a list of your symptoms and concerns to discuss during your appointment.
In conclusion, while there are several benign explanations for the white bumps you are observing, it is essential to have them evaluated by a healthcare professional to rule out any serious conditions and to provide you with peace of mind. Regular check-ups and open communication with your doctor can help alleviate concerns and ensure your health is monitored appropriately.

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