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Vulvar Intraepithelial Neoplasia: Signs and Effective Treatments

Vaginal health is important to your overall health, and if you’re experiencing pain, burning, and itching, your discomfort can be due to a number of issues

Sexually transmitted diseases (STDs), hormonal changes, infections, inflammation, and many other conditions can complicate your life, but they’re often quite treatable. Some conditions, however, don’t present with symptoms, and can even be caused by other infections.

One example is a condition known as vulvar intraepithelial neoplasia (VIN), a precancerous lesion that’s often associated with a human papillomavirus (HPV) infection.

If you’re in the Boston, Massachusetts, area and think you have signs of VIN or other vaginal conditions, Dr. Neeraj Kohli and the team at BostonUrogyn can help. They have years of experience treating a variety of urogynecological conditions, including vulvovaginal disease.

What is vulvar intraepithelial neoplasia (VIN)?

VIN is a condition where abnormal skin cells appear on your vulva, the outer vaginal opening that includes the clitoris and the labia. There are two main types of VIN: 

Usual type

This type of skin abnormality is often associated with an HPV infection, most common in women ages 35-49, and comes in two grades that indicate the extent of the abnormality.

Low grade squamous intraepithelial lesions (LSIL) are the least invasive and often go away without treatment. High grade squamous intraepithelial lesions (HSIL) are more common and present a low risk of getting cancer.


This variation is the least common of all and occurs in women ages 50-60. Unlike the usual type, this version isn’t connected to HPV, but to lichen sclerosus, an uncommon condition that causes itchy, white patches on your genital and anal area.

Patients with differentiated VIN have a higher risk of cancer than those with the usual type.

Common symptoms of VIN include itching, sexual discomfort, and skin changes in the vulvar area. You may not present with any symptoms initially.

Who is at risk for VIN?

While the age groups mentioned above are at higher risk, younger women and even teens are at risk as well. 

HPV infection is a common cause of the usual type VIN, but smoking, diseases that cause immunosuppression (like HIV), and organ transplant medications can contribute to the risks of getting this condition.

Differentiated VIN can be caused by chronic inflammatory skin conditions in the vulvar region like lichen sclerosus or erosive lichen planus.

How is VIN treated?

Treatment options depend on what variation of VIN you’re dealing with. HSIL and differentiated VIN are the variations that most likely need treatment. 

Imiquimod cream is used for HSIL VIN; it boosts the immune system to help the body kill the HPV infection causing the condition. It can take up to six months to be fully effective. 

Laser treatment is also available to burn away the abnormal cells, and surgery is an option if your VIN is widespread.

Vulvar intraepithelial neoplasia can be scary because there’s a small risk of cancer, but it’s treatable. If you’re concerned about VIN, Dr. Kohli and BostonUrogyn are here to help.

Call one of our Boston area locations, including Wellesley and South Weymouth, or book your appointment online today.

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