Small pimples at the vagina of middle-aged women mostly refers to pimples at the vulva and vaginal opening, and the possible causes include folliculitis, pseudo warts, condyloma acuminatum, etc. The most common cause of small pimples at the vagina of middle-aged women is the growth of pimples at the vulva and vaginal opening. 1. Folliculitis: some women don’t pay attention to personal hygiene in their daily life, which can lead to bacterial proliferation and invasion of hair follicles, which in turn causes folliculitis and the phenomenon of small pimples at the vagina. 2. False warts: usually associated with gynecological inflammation. When middle-aged women have gynecological inflammation, it will make the secretion more, and will cause chronic stimulation of the vagina, and make the vagina appeared pinpoint size or green bean-like small pimples, usually non-contagious. 3. Condyloma acuminatum: caused by infection with HPV (human papillomavirus) virus, is a sexually transmitted disease. The first time you see a wart, it’s a small pink or white papillomatous wart, fine and soft finger-like protrusions, scattered or clustered. There may be other conditions that can lead to small pimples in the vagina of middle-aged women, and it is recommended that they be examined and treated in a timely manner.