How to treat red spots on the vulva is to find the cause of the red spots. If the red spot is caused by eczema and is accompanied by vulvar itching, you can give mometasone ointment topical application and do not eat spicy and irritating foods in your diet. If the red spots are caused by allergy to sanitary napkins, wear cotton underwear and apply topical paregoric ointment for treatment. If the local medication is not effective, you can take oral antiallergic treatment with Xithmin. If the red spot is caused by stage II syphilis, it should be treated clinically with long-acting penicillin and a skin test should be done before using the drug.