Red dots on the skin of the vulva that are still painful are considered to be related to external irritation, vulvar eczema, vulvar inflammation, folliculitis, and may also be considered to be related to sexually transmitted diseases. 1. External stimulation: localized impact by external forces may lead to small red spots and swelling in the pubic area. Infrequent replacement of sanitary napkins and pads may lead to the appearance of small red spots on the pubic area. 2. Vulvar eczema: the occurrence of vulvar eczema is related to the results of a variety of internal and external factors, it is a common clinical allergic skin disease of the vulva, usually accompanied by obvious itching, mainly manifested as redness and swelling of the lesion area or the emergence of dense pimples. 3. Vulvovaginal inflammation: Usually do not pay attention to personal hygiene, do not pay attention to cleaning after sex or do not change underwear often, easy to induce gynecological inflammation, such as vaginitis, vulvovaginitis, resulting in the local appearance of red pimples or small red dots. 4. Vulvar folliculitis: low immunity, broken vulvar skin, bacterial infection can cause folliculitis, resulting in localized red pimples, pustules, accompanied by different degrees of pain and itching. 5. Sexually Transmitted Diseases (STDs): small red dots on the vulva may also appear after having sex with high-risk individuals. Therefore, it is important to know if it is related to sexually transmitted diseases, such as genital herpes, which causes herpes and ulcers with pain in the genital and perineal areas. Red spots and pain on the skin of the vulva, it is recommended to pay attention to local hygiene and change underwear frequently. If necessary, go to the hospital dermatology and dermatologic venereology department for examination and clear diagnosis.