Vulvovaginitis

What is vulvovaginitis?

Vulvovaginitis is an inflammation or irritation of the delicate skin of the genital area. It may cause soreness, itchiness, redness, and burning. Sometimes girls with vulvovaginitis have a slight discharge from the vagina which will stain the underpants and produce a strong odour.

Parents often first become aware of the problem when their child complains about the redness and soreness of the skin, which is the most common sign of vulvovaginitis.

Vulvovaginitis

Vulvovaginitis is a irritation of the skin in the genital area. It causes soreness, itching, burning and can be seen as red and irritated skin.

Vulvovaginitis can have several causes

Most often, vulvovaginitis is caused when the genital skin gets irritated. This irritation can be caused by clothing that rubs, dampness, a skin infection, bacteria from the anus, or possibly sexual abuse. Other skin problems, such as eczema, can also affect the genital skin. Vulvovaginitis may result from several of these causes at the same time.

Little girls' bodies are delicate

In girls, the skin in the genital area is thin and delicate. This delicate skin is easily irritated. When they grow and begin to produce their own sex hormones, pubic hair and thickened skin will develop and protect the genital area. Normal vulva skin should not look reddish or raw.

Girls are very active

Many normal things little girls do can irritate the skin around the vagina. For example, playing in sandboxes or on slides and teeter-totters, and wearing wet clothes, bathing suits, or tight ballet leotards can irritate the skin.

Sometimes girls wait too long to go to the bathroom

Children who are playing often forget to go to the bathroom until the last minute. Sometimes they do not wipe themselves properly. When this happens, bacteria from the anus can get into the vagina. Dirty underpants can also bring bacteria into contact with the vagina and the skin surrounding it. Most children will not wash their genital area at bath time. Children need to be helped with bathing so they clean themselves properly.

Other problems: clothing, soaps, and the weather

• Strong soaps, bubble baths, and perfumes can irritate a child's skin.
• Cotton underwear is the best kind for the skin.
• Dry winter air can be irritating to the skin.
• Heat and humidity can also irritate the skin, especially if combined with wet bathing suits or tight clothing.

Diagnosing vulvovaginitis

If your child develops skin irritation in the genital area, develops an odour in the area, or has discharge from the vagina, she should see your family doctor or paediatrician. Depending on the problem and how severe the symptoms are, the doctor may refer her to a gynaecology clinic.

The gynaecologist will ask questions about your child's health and do a physical examination. The doctor will want to make sure that there is no infection or skin problem that needs treatment. Sometimes, a small vaginal swab will be taken very gently to look for infection. If there has been any bleeding, the doctor may need to examine further.

The doctor will also ask questions and examine your child to make sure that she has not been subject to any sexual abuse. Tell your child what the examination is about, using words she can understand. The goal is to let your child feel comfortable with the examination and make sure she does not have a painful or frightening experience.

After the examination, the doctor will tell you what the best treatment is. Whatever treatment is recommended, there will be some things that you can do to help at home.

Treating vulvovaginitis

The treatment of vulvovaginitis will depend on the cause of the irritation. Sometimes, there may be an infection that may be treated with antibiotics. Usually, there is not one specific infection. Rather, the irritation comes from hygiene measures. It may be that your child is not cleaning herself well enough.

You can help your daughter by starting some simple habits and routines. Because your little girl's skin is so delicate, anything you can do to help keep the genital area clean, dry, and healthy will help. Here are some of the things you can do.

Clean and dry underpants and clothes

Make sure your child changes into clean underwear often, especially if her underwear has gotten dirty. Try to have her change her underwear more than once a day. White cotton underpants are best. Your child should change out of wet or tight-fitting clothing as soon as possible.

Wiping properly after the bathroom

Make sure your child knows how to clean herself well after using the toilet. This is a particular problem for parents whose children go to daycare or to babysitters, because the parents are not there to help their child. Girls should wipe themselves from front to back. Use only white toilet paper. Many children can clean themselves better with alcohol- and perfume-free wet wipes. These wipes are easier on the skin than dry toilet paper. A little packet of wet wipes tucked into your child's things when she goes off to daycare may be helpful.

Bathing

If using wet wipes does not solve the problem, have your little girl take a shallow "sitz" bath when she gets home to make sure that she is nice and clean. Do not use strong soaps, bubble baths or perfumed products on your child. When she has signs of vulvovaginitis, it is a good idea to have her bathe three times a day. Adding Oilated Aveeno Bath Powder or other non-allergenic skin softeners to the water will help soften and soothe the genital skin.

Encourage your little girl not to scratch her bottom because scratching can cause more irritation and infection.

After a bath

After the bath, gently blot or pat dry the child’s genital area. Do not use scratchy towels or rub the skin too hard. You may find it helpful to use a hairdryer on a low, cool setting to dry the area gently. It is all right for the child to run around the house wearing skirts or loose shorts without underpants to let the air reach her bottom.

A good daily hygiene routine

Your child needs to learn how to take care of her genital area. It is an important part of her body that needs special cleaning, just as her teeth need special care. If creams have been recommended, your child can learn how to put her own cream on. She can learn to wash her hands before and after and use a hand mirror so that she can put the cream exactly where it is needed. In this way, she will learn that this is her body and she has a responsibility to care for it.

Other things girls can do to treat and avoid vulvovaginitis

• Take sitz baths twice a day when the skin is irritated. Use Oilated Aveeno Bath Powder for dry, itchy skin. You can buy this product in drugstores.
• Do not use strong soaps or deodorant soaps. Use unscented mild soaps such as Neutrogena, Ivory, Aveeno, and Dove.
• If the skin is very sore, try using cotton balls with mineral oil after a bowel movement instead of toilet paper.
• Do not wear underpants to bed.
• Do not wear tight clothing such as pantyhose, tight slacks, or leotards.
• Do not wear wet bathing suits or any other wet clothing.
• Girls who are menstruating should not use perfumed tampons or pads.
• Do not use topical medications like Solarcaine, or topical antibiotic ointments such as Polysporin, or feminine hygiene sprays.
• Use petroleum jelly (Vaseline) or zinc oxide diaper cream on the area. It can be soothing and is harmless.

Vulvovaginitis often comes back

About half the girls who have this problem will have it more than once during their childhood. It usually gets better as girls grow up, and will not cause them any long-term harm.

If the irritation comes back, begin strict hygiene measures again. Your daughter may need to be seen at the clinic again. Sometimes, if the inflammation comes back it may be caused by something different.

The better your child gets at being clean and dry, the less likely she will get vulvovaginitis again.

If your daughter has any pain or bleeding, call the gynaecology clinic to make an appointment.

Key points
Vulvovaginitis can have many different causes. Parents can help their daughter treat and prevent vulvovaginitis with good hygiene measures. Parents can help make sure their child keeps her crotch area clean and dry, and avoids moisture, irritation, and heat. Parents can also help their child avoid activities that cause irritation.

Back to Top>