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Vulvovaginitis

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What is vulvovaginitis?

Vulvovaginitis is an inflammation of the vulva and sometimes the vagina. Girls with vulvovaginitis may have itching, redness and tenderness in the genital area. They may sometimes also have discharge from the vagina. This can stain underwear and have a strong smell.

What causes it?

Vulvovaginitis starts when the skin of the vulva or vagina gets irritated. There are many things that can cause this irritation, like:

  • Tight clothing rubbing against the genital area;
  • Dampness;
  • Strong soap or detergent;
  • Bacteria from the anus;
  • Germs from a cold;
  • Skin problems (eczema or psoriasis);
  • Constipation;
  • Sexual abuse

Why do children get vulvovaginitis?

Young girls have a greater risk for vulvovaginitis because:

  • They have thin and delicate skin in the genital area, which is easily irritated.
  • The opening of the vagina is closer to the anus.
  • After using the toilet, they may wipe from back to front, bringing germs from the anus to the vulva and vagina.
  • They do other things that can irritate the skin of their genitals (playing in sand, on slides, teeter-totters, wearing tight leotards or wet bathing suits).

How is it treated?

It’s important to keep your child’s genital area clean and dry. You’ll also need to remove any causes of irritation.

It can help to:

  • Give your child Sitz baths twice a day in warm water to soothe the skin. You can add Aveeno® Bath Powder for dry, itchy skin (available without a prescription).
  • After bowel movements (poop!), wipe with cotton balls with mineral oil instead of toilet paper. Remember to wipe from front to back.
  • Apply a thin layer of ointment (Vaseline®, Desitin® or Zincofax® to the vulva 2-3 time a day.
  • Treat constipation.
  • Try to stop your child from scratching.

Preventing vulvovaginitis

Clothing

  • Wash underwear with a mild detergent and rinse well.
  • Have you child wear cotton underwear only.
  • Have your child sleep in loose pajamas or a nightgown (no underwear!).
  • Don’t:
    • Use fabric softener or bleach.
    • Let your child wear tight clothing (like leotards or pantyhose).
    • Let your child stay in wet clothing for long periods (wet bathing suits are a problem).

Bathing

  • Give your child a bath every day with hypo-allergenic soap for the body. For example: Dove®, Petro-Phillic®, Aveeno®, Johnson & Johnson®.
  • After a bath, pat the genital area dry with a towel. You can also use a hair dryer on a cool setting.
  • Don't:
    • Use soap directly on the genitals.
    • Use bubble bath.
    • Wash your child’s hair in the bathtub.
    • Let your child sit in the tub after washing.
    • Rub the genitals with a towel to dry.

Toilet routine:

  • Wipe from front to back. Make sure your child wipes from front to back after a bowel movement or after passing urine (peeing). Some children find it’s easier to do a good job with wet wipes (alcohol and perfume free). They can bring these to school or daycare in a backpack.
  • Wash hands! Help your child to wash her hands well after using the toilet.
  • Prevent constipation. Make sure your child gets plenty of physical activity, fluids, fruits and vegetables. Stools (poop!) should be shaped like a sausage. Stool that has cracks or comes out as small pebbles means your child has consitipation. Check out our fact sheet on constipation
  • Dont't
    • Use coloured toilet paper.
  • Try to avoid using Pull-Ups® at night, if possible. Start toilet training as soon as you can.

For girls who have urinary incontinence (can’t control the bladder):

  • Keep underwear dry. Change your child into dry underwear often. Don’t use panty liners, these make irritation worse.
  • Have your child sit on the toilet to void (pee!) at least 4 times a day. This is most important before bed and after getting up each morning. Emptying the bladder regularly can help incontinence.

Can vulvovaginitis come back?

Yes. About half of young girls who get vulvovaginitis will have it more than once. These episodes happen less often as girls get older. Good hygiene and removing irritants (described above) will make it less likely that the vulvovaginitis will come back.

Call your health care provider if your child has :

  • Irritation that has not improved or cleared after 1 week.
  • Discharge from the vagina that lasts more than 1 week.
  • Bloody discharge.
  • Constipation, even after increasing fluids and fiber.
  • Significant discomfort or pain.
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