Vulvovaginitis in Children

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Vulvovaginitis is Inflammation or irritation of the vagina and vulva (the opening of the vagina). It is common in young girls but improves at the onset of puberty when your child starts producing oestrogen and the area produces its own natural moisturiser.

Your child may have redness, irritation, itching and sometimes there may be a discharge. The colour of the discharge may range from clear to yellow or green or even faintly brown. There may be discomfort when passing urine.

• Moisture/dampness in the area resulting from sweat. This is made worse by tight clothing, artificial fabrics and being overweight.
• The shape of the pre-pubescent vagina / vulva can cause urine to pool and then come out later on (vaginal reflux), which may irritate the skin. If your daughter’s pants are wet soon after going to the toilet speak to your GP about this.
• Irritation from faeces resulting from incontinence or wiping back to front and from chlorine in swimming pools.
• Friction in the area from being overweight or from activities like horse riding.
• Eczema may cause the skin to be more easily irritated by bubble baths, soaps and washing powders.
• Threadworms can cause severe itching or irritation, especially at night. Your doctor may ask you to check for these.

Tests (swabs) are rarely indicated and very rarely helpful.

• Wash once daily in water to remove urine from the skin. Avoid using soap, bubble baths, shower gels or antiseptics like Dettol or Savlon. A cream can be used instead. Wash hair separately or at the end of the bath, with non-perfumed shampoo if possible, then rinse the vulval area thoroughly. Avoid hot tubs/hot baths.
• Use lots of moisturiser such as Vaseline® to the affected area as a barrier to urine, especially if wetting is an issue. Apply twice daily and before and after swimming.
• Wipe front to back after toileting, using non-coloured, unscented toilet paper.
• Avoid tight fitting clothes e.g. jeans and tights which increase sweating and friction. Cotton underwear and nightwear is best.
• A cotton nightdress without pants is best to sleep in.
• If your child is overweight, addressing their weight by increasing activity and cutting out high calorie snacks and drinks will help reduce friction and sweating in the area.
• Avoid swimming in highly chlorinated pools. When swimming, use barrier cream beforehand to reduce irritation and then shower and the area well afterwards.
• Keep finger nails short. Your child may be scratching the skin during the night when she is unaware of doing so.

The condition can be distressing at times, but is usually controlled by the above measures. If it does not settle with the above measures or incontinence is an issue, seek advice from your GP.