Vulvovaginitis is an inflammation of the vulva and vaginal tissues. It can be caused by infection, irritation, a foreign body, allergy, or systemic disease.
In childhood, the infection usually begins in the vulva, with secondary spread to the vagina. In adolescence, particularly after the onset of sexual intercourse, vaginal involvement is primary. Vulvovaginal candidiasis (yeast infection) is very rare in children unless the child is immunocompromised or on antibiotics.
Young girls are particularly susceptible to vulvovaginitis. Because the genital area is close to the rectum, bacteria (and sometimes parasites –like pinworms) spreads easily. In addition, children can spread bacterial respiratory infections from their nose and mouth to the vulva. Infection with sexually transmitted pathogens suggests sexual abuse.
In addition, vulvar skin is thin and sensitive to trauma from scratching, rubbing from tight-fitting clothing, or exposure to irritants like harsh soaps or bubble baths.
Symptoms of vulvovaginitis include:
Burning sensation during urination
Discomfort, pain, or itching
Tests and Diagnosis
If your daughter has symptoms of vulvovaginitis, her doctor will first ask about her symptoms as well as about:
Bathroom habits and hygiene
Recent respiratory infections
Use of soaps and bubble baths
Her doctor will then examine the vulvar area and may swab the area to test for bacterial and other infections. If the doctor suspects a foreign body is present, he or she will conduct a pelvic exam and remove it.
In many cases, vulvovaginitis does not need to be treated with anything more than improved hygiene and vulvar care. This includes:
Making sure your daughter wipes from front to back after using the bathroom.
Using toilet paper without perfumes or dyes.
Avoiding the use of harsh or perfumed soaps and bubble baths, which can irritate the vulva
Patting the vulvar area dry after bathing, or allowing it to air dry
Avoiding tight-fitting, non-breathable clothing and underwear
Washing clothes in a mild detergent with no rinse or dryer additives
Discouraging the child from touching the area when sick
Taking “sitz baths” in lukewarm water to soothe inflammation
In some cases, the doctor may prescribe a low-dose topical steroid to reduce itching and inflammation. If these methods don’t work, and vulvovaginitis is caused by infection, her doctor may prescribe antibiotics (or an anthelmintic in the case of pinworm infection).