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Vulvovaginitis in girls

Vulvovaginitis in girls before puberty

Key points about vulvovaginitis in girls

Vulvovaginitis is inflammation of the vulva and vagina.
It causes itching, redness and soreness.
It is most common in girls between the ages of 3 and 10.
Childhood vulvovaginitis will always improve at puberty if not before. It's a different condition from vulvovaginitis in adult women(external link).
Most often, it can be treated at home through removing any irritants and teaching your child good hygiene practices.

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Before puberty, girls are prone to vulvovaginitis because their vagina and vulva are thin and less resistant to infection. Bacteria can easily grow and cause infection before puberty, as the vagina is much less acidic than it is after puberty.

Also, young girls are still learning how to toilet themselves. They may not wipe their bottom correctly (you should wipe from front to back) or thoroughly enough. Bacteria from the bottom can irritate the sensitive genital area.

Most commonly, vulvovaginitis is caused when the skin becomes irritated. This may be caused by:

urine (wee) or faeces (poo) that isn't wiped away after toileting
soaps or bubble baths
tight-fitting clothing
scratchy toilet paper
putting something inside the vagina (toilet paper, coins etc)
trauma to the area.

Unlike adult women, in girls who have not reached puberty, symptoms are not often caused by thrush (candida).

Itching or pain that is worse at night-time and mostly around the anus may be a sign of threadworms. Some conditions that affect the rest of the body (eg, chickenpox, eczema (external link), Crohn's disease (external link)) can present with irritation around the vulva or vagina.

Treatment of vulvovaginitis depends on the cause. For young girls, this normally involves identifying and avoiding the irritant causing it and teaching your child how to keep their genital area clean.

Infographic providing advice for girls on how to keep genital area clean

Image credit: Healthify He Puna Waiora, NZ

The following tips may help:

Teach your child to use a front to back motion when wiping.
Change underpants daily or more frequently if soiled.
Wear loose-fitting comfortable underwear and outer clothing.
Avoid tight-fitting nylon clothing such as leotards and pants that restrict airflow and promote sweating. Cotton underwear is best.
Avoid using bubble baths and harsh soaps; try a soap-free cleanser instead of conventional soap.
Daily soap-free baths can be soothing and will improve hygiene.
Encourage your child to gently use her fingers to separate the folds of her vulva to clean them.
Teach her to pat dry the vulva with a clean towel after bathing rather than rubbing vigorously.
Bland emollient creams can be used to help soothe irritation.
If a threadworm infection is suspected, this is treated with tablets that get rid of the worms.