Vulvovaginitis in girls
What is vulvovaginitis?
Vulvovaginitis describes inflammation of the skin (dermatitis) around the lower genital tract, specifically the vagina and vulva. It can be caused by infection with yeasts, parasites, bacteria or viruses, or it can also arise due to physical or chemical irritation. Some chemical substances that can contribute to vulvovaginitis include soaps, lotions and perfumes.
Vulvovaginitis is very common in females of all ages; it is the most common gynecological condition in girls up to the age of eight years. [1]
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Bacteria
Microscopic, single-celled organisms with DNA but no definite nucleus. Bacteria are the cause of many human diseases.
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Genital tract
All of the organs involved in reproduction, from the ovaries to the vulva in females and from the testes to the penis in males.
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Infection
Entry into the body of microorganisms that can reproduce and cause disease.
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Inflammation
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
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Parasites
An organism that lives off another organism.
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Vulva
External female genitalia.
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Yeasts
A single-celled fungus that can causes infections. Candida, the cause of thrush, is an example of a yeast.
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Gynecological
Relating to the female reproductive system.
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Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.
Causes
Vulvovaginitis can be caused by any of a large variety of infections and irritations.
Infection
In young girls, the genital tract is not as acidic as it is after puberty and therefore it is more prone to infection. Infectious agents can include:
- Bacteria in stools infecting the genital tract;
- Viral infections;
- Parasite infections (such as trichomoniasis or threadworm), and;
- Yeast infections (candidiasis) - rare in pre-pubescent girls unless they have type 1 diabetes, have recently undergone antibiotic treatment or have a weak immune system.
Chemical irritation
Chemical substances that can lead to vulvovaginitis in girls include:
- Soaps;
- Shower gels;
- Fabric softeners and laundry detergents, and;
- Chlorinated water (as in swimming pools).
Physical irritation
Factors that can cause vulvovaginitis through physical irritation include:
- Playing in the sand, which can lead to 'sandbox' vulvovaginitis;
- Irritation due to tight and/or wet underwear or bathers;
- Small foreign objects, and;
- Sexual abuse.
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Antibiotic
Chemical substances that kill or suppress the growth of bacteria.
X
Bacteria
Microscopic, single-celled organisms with DNA but no definite nucleus. Bacteria are the cause of many human diseases.
X
Genital tract
All of the organs involved in reproduction, from the ovaries to the vulva in females and from the testes to the penis in males.
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Infection
Entry into the body of microorganisms that can reproduce and cause disease.
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Puberty
The period of life, initiated by hormonal signals, in which a person becomes capable of reproduction as the sexual and reproductive organs mature.
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Viral
Pertaining to an illness caused by a virus.
Risk factors
Risk factors for vulvovaginitis in girls include:
- Age - it is especially common in girls 2-8 years old, [1] and;
- Poor hygiene.
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Hygiene
The practice of health maintenance and the prevention of infection, disease and the spread of disease.
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Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.
Signs and symptoms
Symptoms of vulvovaginitis include:
- Inflammation of the vagina and/or vulva, characterized by swollen, irritated, itchy and red skin;
- Unusual vaginal discharge;
- Unpleasant odor from the vaginal area, and;
- A painful, burning sensation when urinating (peeing).
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Inflammation
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
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Vulva
External female genitalia.
Methods for diagnosis
Your doctor will diagnose vulvovaginitis by physical examination. A sample of vaginal discharge may also be taken for analysis.
Types of treatment
Treatment for vulvovaginitis depends on the cause of the inflammation. For bacterial infection, antibiotics are the preferred treatment; for yeast infections, antifungal cream; for chemical irritations, recognizing the source of the irritation and avoiding it, and so forth.
To treat the irritation, it may be helpful to run a warm bath for the child, or apply soothing creams that contain ingredients such as paraffin or castor oil.
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Infection
Entry into the body of microorganisms that can reproduce and cause disease.
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Inflammation
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
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Bacterial
Relating to bacteria, which are microscopic organisms with DNA, but no definite nucleus. They are capable of causing many diseases in humans.
Prognosis
Vulvovaginitis normally goes away if it is treated correctly.
Potential complications
Ongoing itching and discomfort can be emotionally distressing, particularly in younger girls. Scratching the itch can break the skin, which increases the chances of further infections.
Prevention
You can lower the chance of vulvovaginitis in your child by:
- Reducing the use of soaps and gels, and choosing oil-based products.
- Not shampooing hair in the bath;
- Using plain, unperfumed toilet paper;
- Avoiding tight clothes and underwear;
- Preferring cotton underwear to synthetic fabrics, and;
- Changing nappies regularly in babies and younger girls.
References
- Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.
- Simpson, R.C. & Murphy, R. Paediatric vulvar disease. Best Practice & Research Clinical Obstetrics & Gynaecology.
- Pierce, A.M. & Hart, C.A. (1992). Vulvovaginitis: causes and management. Archives of Disease in Childhood 67: 509–512.
- 1. Simpson R.C. & Murphy R. Paediatric vulvar disease. Best Practice & Research Clinical Obstetrics & Gynaecology. Accessed from link here
- 2. Pierce A.M. & Hart C.A. (1992). Vulvovaginitis: causes and management. Archives of Disease in Childhood 67: 509–512.
- 3. Board A.D.A.M.E. (2012b). Vulvovaginitis. PubMed Health. Accessed from link here
- 4. Choices N.H.S. (2014 October 7). Vaginitis - NHS Choices. Accessed 24 September 2014 from link here
- 5. Dei M. Di Maggio F. Di Paolo G. et al. (2010). Vulvovaginitis in childhood. Best Practice & Research Clinical Obstetrics & Gynaecology 24: 129–137.
- 6. Eckert L.O. (2006). Acute Vulvovaginitis. New England Journal of Medicine 355: 1244–1252.
- 7. Giugno S. Risso P. Ocampo D. et al. (2014). Vulvovaginitis in a pediatric population: relationship among etiologic agents age and Tanner staging of breast development. Archivos argentinos de pediatría 112: 65–70.
- 8. Murtagh J. MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde N.S.W.: McGraw-Hill Medical Publishing.
- 9. Pierce A.M. & Hart C.A. (1992). Vulvovaginitis: causes and management. Archives of Disease in Childhood 67: 509–512.
- 10. Simpson R.C. & Murphy R. Paediatric vulvar disease. Best Practice & Research Clinical Obstetrics & Gynaecology. Accessed from link here
- 11. Sobel J.D. (2007). Vulvovaginal candidosis. The Lancet 369: 1961–1971.
- 12. Vulval conditions. Better Health Channel. Accessed 24 September 2014 from link here
- 13. Vulvovaginal complaints in the prepubertal child. Accessed 24 September 2014 from link here
- 14. Vulvovaginitis: MedlinePlus Medical Encyclopedia. Accessed 24 September 2014 from link here
10 Most frequently asked questions (FAQs)
Vulvovaginitis is inflammation of the skin of the female lower genital tract. What are the symptoms of vulvovaginitis? Symptoms of vulvovaginitis include: inflammation of the vagina and/or vulva, characterized by swollen, irritated, itchy and red skin; unusual vaginal discharge; an unpleasant odor from the vaginal area, and; a painful, burning sensation when urinating (peeing). What causes vulvovaginitis? Vulvovaginitis can be caused by any of a large variety of infections and irritations, bacterial, viral or fungal infections, chemical irritations (from soaps and other detergents), or physical irritation ('sandbox vulvovaginitis' is common in young girls playing in sand). Women of all ages can get vulvovaginitis, but it is a common problem in young girls, particularly those aged 2-8 years old. How is vulvovaginitis diagnosed? Vulvovaginitis is diagnosed by physical examination. If infection is suspected, a swab will be taken to diagnose the type of infection. How is vulvovaginitis treated? Treatment of vulvovaginitis depends on the cause of the inflammation. For a bacterial infection, antibiotics are the preferred treatment; for yeast infections, antifungal cream; for chemical irritations, recognizing the source of the irritation and avoiding it, and so forth. Can vulvovaginitis in girls be prevented? You can lower the chance of vulvovaginitis in your child by: teaching her how to wipe 'front to back' after using the toilet, so that there is less chance of bacteria in stools reaching the vulvovaginal area; reducing the use of bathing soaps and gels, and choosing oil-based products; not shampooing hair in the bath; using plain, unperfumed toilet paper; avoiding tight clothes and underwear; choosing cotton underwear instead of synthetic fabrics, and; changing nappies regularly in babies and younger girls.
Related topics
Bacterial vaginosis occurs when there is an overgrowth of certain types of bacteria normally found in the vagina. It often causes a grey-coloured discharge. Although more common in sexually active women, bacterial vaginosis is not passed on through sexual activity. Chlamydia is a common sexually-transmitted infection (STI). Most people with chlamydia will not have symptoms, but others may experience pain when urinating, during intercourse, or have an abnormal discharge. If sexually active, it is important to get regular check-ups so it can be detected early and treated. Gonorrhoea is a common sexually-transmitted infection. It may not have any symptoms, but if it’s untreated, it can lead to complications. If sexually active, it is important to get regular check-ups so it can be detected early and treated. Candidiasis is a common infection that occurs in the mouth, vagina or nipples when there is an overgrowth in these areas of a particular fungal yeast, called Candida albicans. Other names for candidiasis include thrush, monilia or a yeast infection.