VULVOVAGINITIS BEFORE PUBERTY

 Basic information

description

Vulvovaginitis before puberty is an inflammation (redness and soreness) of the vagina or vulva before a young girl reaches puberty. Before puberty, the skin around the vaginal area can be very sensitive, and it can easily become red and inflamed.

FREQUENT SIGNS & SYMPTOMS

• Redness, pain, and itching around the genital area.
• Vaginal discharge. It may or may not have an odor.
• Pain with urination.
• Bleeding from the affected area (sometimes).

causes

• Infections caused by bacteria, parasites (including pinworms), yeast-like fungi, or viruses.
• Allergies to synthetic fabrics, soap, or other items in contact with the genitals.
• Scratches, abrasions, or genital injury from foreign body in the vagina (this could be some toilet paper).
• Genital injury from sexual abuse.
• Irritation from bubble bath or oils put in bath water.

risk increases with

• Poor hygiene such as infrequent bathing, not wiping, or wiping incorrectly after urinating or bowel movement.
• Diabetes.
• Trauma or injury to the vaginal area.
• Overweight.
• Wearing tight leotards, jeans, underwear, or bathing suits, or using bubble bath.

PREVENTIVE MEASURES

• Teach the child to wipe from the vagina toward the anus after bowel movements.
• Don't let the child sit around in wet clothing, especially a wet bathing suit. Avoid tight clothing.
• Have the child bathe or shower frequently. No soap is needed in the genital area.
• Don't use scented or antibacterial soap or any bubble bath, or dyed or perfumed toilet tissue.
• Provide the child with cotton underpants or underpants with a cotton crotch. Change underpants daily.
• Teach your child to resist and report any attempted sexual contact by anyone.
• Don't wash your child's hair in the bath. Shampoo the hair over a sink instead. If you do it in the bath, wash it at the end of the bath. Be sure to rinse off any shampoo that may have gotten on the genital area.
• Use a bland ointment for protection of the skin.

expected outcomes

Symptoms often clear up by using preventive measures. In cases of infection, drugs will relieve symptoms.

possible complications

Symptoms may persist or other skin infections may develop. Rarely, an infection may worsen.

 diagnosis & treatment

general measures

• Your child's health care provider will usually do a physical exam, including a gentle exam of the genital area. Medical tests may include blood studies and a culture of any vaginal discharge.
• Treatment will depend on the cause.
• It may involve removing any foreign object in the vagina.
• Stop the use of any product that may cause irritation or allergy, such as soap or bubble bath.
• Follow steps in Preventive Measures.
• Your child's health care provider will be discuss any possibility of child abuse with you.
• Prevent urine from stinging inflamed skin. The child may urinate while in the shower. Urinate through a toilet paper roll or plastic cup with the bottom cut out. Pour a cup of warm water over the genital area while urinating.
• Taking sitz baths (warm water baths) in clear water 2 to 4 times a day may help relieve symptoms.

medications

• Nonprescription topical ointments, or 0.5% or 1% hydrocortisone cream, 3 to 4 times a day may be recommended to relieve burning and itching.
• Drugs for infection (including antibiotics, antifungal, or antiparasitic drugs) may be prescribed.

activity

No limits.

diet

No special diet.

 notify our office if

• Your child has symptoms of vulvovaginitis.
• You suspect your child has been sexually abused.
• Symptoms don't improve in 7 to 10 days or symptoms worsen, despite treatment.

Special Notes: