Vulvovaginitis - Paediatrics
Vulvovaginitis is the inflammation of the external female genitalia: vulva and vagina. It is very common in girls before puberty, between the ages of 2 and 7.
The majority of cases of vulvovaginitis in prepubertal girls is caused by contamination by bacteria from faeces or from the airways, which alter the balance of the genital area. This means that there is no specific germ that causes the inflammation.
Some perfumed soaps, wearing very tight or synthetic underwear, are irritants that can cause vulvovaginitis by themselves or worsen it.
Sometimes a specific cause is found:
- Worms from the faeces can cause vulvar itchiness and irritation when migrating from the anus to the genital region.
- The fungal infection called Candida is a very rare cause of vulvovaginitis in prepubertal girls, unless there are risk factors such as having taken antibiotics, having diabetes or using nappies.
- The exploratory desire of children means that, relatively often, they put small objects (chickpeas, modelling clay, paper…) through their natural orifices (nose, ear, vagina). The presence of a foreign body in the vagina can produce symptoms of vulvovaginitis that, if it is maintained over time, produce a malodorous discharge.
Girls may experience itchiness in the vagina area, redness of the skin, vaginal discharge, bleeding and discomfort or burning when urinating.
In most cases, asking some questions (medical history) and exploring the affected area is sufficient.
Occasionally, the paediatrician will request a culture of the vaginal discharge: when there is abundant vaginal discharge or this is purulent, if the vulvovaginitis is recurrent or does not improve. The result will determine if any antibiotic treatment is necessary.
If there is a suspicion of a foreign body in the vagina, the girl will be referred to hospital so that a more thorough examination can be carried out.
Treatment And Prevention
Most cases of vulvovaginitis improve in 2 or 3 weeks with a series of measures and appropriate hygiene practices. The following measures are recommended:
- Teaching and reviewing the correct technique for cleaning the genitalia after urinating or defaecating (from front to back).
- Avoid wearing tight clothes (leggings, tights).
- Use cotton underwear.
- Do not use perfumed soaps or irritants to clean the genital area.
- Avoid using softeners in underwear and swimsuits.
- Dry the area completely after bathing.
- If the vulvar area is very irritated their paediatrician will be able to recommend some specific gel or vulvar cream.