Pediatric Vulvovaginitis
What is Pediatric Vulvovaginitis?
Nonspecific Vulvovaginitis
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.
Yeast Vulvovaginitis
Everyone has a fungus called candida, which is typically found in the intestines, mouth, skin and the tissues around the genital areas. When, candida grows out of control, it causes a yeast infection. Candida flourishes in warm, dark areas, such as the vagina or armpit.
What are the different types of Pediatric Vulvovaginitis?
Nonspecific Vulvovaginitis
Vulvovaginitis is an inflammation of the vulva and vaginal tissues . This is common problem in prepubertal girls. It is typically not caused by a specific pathogen and is not treated with antibiotics. It can also be caused by infection, irritation, a foreign body, allergy, or systemic disease.
Yeast Vulvovaginitis
Pediatric yeast infection is a general term that describes when a naturally occurring fungus grows in excess and causes irritation.
Toddler (1 to 3 years) yeast infection – This infection creates a rash in the armpit, diaper area, mouth and neck.
Vaginal yeast infection – This is the most common type of yeast infection. Approximately 75 percent of all women will have at least one during her lifetime. Yeast infections are uncommon in normal prepubertal girls, so treatment is usually avoided in these girls.
What are the signs and symptoms of Pediatric Vulvovaginitis?
Nonspecific Vulvovaginitis
Abnormal odor
Burning sensation during urination
Discharge
Discomfort, pain, or itching
Vulvar irritation
Vulvar redness
Yeast Vulvovaginitis
Itching and irritation
Pain during urination
Pain during intercourse
Rashes
Vaginal swelling
White, thick coating on tongue
How is Pediatric Vulvovaginitis diagnosed?
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.
What are the causes of Pediatric Vulvovaginitis?
The prepubertal vulva and vagina is easily irritated by urine, sweat, stool, soaps, and perfumed products. This can cause discharge which further irritates the skin of the vulva.
How is Pediatric Vulvovaginitis treated?
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
Barrier emollients such as Vaseline, Aquaphor ointment, Desitin, or coconut oil can be applied to the vulva to decrease the itching
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).
Pediatric Vulvovaginitis Doctors and Providers
