Vulvovaginitis

Definition

Vulvovaginitis refers to inflammation or irritation of the vulva (external genitalia) and sometimes the vagina. It is common in young girls, who are more prone to skin irritation due to their lower hormone levels compared to adults. Most cases are mild and can be managed with improved hygiene and simple comfort measures.

Common Causes

  • Certain soaps and detergents
  • Bubble baths
  • Tight-fitting clothing
  • Foreign objects like toilet paper

Presentation

  • Redness or mild swelling around the vulva
  • Itching or a burning sensation
  • Possible clear or milky discharge (usually in small amounts)
  • Discomfort while urinating if urine contacts irritated skin

Management

Hygiene and Clothing

  • Wear plain white cotton underpants
  • Wash underpants with a small amount of unscented detergent and rinse twice
  • Avoid fabric softeners or “freshening” products when washing clothes
  • Avoid tight-fitting clothing like one‐piece leotards, tight jeans, or leggings
  • After Swimming, change into dry clothes right away

Bathing

  • Bathe once a day until symptoms improve
  • Soak in clean, warm water without soap, vinegar, or baking soda
  • Avoid scrubbing the vulva with a washcloth
  • Limit use of soaps directly on the genital area
  • Gently pat the genital area dry after bathing
  • Avoid bubble baths or perfumed soaps

Toilet Habits

  • Encourage sitting with knees apart to help urine flow away from areas of irritation
  • For younger children, supervise wiping from front to back
  • Mild, non-stinging wet wipes may be used if tolerated

Soothing Measures

  • Cool compresses applied to the area for short periods if discomfort is severe
  • Barrier ointments (like Aquaphor or Vaseline) to protect irritated skin
  • Sitz baths: Soak in warm water with Epsom salt for 10–15 minutes, 2–3 times a day for symptom relief

Prevention

  • Daily baths with gentle, fragrance‐free soaps
  • Teach proper front‐to‐back wiping
  • Avoid bubble baths, harsh soaps, or scented products on the genital region
  • Use cotton underwear and loose‐fitting clothing
  • Practice good hand hygiene to minimize risk of infectious causes

When Should You Seek Help?

Contact Modern Pediatrics if you notice:

  • Increasing pain or severe itching not relieved by hygiene measures
  • Foul‐smelling or unusual discharge that persists
  • Fever or other signs concerning for infection
  • Symptoms that have not resolved after 2 weeks of consistent care
  • Symptoms that have gotten worse after a few days of consistent care