Vulvovaginitis - Paediatric
Vulvovaginitis is inflammation of the external female genital region: vulva and vagina. It is very common in girls before puberty, between the ages of 2 and 7.
Causes
Most cases of vulvovaginitis in prepubescent girls are caused by contamination from germs in faeces or the respiratory tract, which alter the balance of the genital area. In other words, there is no specific germ that causes the inflammation.
Some perfumed soaps and wearing tight or synthetic underwear are irritants that can cause vulvovaginitis on their own or make it worse.
Sometimes, a specific cause can be found:
- Worms in faeces can cause itching and vulvar irritation when they migrate from the anus to the genital region.
- Infection by a fungus called Candida is a very rare cause of vulvovaginitis in prepubescent girls, unless there are risk factors such as having taken antibiotics, having diabetes or wearing nappies.
- Children's exploratory nature means that they often insert small objects (chickpeas, plasticine, paper, etc.) into their natural orifices (nose, ear, vagina). The presence of a foreign body in the vagina can cause symptoms of vulvovaginitis which, if left untreated, can lead to foul-smelling discharge.
Symptoms
Girls may experience itching in the vaginal area, redness of the skin, vaginal discharge, bleeding, and discomfort or burning when urinating.
Diagnosis
In most cases, it is sufficient to ask a few questions (medical history) and examine the affected area.
Occasionally, the paediatrician will request a vaginal discharge culture: when there is abundant vaginal discharge or it is purulent, if the vulvovaginitis is recurrent or does not improve. The results will determine whether antibiotic treatment is necessary.
If a foreign body is suspected in the vagina, the girl will be referred to the hospital for a more thorough examination.
Treatment And Prevention
Most cases of vulvovaginitis improve within 2 to 3 weeks with a series of appropriate measures and hygiene habits. It is recommended to:
- Teach and review the correct technique for cleaning the genitals after urinating or defecating (from front to back).
- Avoid wearing tight clothing (tights, leggings).
- Wear cotton underwear.
- Do not use perfumed or irritating soaps to clean the genital area.
- Avoid using fabric softeners on underwear and swimwear.
- Dry the area thoroughly after bathing.
- If the vulvar area is very irritated, your paediatrician may recommend a specific gel or vulvar cream.