Vulvovaginitis

Patient information factsheet

Overview

• Vulvovaginitis is when the skin around the vulva and vagina becomes red, sore, or swollen (inflamed).
• It is common in girls aged between 2 to 7 years old.

Symptoms

• The condition often causes soreness and ‘discharge’. 'Discharge’ is a fluid or liquid that comes out of the vagina.
• The discharge can be yellow or green and can be smelly.
• The skin around the urethra (the tube that carries urine (pee) from the bladder out of the body) can also be inflamed.
• This can cause soreness when passing urine (doing a pee).
• The condition does not cause vaginal bleeding.

Causes

-The anus and the vulva are very close together, especially in children.

• Germs (gut bacterium) that normally live in the bowel can be spread from the anal area to the vulva.
• This bacterium is normally harmless in the gut, but when they are spread the vulva or vagina, they can cause irritation or infection.
• This leads to vulvovaginitis.
• Vulvovaginitis often happens when a child starts wiping her own bottom or vulva after going to the toilet.
• They are learning how to clean themselves properly.
• The skin around the vagina in young girls can get infections more easily because:
  • A child’s body does not make oestrogen, and this leads to a thinning of the vaginal skin.
  • Oestrogen is a hormone that amongst other things, keeps the vagina and vulva healthy.
  • The vagina is very close to the anus.
  • The labia (lips of the vagina) are flat and thin.

Tests to identify infection

• Your Doctor may take a swab (a wipe of the affected area with a cotton bud) and send it to the laboratory for tests.
• If your child experiences stinging during urination, the Doctor will also test their urine.

Treatment

• There is no single treatment for the condition, and the symptoms can be hard to cure.

• The following steps should help to improve the symptoms:

  • Make sure your daughter’s bottom is thoroughly cleaned after she goes to the toilet (poo).
  • Always wipe from front to back after urination or having a poo.
  • Teach your daughter to do this herself. She may not be able to do this properly till she is seven years old.
  • Do not have bubble baths or use perfumed soaps. This is because perfumed products can irritate the sensitive skin around the vulva.
  • Use hypoallergenic soaps (for sensitive skin) or mild, fragrance-free soap. Rinse the genital area with clean water.
  • Use nonbiological washing powder for underwear.
  • Do not wear tights or leggings. Tight clothing can irritate the genital area, prevent airflow and trap moisture.
  • Use cotton nightwear.
  • Do not wear underwear at night (loose pyjama bottoms or night dresses are best).
  • A medicated cream such as E45 or Sudocrem can be used if the skin is sore. This should be applied at night.
  • Do not apply Canesten cream unless advised to do so by your Doctor.

• If these steps do not work, your Doctor may prescribe a short course of oestrogen cream.

• This is usually applied with the fingertip to the external vulvar area, at night, three times a week for up to a month.

• The cream can strengthen the skin and help stop soreness and infection.

• It is not licensed for use on children but is very safe if used in small amounts, over a short period of time. It should not be used long-term.

Can the condition cause long-term problems?

• The symptoms of vulvovaginitis will improve as the child reaches puberty, usually from the age of eight.
• The condition does not cause any long-term problems.

Get more information about Vulvovaginitis

The British Society for Paediatric and Adolescent Gynaecology

Cambridge University Hospital

Contact our service

Call us on 020 7288 5635, Monday to Friday 9am to 5pm.