Pediatric Vulvovaginitis

What is it?

Prepubertal females that present with itching, local irritation and/or odor. Pain can be severe with urinating. Occasionally will have discharge present.

Prevention

1. No bubble baths, no bath bombs. 

2. Avoid long periods of time in leotards/bathing suits

3. Avoid dryer sheets and scented laundry detergent

4. Avoid sleeping in underwear. During the day encourage cotton underwear.

5. Pee facing the wall while sitting on the toilet (helps with better bladder drainage)

6. Never apply soap to private area, only water

7. Do not cross legs when peeing (keep knees spread apart while peeing)

8. Do not wipe harshly. Try to encourage just “patting” and not wiping with toilet paper

Treatment

1. Apply nightly Aquaphor, Eucerin or Vaseline. Avoid lanolin.

2. Rinse with warm water with shower head or take a water only shower

3. Sitz Bath- ¼ cup baking soda in normal size tub can help with pain

4. If fails to improve, would need to be seen in clinic. Steroid cream and/or antifungal cream may be helpful.

My Daughter is Not Improving, what else could it be?

1. Pinworms: presents particularly worse at night +/- anal itching

2. Bacteria: Strep, for example, can cause similar symptoms and would need to examine the patient

3. Yeast:  Quite uncommon in prepubertal females. Not likely the cause.

4. Viruses: consider this a possibility if paired with a upper respiratory infection