What is vulvovaginitis?

Vulvovaginitis describes inflammation of the skin (dermatitis) around the lower genital tract, specifically the vagina and vulva. It can be caused by infection with yeasts, parasites, bacteria or viruses, or it can also arise due to physical or chemical irritation. Some chemical substances that can contribute to vulvovaginitis include soaps, lotions and perfumes.

Vulvovaginitis is very common in females of all ages; it is the most common gynecological condition in girls up to the age of eight years. [1]

Bacteria

Microscopic, single-celled organisms with DNA but no definite nucleus. Bacteria are the cause of many human diseases.

Genital tract

All of the organs involved in reproduction, from the ovaries to the vulva in females and from the testes to the penis in males.

Infection

Entry into the body of microorganisms that can reproduce and cause disease.

Inflammation

A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.

Parasites

An organism that lives off another organism.

Vulva

External female genitalia.

Yeasts

A single-celled fungus that can causes infections. Candida, the cause of thrush, is an example of a yeast.

Gynecological

Relating to the female reproductive system.

1. Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.

Causes

Vulvovaginitis can be caused by any of a large variety of infections and irritations.

Infection

In young girls, the genital tract is not as acidic as it is after puberty and therefore it is more prone to infection. Infectious agents can include:

  • Bacteria in stools infecting the genital tract;
  • Viral infections;
  • Parasite infections (such as trichomoniasis or threadworm), and;
  • Yeast infections (candidiasis) - rare in pre-pubescent girls unless they have type 1 diabetes, have recently undergone antibiotic treatment or have a weak immune system.

Chemical irritation

Chemical substances that can lead to vulvovaginitis in girls include:

  • Soaps;
  • Shower gels;
  • Fabric softeners and laundry detergents, and;
  • Chlorinated water (as in swimming pools).

Physical irritation

Factors that can cause vulvovaginitis through physical irritation include:

  • Playing in the sand, which can lead to 'sandbox' vulvovaginitis;
  • Irritation due to tight and/or wet underwear or bathers;
  • Small foreign objects, and;
  • Sexual abuse.

Antibiotic

Chemical substances that kill or suppress the growth of bacteria.

Bacteria

Microscopic, single-celled organisms with DNA but no definite nucleus. Bacteria are the cause of many human diseases.

Genital tract

All of the organs involved in reproduction, from the ovaries to the vulva in females and from the testes to the penis in males.

Infection

Entry into the body of microorganisms that can reproduce and cause disease.

Puberty

The period of life, initiated by hormonal signals, in which a person becomes capable of reproduction as the sexual and reproductive organs mature.

Viral

Pertaining to an illness caused by a virus.

1. Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.

Risk factors

Risk factors for vulvovaginitis in girls include:

  • Age - it is especially common in girls 2-8 years old, [1] and;
  • Poor hygiene.

Hygiene

The practice of health maintenance and the prevention of infection, disease and the spread of disease.

1. Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.

Signs and symptoms

Symptoms of vulvovaginitis include:

  • Inflammation of the vagina and/or vulva, characterized by swollen, irritated, itchy and red skin;
  • Unusual vaginal discharge;
  • Unpleasant odor from the vaginal area, and;
  • A painful, burning sensation when urinating (peeing).

Inflammation

A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.

Vulva

External female genitalia.

1. Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.

Methods for diagnosis

Your doctor will diagnose vulvovaginitis by physical examination. A sample of vaginal discharge may also be taken for analysis.

1. Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.

Types of treatment

Treatment for vulvovaginitis depends on the cause of the inflammation. For bacterial infection, antibiotics are the preferred treatment; for yeast infections, antifungal cream; for chemical irritations, recognizing the source of the irritation and avoiding it, and so forth.

To treat the irritation, it may be helpful to run a warm bath for the child, or apply soothing creams that contain ingredients such as paraffin or castor oil.

Infection

Entry into the body of microorganisms that can reproduce and cause disease.

Inflammation

A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.

Bacterial

Relating to bacteria, which are microscopic organisms with DNA, but no definite nucleus. They are capable of causing many diseases in humans.

1. Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.

Prognosis

Vulvovaginitis normally goes away if it is treated correctly.

1. Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.

Potential complications

Ongoing itching and discomfort can be emotionally distressing, particularly in younger girls. Scratching the itch can break the skin, which increases the chances of further infections.

1. Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.

Prevention

You can lower the chance of vulvovaginitis in your child by:

  • Reducing the use of soaps and gels, and choosing oil-based products.
  • Not shampooing hair in the bath;
  • Using plain, unperfumed toilet paper;
  • Avoiding tight clothes and underwear;
  • Preferring cotton underwear to synthetic fabrics, and;
  • Changing nappies regularly in babies and younger girls.

1. Murtagh, J., MD. (2011). John Murtagh’s General Practice (5th Revised edition.). North Ryde, N.S.W.: McGraw-Hill Medical Publishing.