Patient education: Vaginitis in children (The Basics)

What is vaginitis? — Vaginitis is when the vagina and vulva become red and swollen. (The vulva is the area around the opening of the vagina.) It is sometimes called "vulvovaginitis."

Many different things can cause vaginitis in children. These include:

●Irritation – This can be caused by soaps, bubble bath, detergents, or perfumes.

●Foreign bodies – These are things that were put into the vagina. An example is toilet paper.

●Hygiene issues – These include the skin around the vagina not being clean or dry. Examples include not wiping well after using the toilet or sitting in a wet swimsuit.

●Infection – Children sometimes spread bacteria from their nose, mouth, or anus to the vagina. This can cause a bacterial infection. In some cases, another type of infection can cause vaginitis. Rarely, children can get a "Candida" or "yeast" infection. This is more likely in children who have a weak immune system or who have been taking antibiotics.

●Pinworms – These are small worms that can live in the intestines. At night, female pinworms lay their eggs in the folds of skin around the anus. Sometimes, pinworms move to the area around the vagina.

●Certain types of clothing – These include clothes that are tight or made of fabrics that are not breathable.

●Sexual abuse – In some cases, sexual abuse can cause vaginitis in children.

What are the symptoms of vaginitis? — Symptoms of vaginitis include:

●Itching or irritation around the vagina

●Redness, swelling, or cracks in the skin around the vagina

●Change in color, odor, or amount of vaginal discharge

●Pain when urinating

Should the child see a doctor or nurse? — Yes. If a child in your care has the symptoms listed above, take them to see a doctor or nurse.

Will the child need tests? — Maybe. In some cases, the doctor or nurse can tell what is causing vaginitis by asking questions and doing an exam. But sometimes, tests are needed to check for other possible causes.

Usually, symptoms get better after a few weeks of changing the child's habits. But if not, tests might be needed.

If tests are needed, they can include:

●Vaginal cultures – The doctor or nurse will collect a sample of vaginal discharge. Then, the discharge is tested in a lab. This is used to find out if a bacterial infection is the cause.

●Tests for sexually transmitted infections ("STIs")

How is vaginitis treated? — Treatment for vaginitis depends on what is causing it.

For most children, the first step of treatment is to follow good "vulvovaginal hygiene" for 2 to 3 weeks. This includes things like keeping the area clean and avoiding tight clothing, irritating products, and other things that could make symptoms worse. See the table for a list of ways to improve hygiene (table 1). The child's doctor or nurse will tell you exactly what to do.

If the vaginitis was caused by pinworms or an infection, or symptoms do not get better after 2 to 3 weeks of practicing good hygiene, the child might need medicines. These might include:

●Pills that are taken by mouth

●Creams or gels you put around the child's vagina

Can vaginitis be prevented? — The best way to prevent vaginitis in children is to make sure that they practice good hygiene (table 1).

What problems should I watch for? — If a child in your care has been diagnosed with vaginitis, call their doctor or nurse for advice if:

●Their symptoms do not improve or get worse after treatment.

●Their vaginitis comes back after getting better.

What should I do if I think that a child has been sexually abused? — Vaginitis is common in children, and most cases are not caused by sexual abuse. But it is important to know that it can be a cause.

If you think that a child in your care might have been sexually abused, seek help immediately. You can contact:

●The child's doctor or nurse

●A local child welfare agency

●The police – In the US and Canada, you can call 9-1-1 or a local police number.

●A child abuse hotline – In the US, you can call or text the Childhelp National Child Abuse Hotline at 1-800-422-4453.

They will be able to give you advice about what to do next.

More on this topic

Patient education: Vaginitis in adults (The Basics)
Patient education: Vaginal discharge (The Basics)
Patient education: Vulvovaginal yeast infection (The Basics)
Patient education: Bacterial vaginosis (The Basics)

Patient education: Bacterial vaginosis (Beyond the Basics)