Vulvovaginitis

What are the aims of this leaflet?

This leaflet has been written to help you understand more about vulvovaginitis. It tells you what it is, what causes it and what can be done about it.

What is vulvovaginitis

Vulvovaginitis (Pronounced: Vul-vo-vaj-ee-night-is) is inflammation or irritation of the vagina and/ or vulva.

Mild vulvovaginitis is a very common problem in young girls. It will affect most girls at some stage and some girls will have vulvovaginitis many times. As girls approach puberty, their vulvovaginitis usually gets better.

In most girls vulvovaginitis is not a serious problem and it will usually improve with simple steps. In most cases no tests are needed.

What are the symptoms of vulvovaginitis?

Girls with vulvovaginitis often have:

• Itching in the vaginal area
• Some discharge from the vagina
• Redness of the skin between the labia majora (outside lips of the vagina)
• Burning or stinging when they pass urine

What causes vulvovaginitis?

The things that contribute to vulvovaginitis are:

• The lining of the vagina and vulva can be quite thin in young girls; this can lead to it being easily irritated.
• Moisture / dampness around the vulva; this is made worse by tight clothing and obesity.
• Irritants (soap residue, bubble baths, antiseptics etc).
• Poor cleaning and drying of this area after going to the toilet.
• Chlorine in swimming pools; this can be quite irritating.

Threadworms sometimes cause or worsen vulvovaginitis. Children with threadworms often scratch a lot at night. If itching or night time problems are major symptoms then your daughter’s doctor may suggest treatment for threadworms.

In a small number of children similar symptoms can be caused by sexual abuse. If you have any concerns about this please ask to speak to the doctor alone.

How can vulvovaginitis be treated?

The mainstay of treatment is avoiding irritants and protecting the vulval skin with emollients.

General care of vulval skin

• Washing with water only causes dry skin and makes itching worse. Use a soap substitute (eg Hydromol, Epaderm or Diprobase) to clean the vulval area. This will stop the skin from getting as dry and irritated as it would if you used soap or water alone. This is safe to use frequently. Avoid soaps, shower gel, scrubs, bubble baths, baby wipes in the vulval area. Try not to shampoo hair in the bath as the shampoo in the bath water can irritate the skin.
• It is better to shower rather than bath. Try not to clean the vulval area more than once a day as overcleaning can aggravate vulval symptoms. If your daughter uses a bath, it is helpful to add a bath emollient (eg oilatum).
• Avoid using sponges or flannels to wash the vulva. These can irritate the skin. Gently dab the vulval area dry with a soft towel.
• Encourage your daughter to wear loose-fitting cotton underwear. If possible avoid close-fitting clothes such as tights and leggings.
• Encourage her to sleep without underwear.
• Avoid fabric conditioners and biological washing powders. You may want to wash her underwear separately in a non-biological washing powder/gel.
• If your daughter goes swimming encourage her to have a shower immediately after to wash off the chlorine. Some girls also find it helpful to use an emollient (eg hydromol) just before swimming to protect the vulval skin.

Use of emollients to protect the skin

• Emollients (eg Hydromol, Epaderm or Diprobase) can be used as moisturisers throughout the day.
• Using one of these moisturisers every day can help relieve symptoms. Even when she does not have symptoms, using a moisturiser will protect the skin and can prevent flare-ups.
• It is important to find the moisturiser that suits her best. If the first one does not work well, it is well worth trying another one.

Safety advice when using emollients

Follow this general safety advice when using emollients:

1. Keep away from fire, flames and cigarettes when using paraffin-based emollients. Dressings and clothing soaked with the ointment can be easily ignited. It is also advisable to wash clothing and bed linen regularly, preferably daily.
2. Use a clean spoon or spatula to remove emollients from a pot or tub. This reduces the risk of infections from contaminated pots.
3. Take care of slipping when using emollients in a bath or shower, or on a tiled floor. Protect the floor with a non-slip mat, towel or sheet. Wearing protective gloves, wash your bath or shower after with hot water and washing up liquid, then dry with a kitchen towel.
4. Never use more than the recommended amount of bath additive. It may cause skin irritation if the concentration is too high.

Helping your daughter stay safe

As your daughter has a genital problem the doctor needs to look at her genital area to see if she needs any treatment. This can be a good opportunity for parents to later talk with their daughters about staying safe. The NSPCC offer an excellent on line resource for this at nspcc.org.uk/pants.

TREATMENT PLAN