Vulvovaginitis : University College London Hospitals NHS Foundation Trust

What is vulvovaginitis?

Vulvovaginitis is a very common condition in younger children. The vulva and vagina are irritated and become sore and red. There can also be discharge from the vagina which can be white, yellow, or greenish. It’s usually not serious and generally gets better with simple steps.

A child with vulvovaginitis might have:

Redness and soreness around the vulva (the vulva is the skin around the vagina and urethra (opening where urine comes out)
Itching around their vulva
A burning feeling when passing urine
Vaginal discharge that might stain underwear

Before puberty, the low hormone levels make the vulva and vagina more sensitive. This makes it easier for irritation or infection to happen. The vulva is very close to the anus (where poo comes out). This means it is easy for bugs (bacteria) in poo to spread to the vulva and vagina.

Common causes are:

Poor toilet hygiene (it’s very important to wipe front to back to avoid this)
Moisture and dampness, especially from tight clothing
Irritation from soaps, shower gels, bubble bath
Not washing or over-washing
Threadworms - which can cause itching
Constipation - which can make things worse

Most cases of vulvovaginitis don’t need medical treatment and should improve fairly quickly. Here are some things you can do:

Encourage good toilet hygiene: Teach your child to wipe from front to back and wash their hands after using the toilet.

If you have a bidet hose at home and your child is using this, make sure that they are not directing water into the vagina- the angle should allow water to flow down over vulva or anus
Better toileting position: Sitting with legs apart or using a footstool can help prevent urine from irritating the skin.
Wear loose cotton underwear
Avoid tight clothing like leggings or tights
Try and use non-biological washing detergents for laundry and avoid fabric conditioners
If your child regularly does swimming or wears a leotard (for example for ballet or gymnastics) then try and minimise the time they wear their swimsuit or leotard.
To wash the vulva use a non-scented sensitive wash. Your doctor may recommend using a moisturising cream to use instead of soap which they can prescribe for you.
Avoid bubble baths or bath bombs
Avoid wet wipes
A simple moisturiser can be used on the vulva to help reduce irritation. Using a moisturiser every day can help relieve symptoms and protect from return of symptoms.

There are many different brands.Your doctor will prescribe or recommend some options and a pharmacist can also advice.

Creams that could be used include: Cetraban, Diprobase, Epimax, Epaderm, E45, Hydromol, Epaderm or Diprobase.
Avoid using a thrush treatment (ec. Canastan cream) unless this has been prescribed by a doctor following a swab result. Thrush is a fungal infection of the vulva and vagina. Adults are often affected by this but it’s very uncommon in children. Thrush creams can be irritating and so can make vulvovaginitis in children worse.
If your child has persistent itching, especially at night, it’s a good idea to talk with your doctor or a pharmacist about threadworm treatment.

Sometimes your doctor may take a swab of the discharge from the entrance of the vagina. This does not hurt. If there is pain with passing urine, a urine sample may be sent to look for infection. If any infection shows up on either of these tests, it may be treated with antibiotics.

The doctors may sometimes recommend a vaginoscopy. This could be needed if:

there’s some vaginal bleeding
there’s no improvement in irritation or discharge with recommended steps.

A vaginoscopy is a low risk procedure to examine the vagina whilst a child is in theatre asleep with a general anaesthetic. To find out more, read our Vaginoscopy page. Occasionally your doctor may also recommend a biopsy of the vulva at the time of vaginoscopy. This would be to look for skin conditions that could be causing the irritation.

Having vulvovaginitis and needing examinations by doctors can be a good opportunity to talk to your child about staying safe. Take a look at PANTS (The Underwear Rule), an excellent on-line resource which the NSPCC offer.

The paediatric gynaecology clinic is in the children and young people outpatient department. This is on the lower ground floor of the Elizabeth Garrett Anderson Wing.