Vulvitis is the irritation or inflammation of the vulva, the outermost portion of the female genitalia. Vulvitis is not uncommon in children. In this article, we will discuss the causes, symptoms, and treatment options for vulvitis. In order to help children feel better as soon as possible, parents and doctors need to understand paediatric vulvitis.

Causes of Vulvitis in children

Irritants

harsh soaps and detergents

Washing the intimate region with harsh soaps or detergents can irritate the skin and cause vulvitis.

Perfumed goods

Certain scented goods, such as scented toilet paper or wipes, can irritate the skin and lead to vulvitis.

Bubble baths

Although enjoyable, the chemicals in bubble baths have the potential to irritate and cause inflammation on the delicate skin surrounding the vulva.

Infections

Children can develop vulvitis as a result of infections. The vulva area can become infected with a variety of microorganisms, including bacteria, fungi, and viruses, which can cause redness, swelling, and discomfort. Examples of infections that can result in vulvitis include the following:

Bacterial infections

Itching, burning, and discharge are some of the symptoms that can result from an infection of the vulva area caused by bacteria such as Streptococcus or Staphylococcus. These infections can arise from skin-to-skin contact with an infected person or from poor hygiene.

Fungal infections

Fungi that cause yeast infections, such as Candida, can thrive in the warm, humid environment of vulvae and cause vulvitis. Itching, redness, and a thick, white discharge are common symptoms of yeast infections in children, particularly in children assigned female at birth (AFAB).

Viral infections

Viral infections, such as infection with herpes simplex virus, can lead to vulvitis by causing sores and blisters on the vulva. Skin-to-skin contact with an infected individual can spread herpes infections, which can cause painful sores, itching, and flu-like symptoms.

Allergic reactions

Latex

Products containing latex, such as some kinds of pants or balloons, can cause allergic reactions in some children that result in vulvitis.

Certain foods

Eating foods like nuts, dairy, eggs, or seafood that a child is allergic to can result in an allergic reaction in the vulva region.

Fabrics 

Clothes made of wool or synthetic materials, which some children are allergic to, can also cause vulvitis.

Poor hygiene habits

Children may have vulvitis as the result of poor hygiene habits. Inadequate cleaning of the vulva area can result in an overgrowth of bacteria and fungi, which can cause discomfort and inflammation. The following bad hygiene habits can raise a child’s risk of developing vulvitis:

Poor personal hygiene 

Perspiration, grime, and bacteria can build up in the vulva region if it isn't cleaned with mild soap and water on a regular basis. This can result in vulvitis.

Wearing unclean clothes 

Dirty clothing, particularly pants, can harbour bacteria and fungi that can irritate and infect the vulva area. Wiping the wrong way after using the bathroom can spread bacteria from the anus to the vulva, raising the risk of vulvitis. One example of this is wiping from the front to the back rather than the back to the front.

Prolonged moisture 

Wearing wet swimsuits or staying in damp underwear for an extended period of time can keep the vulva area moist and promote the growth of bacteria and fungi, which can cause vulvitis.

Tight clothes 

Tight clothing can trap heat and moisture around the vulva, encouraging the growth of bacteria and fungi and raising the risk of vulvitis. This is especially true of synthetic materials that prevent adequate airflow.^{1 2}

Signs and symptoms

Parents and carers should be aware of the various signs and symptoms that children with vulvitis may present with. The typical symptoms and indicators are broken down as follows:

Vulva redness and swelling 

The vulva may have a red, swollen, or inflammed appearance. This redness and swelling can be seen in nearby areas of the external genital area.

Example: When Sarah changed her diaper, her mother saw that her daughter's vulva appeared redder than normal and somewhat swollen.

Itching or burning sensation

Children with vulvitis may experience itching or burning in the vulva area. This discomfort may interfere with daily activities and range in severity from mild to severe.

Example: Emily kept scratching her vulva and complained that she felt itchy "down there," especially after using the bathroom.

Pain or discomfort

Children who have vulvitis may experience pain or discomfort in the vulva area, which may make it difficult for them to sit, walk, or urinate.

Example: Jason's mother noticed that he appeared uncomfortable while urinating, and he cried out in pain when he tried to sit down.

Discharge

Abnormal vaginal discharge is a possible symptom in some children with vulvitis. This discharge may have an unpleasant smell in addition to varying in colour and consistency, such as being white, yellowish, or greenish.

Example: When Lily's mother saw an odd white discharge resembling cottage cheese in her daughter's underwear, she began to suspect vulvitis.

Difficulty urinating

Children suffering from vulvitis may find it painful or uncomfortable to urinate. When they urinate, they might feel a burning or stinging sensation.

Example: Timmy's mum noticed that he was having difficulty and taking longer than usual to urinate, and he started crying when he tried.

Sores or blisters present (in the event of a viral infection)

Herpes and other viral infections may result in the development of sores or blisters on the vulva area.

Example: Maria thought her daughter had a viral infection similar to herpes after noticing tiny, painful sores on her vulva.

It's critical for parents and other carers to recognise these vulvitis signs and symptoms in order to help ease their child's discomfort and seek medical attention as soon as possible.

Diagnosis

There are several steps healthcare professionals may take to check for and diagnose vulvitis in children, and to determine what is causing the symptoms. This is how vulvitis is usually diagnosed by physicians:

Medical history and physical examination 

The physician will inquire about the child's past medical history, current health issues, and exposure to any potential irritants. After that, they will physically examine the vulva area to check for discharge, swelling, redness, or inflammation.

Laboratory ests (e.g., Swabs, Cultures): 

Physicians may sometimes use a cotton swab to take samples from the vulva region in order to conduct laboratory tests. These examinations could involve swabs or cultures to pinpoint the precise bacteria, fungus, or virus causing the vulvitis.

Differential diagnosis to rule out other conditions (e.g., Sexual Abuse): 

If vulvitis is suspected to be caused by sexual abuse, the physician may assess the patient carefully to rule out other potential causes and safeguard the child's health and safety.⁴

Doctors can identify the underlying cause of vulvitis and create a suitable treatment plan to improve children's symptoms by performing a comprehensive diagnosis.

Treatment options

In order to treat paediatric vulvitis, it is necessary to address the underlying cause as well as the symptoms. 

First and foremost, it's critical to avoid irritating items like bubble baths and harsh soaps. Limiting bubble baths and using mild, unscented products can help soothe the skin. Medication such as antifungal creams for yeast infections, antibiotics for bacterial infections, or antiviral medications for viruses like herpes may be prescribed by doctors. Topical steroids can reduce inflammation in severe cases. It's crucial to maintain good personal hygiene, which includes wearing loose cotton pants and gently washing the vulva region with warm water. In order to prevent flare-ups in the future, parents and carers should also be given advice on good hygiene and avoiding irritants. By taking these steps, the child's vulvitis can be effectively managed and relieved.³

How to prevent vulvitis in children?

Encourage good hygiene practices

Teach children how to clean gently with warm water and how to wipe properly. 

After using the toilet, encourage wiping from front to back to stop the spread of bacteria.

Avoid irritants

Recognise and stay away from possible irritants, such as tight clothing and scented items.
To avoid irritation, use hypoallergenic wipes and choose loose cotton pants.

Treat infections right away

Acknowledge symptoms of infection, such as redness or peculiar discharge.
For an accurate diagnosis and course of treatment, seek medical help as soon as possible if you suspect vulvitis.

Attend routine check-ups with the doctor

Make time for regular check-ups with medical professionals.
Make sure that any vulva-related problems are identified early on and managed before they get worse.

Complications

Untreated vulvitis can recur, spread infections, and cause psychological distress, discomfort, and disruption of daily life in children. Clinical complications may include secondary infections, abscesses, or cellulitis, necessitating medical intervention and possibly hospitalisation.

Summary

Vulvitis in children can be managed by avoiding irritants, practising good hygiene, and seeking prompt medical attention for infections. Early detection and treatment are crucial to prevent complications and ensure the child's well-being. Parents, caregivers, and healthcare providers must address vulvitis in children promptly and effectively to alleviate discomfort and prevent recurrence.