Vaginal Symptoms-Child

• Genital symptoms in young girls (before puberty)
• Vaginal symptoms include discharge, bleeding and pain
• Vulva symptoms include itching and pain when passing urine
• Vulva itching and irritation from soap is the most common problem
• Symptoms not caused by an injury

Symptoms Covered in this Topic

• Vaginal symptoms include discharge, bleeding and pain
• Vulva symptoms include itching and pain when passing urine
• Genital area skin symptoms include itching, pain, rash and swelling

Causes of Genital Symptoms in Young Girls

• Soap Vulvitis. The vulva is the area outside the vagina. Soaps can cause this area to be red, sore and itchy. Bubble baths are the most common cause of genital itching.
• Poor Hygiene. Not rinsing the genitals at all can also cause itching. Any stool left on the vulva is very irritating. This can happen with loose stools or back to front wiping. It's also seen in children who leak stool because they are blocked up. Traces of sand or dirt may do the same.
• Yeast Vulvitis. Yeast infections of the female genital area are rare before the teen years. They do occur in girls who are still wearing diapers. They can happen after a course of antibiotics. They can also happen in girls with diabetes.
• Labial Fusion. (Also called labial adhesions.) This is when the vaginal lips or folds are stuck together. The vaginal opening looks closed off. Labia that are closed more than half way can collect soap or stool. The main symptom is itching in this area.
• Pinworms. Sometimes, an adult pinworm will travel into the vagina. The pinworm's secretions are very irritating. This leads to intense itching.
• Vaginitis. Vaginitis is a bacterial infection of the vagina. The main symptom is a yellow discharge. The most common cause in young girls is Strep, the same one that causes bad sore throats. Vaginal discharge from STIs (sexually transmitted infections) is rare before the teen years.
• Vaginal Foreign Object. Young girls may put an object (such as a bead) in the vagina. This can be part of normal behavior as young girls explore their bodies. It will cause a bad-smelling discharge. If the object is sharp, the discharge will be blood-tinged.
• Bladder Infection. These are common in young girls because the urethra is so short. The main symptom is pain or burning when passing urine.
• Skin Rash. Most skin rashes are from contact with some irritant. The irritant is often on dirty hands. The cause is from not washing them before using the toilet.
• Serious Cause: Sexual Abuse. Suspect for any symptoms that are strange or not explained.

Soap Vulvitis

• Soap is the most common cause of genital itching in young girls. It can also cause the area to become red and sore. This is called soap or chemical vulvitis.
• The vulva is very sensitive to the drying effect of soaps.
• Sitting for a long time in a bubble bath is the main cause.
• Shampoo or soap in the bath water can also cause redness and itching. So can washing the genitals with a soapy washcloth.
• In young girls, the inner female genitals should only be washed with warm water. The skin around the genitals can be washed with soap.
• Soap vulvitis only occurs in young girls before puberty. Breast buds are the first sign of puberty. This diagnosis is easy if young girls are using bubble bath.

Call Doctor or Seek Care Now

• Could be from sexual abuse
• Vaginal bleeding
• Severe genital pain
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Vaginal discharge
• Fever is present
• Pain or burning when passing urine
• Vaginal pain
• Vaginal foreign object suspected
• Genital area looks infected (such as spreading redness, draining sore)
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Vaginal itching lasts more than 3 days using this care advice
• Vaginal itching is a frequent problem
• Mild rash of genital area lasts more than 3 days using this care advice
• You have other questions or concerns

Self Care at Home

• Soap vulvitis suspected as cause of itching
• Mild skin rash of genital area

Care Advice

Soap Vulvitis - Treatment

1. What You Should Know About Soap Vulvitis:
   • Genital itching in young girls is most often caused by soap (especially bubble bath). The vulva area is sensitive to the drying effect of soap.
   • Only clean the genitals with warm water.
   • After puberty, soap can be tolerated.
   • Here is some care advice that should help.
2. Baking Soda Baths - Young Girls Only:
   • Soak for 10 minutes to remove germs and to help with healing.
   • Add 2 ounces (60 mL) baking soda per tub of warm water.
   • Reason: Baking soda is better than vinegar for young girls.
   • During soaks, be sure she spreads her legs. This allows the water to cleanse the genitals.
   • Repeat baking soda soaks 2 times per day for 2 days.
3. Steroid Cream for Itching:
   • Put a tiny amount of 1% hydrocortisone cream (such as Cortaid) on the genitals.
   • No prescription is needed.
   • Use after soaks for 1 or 2 days. Do not use more than 2 days.
4. Prevention - Do Not Use Soaps:
   • Do not use bubble bath, soap and shampoo in the bath water. They can cause the genitals to be red, sore or itchy.
   • Only use warm water to cleanse the genitals.
   • Baby oil can be used to remove any dried body fluids.
   • After puberty, soap can be used.
5. What to Expect:
   • If soap is the cause, symptoms should go away within 2 days.
6. Call Your Doctor If:
   • Itching lasts over 48 hours using this care advice
   • Vaginal discharge or bleeding occurs
   • Passing urine becomes painful
   • You think your child needs to be seen
   • Your child becomes worse

Mild Skin Rash near Genital Area - Treatment

1. What You Should Know about Genital Rashes:
   • Rashes can be caused by skin irritants. The hand may touch the genital area when passing urine. Rashes are commonly from an irritant that was on the hands.
   • Examples are a plant (such as an evergreen) or chemicals (such as bug repellents). Fiberglass, pet saliva or even food can also be irritants.
   • Most small rashes can be treated at home.
   • Here is some care advice that should help.
2. Clean the Area:
   • Wash the area once with soap to remove any irritants.
3. Steroid Cream for Itching:
   • For itchy rashes, use 1% hydrocortisone cream (such as Cortaid). No prescription is needed.
   • Do this 2 times per day for a few days.
4. Antibiotic Ointment for Infections:
   • For any cuts, sores or scabs that look infected, put on an antibiotic ointment. An example is Polysporin. No prescription is needed.
   • Use 2 times per day until seen.
5. What to Expect:
   • Small rashes from irritants should go away in 2 days with treatment.
6. Prevention of Rashes:
   • Teach your daughter to wash her hands if they are dirty.
   • Have her clean her hands before touching her genital area.
7. Call Your Doctor If:
   • Rash spreads or gets worse
   • Rash lasts more than 3 days
   • Fever occurs
   • You think your child needs to be seen
   • Your child becomes worse