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Paediatric vulvovaginitis

Paediatric vulvovaginitis is a common cause of soreness or irritation of the genital area of young girls before puberty. It is usually caused by a combination of a natural lack of oestrogen and not wiping properly after going to the toilet. It can usually be alleviated by some simple hygiene and bathing changes.

See the separate leaflets called Vulval Problems and Vulvitis (in adults).

At a glance

  • Paediatric vulvovaginitis is inflammation of the vulva or vagina in young girls before puberty.

  • Symptoms include soreness, itching, pain when urinating, and sometimes vaginal discharge.

  • Low oestrogen levels make the skin prone to irritation and infection in this age group.

  • Avoiding irritants like bubble bath and ensuring good hygiene can help.

  • See a doctor if there is bleeding, home treatments are not helping, or you are worried.

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What is paediatric vulvovaginitis?

Paediatric vulvovaginitis is inflammation of the vulva and/or vagina in young girls who have not yet reached puberty.

Nonspecific vulvovaginitis

The most common type, caused by a combination of factors.

Yeast vulvovaginitis

Yeast infections - eg, thrush - are rare in younger girls and not usually the cause of vulvovaginitis in this age group.

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The external genital area can often look red and sometimes slightly swollen. There can be a discharge which may be yellow or green.

Before girls reach puberty, the levels of oestrogen in the genital area are low. This causes the skin and vaginal lining to be quite thin and easily irritated by bacteria from the anus, as it is close to the vagina.. The area is also less acidic before puberty, so bacteria can grow more easily. Irritants can include products such a soap and bubble bath, and also urine and faeces if the area is not wiped properly after toileting.

Rare causes for similar symptoms are a foreign body inside the vagina, and sexual abuse.

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Symptoms include soreness, itching, hurting to pass urine and sometimes a vaginal discharge.

Similar symptoms including vulval pain and itching, particularly at night, may also be caused by threadworms.

A doctor can diagnose it by listening to the symptoms and performing an external examination. Sometimes a swab is taken to check for bacterial infections.

Vulvovaginitis can usually be treated at home with the following measures:

  • Warm baths to soothe itching.

  • Loose-fitting cotton underwear.

  • Not wearing pants in bed.

  • Avoiding bubble bath and soap on the genital area, especially perfumed.

  • After bathing, patting the area dry with a soft towel.

  • Nappy rash creams such as Bepanthen® may soothe the discomfort and protect the skin.

  • Good toilet hygiene - part the legs while passing urine and wipe front to back.

  • Rinse with warm water after passing urine or opening bowels.

  • Antifungal creams, such as Canesten®, are not usually helpful in this age group.

When to see a doctor

  • If there is any bleeding.

  • The above measures are not helping.

  • You are worried about other causes.

  • Wear loose-fitting cotton underwear.

  • Avoid tight clothing - eg, tight jeans.

  • Wipe from front to back.

  • Consider rinsing after wiping.

  • Avoid bubble bath and soap - wash with warm water.

  • Pass urine with the legs parted.

  • Avoid wearing pants in bed.

No, the symptoms usually resolve as girls reach puberty.

Frequently asked questions

My daughter has some redness and discharge, but it's not thrush. Is this normal for vulvovaginitis?

Yes, yeast infections like thrush are uncommon in young girls. The most common type of paediatric vulvovaginitis is non-specific, caused by a combination of factors. The external genital area can look red and sometimes slightly swollen, and there might be a yellow or green discharge.

Why are young girls more prone to vulvovaginitis compared to adult women?

Before puberty, girls have low levels of oestrogen in the genital area. This makes the skin and vaginal lining thin and easily irritated by bacteria from the anus, which is close by. The area is also less acidic before puberty, creating an environment where bacteria can grow more easily.

Could my daughter's symptoms be caused by something else, even if it seems like vulvovaginitis?

While irritation is the most common cause, similar symptoms of vulval pain and itching, especially at night, can also be caused by threadworms. In rare cases, a foreign body inside the vagina or sexual abuse can present with similar symptoms.

What kind of soaps and bubble baths should we avoid to prevent irritation?

It's best to avoid all bubble baths and soaps on the genital area, especially perfumed ones, as these can act as irritants. Washing the area with warm water is recommended instead.

My daughter is experiencing soreness when she urinates. Is this a common symptom of vulvovaginitis?

Yes, hurting to pass urine is a common symptom of paediatric vulvovaginitis, along with soreness, itching, and sometimes a vaginal discharge.

If we've tried the home treatments, but they don't seem to be working, what should we do next?

If the home measures suggested are not helping, or if you notice any bleeding, or if you are worried about other potential causes for your daughter's symptoms, you should see a doctor.

Are antifungal creams, like Canesten, helpful for this condition?

Antifungal creams, such as Canesten®, are generally not helpful for paediatric vulvovaginitis in this age group, as yeast infections are rarely the cause.

Further reading and references

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About the authorView full bio

Author image

Dr Rachel Hudson, MRCGP

General Practitioner and Medical Author

MBChB, MRCGP (2008), BSc (Medical Science), DFSRH, DRCOG, DCH

Dr Rachel Hudson, is an NHS GP working in the North West of England.

About the reviewerView full bio

Author image

Dr Doug McKechnie, MRCGP

Medical Writer

MA, MBBS, MSc, DRCOG, MRCP(UK), MRCGP(2021), FHEA

Dr Doug McKechnie is an NHS GP working in London. He works full-time clinically and is also the Deputy Lead for the Clinical and Professional Practice module at University College London Medical School.

Article history

The information on this page is written and peer reviewed by qualified clinicians.

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