What is vulvovaginitis, and what can I do about it?

Vulvovaginitis refers to a red, itchy irritation of the labia and vaginal area. Often, there is a film or discharge from the raw tissue which can be foul-smelling. Sometimes vulvovaginitis can be so severe that it hurts to urinate, even though there is no urinary tract infection (UTI). Many young girls have this condition from time to time.

In teen girls and adult women, a yeast infection is the most common cause -- especially after a course of antibiotics. Fortunately, in little girls, vulvovaginitis usually isn't caused by yeast or other infections. More often, it's caused by salt and acid from chemicals, sweat, urine, and other secretions. To soothe vulvovaginitis, we recommend the following:

• Don't use bubble bath in the tub.
• Don't let a bar of soap sit in the tub with your child.
• Have your child get out of the bathtub right after washing and rinsing her hair -- shampoo can also irritate this sensitive area.
• Have your child take time to fully empty her bladder when using the toilet. Children who don't empty fully tend to "dribble" urine in between trips to the restroom.
• Little girls should wipe gently from front to back after using the toilet.
• Wear clean cotton underpants every day. Underpants should be changed during the day if they get damp from urine or sweat.
• Wash underpants in a mild, fragrance-free detergent such as Dreft.
• After getting out of the swimming pool or lake, get out of the wet swimsuit quickly.
• Avoid tight pants and shorts.
• Use plain toilet paper without color or scent.
• If your child is toilet trained at night, let her go without underwear at night. This will let air circulate around the skin.
• Unless we specifically recommend it, don't use any ointments or creams on the area. Many creams have chemicals in them that make irritation worse.
• Discourage your child from rubbing or scratching the itchy area. Just like repeatedly scratching an itchy bug bite can infect it, scratching can introduce bacteria.
• Use sitz baths two or three times a day to soothe and cleanse the area. Fill the bathtub with a few inches of warm water and let your child sit in it for about 10 minutes. Don't put any soap or bubble bath in the water. (However, adding a few tablespoons of baking soda is OK.) After getting out of the bathtub, gently pat dry.