Does your little daughter also have vaginal problems? (Vulvovaginitis) - Let's talk about this!

Have you noticed that your little girl sometimes scratches her private parts, or that they are red? Or do you see any stains on her underwear? Does she cry or seem to be in pain when she urinates ? It is actually very common for little girls to have this kind of discomfort. This is what we medically call ``Vulvovaginitis``. Simply put, it is when a girl's vagina (``vagina``) and the surrounding external area (``vulva``) become swollen or inflamed.

Why do young children develop this ``(Vulvovaginitis)`` more often?

You may be thinking, "Oh, why is this happening to my little girl?" There are several reasons for this.

The first thing is that before young girls reach puberty, their bodies produce very little of the hormone `(Estrogen)`. This `(Estrogen)` hormone is what helps keep the skin around the vagina healthy and thick. Because of the lack of `(Estrogen)`, the skin around the vagina of young children is very thin and very sensitive. Like a small rose petal. So even the smallest thing can quickly `irritate` that skin, meaning it becomes red, itchy, and inflamed.

Another thing is that young children do not have the protective pubic hair and fatty labia that adults have around their vagina. These provide some protection from germs and debris. Problems can also arise because of this lack of protection.

In addition, the gap between the vagina and the anus (where poop goes) in young children is very small. So, germs from the anus, especially those that come with poop, can easily enter the vagina.

Finally, we all know that young children are still learning how to properly clean themselves on the toilet. They may not yet be used to the idea of ​​wiping from front to back. Sometimes wiping from back to front can allow bacteria from the stool to enter the vagina or urethra (where urine goes).

Imagine, when all of this is combined, how likely is it that a young child will develop ``Vulvovaginitis``? In fact, the majority (about 62%) of gynecological problems in young girls are ``Vulvovaginitis``.

What are the symptoms of ``(Vulvovaginitis)``?

If your daughter has vulvovaginitis, she may experience the following vaginal discomforts:

• Redness: The vagina and surrounding skin may be red.
• Itching: You may notice your daughter scratching the area frequently. Sometimes, she may wake up at night because of this itching.
• Pain, bruising, or swelling: You may feel pain when you touch it. Sometimes it may even look a little swollen.
• Vaginal discharge: You may notice a white, yellow, green, or brown discharge that stains your underwear. Sometimes, it can also have a foul odor.
• Vaginal bleeding: Sometimes you may see a few small drops of blood. This is often caused by skin injury from scratching too hard.
• Burning or pain when urinating : If your daughter cries or is in pain when urinating , that could also be a sign of this condition.

If your daughter has one or more of these characteristics, it's a good idea to be a little concerned about her.

What are the main causes of Vulvovaginitis?

As we have already discussed, young children are more prone to this condition because their skin is sensitive. The main cause is irritation caused by external factors, which is an allergic reaction to something. This type of irritation accounts for about 75% of cases of vulvovaginitis.

What are these things that cause irritation?

• Tight clothing and underwear: Wearing clothes that are tight, especially those made of synthetic fabrics, can cause sweat to accumulate and trap moisture, causing irritation.
• Soap and bubble baths: Some of the scented soaps, body washes, and bubble baths we use contain chemicals that can be harmful to the sensitive skin of young children.
• Perfumes and lotions: Some scented lotions and powders can also cause irritation in this way.
• Laundry detergents and fabric softeners: Harsh chemicals in laundry detergents can also cause problems by penetrating clothing and getting on the skin.

In addition to this `irritation`, poor hygiene and bacterial infections are also a major cause of ``Vulvovaginitis``. As we mentioned earlier, since young children do not yet know how to clean themselves properly, bacteria can easily enter the vagina.

For example, if a girl doesn't wipe properly after urinating , urine droplets collect inside the vagina, creating a good environment for bacteria to grow. Also, if she picks her nose, puts her fingers in her mouth, and then touches the vaginal area without washing her hands, germs can also be introduced.

Other reasons

In addition to these common causes, there are several other possible causes of ``Vulvovaginitis'':

• Pinworms: These are small worms. They live in the intestines and rectum of a child. At night, when the child is sleeping, these worms lay eggs around the anus. This can cause severe itching. This itching can also cause irritation around the vagina, causing vulvovaginitis.
• Foreign objects: Young children are curious and put small objects in different parts of their bodies. Sometimes, things like pieces of toilet paper or toys can get stuck inside the vagina. If something like this gets inside, it can cause an infection (vulvovaginitis).
• Labial adhesions:This is when the outer lips (labia) of the baby's vagina stick together. This can also be caused by low estrogen levels.
• Lichen sclerosus: This is an inflammatory skin condition. It mainly affects the genitals and anus. It is an autoimmune disease, which means it is believed to be caused by a problem with the body's own immune system.
• Candida (yeast) infection: It is very rare for young girls to get yeast infections, but they can sometimes happen.
• Sexual abuse: This is a difficult topic to talk about, but it's important to be aware of it. Vulvovaginitis can also be caused by sexually transmitted infections (STIs). If a child has an STI or has persistent vulvovaginitis, doctors may suspect sexual abuse. In such cases, they will be thoroughly tested.

How to know for sure if you have `(Vulvovaginitis)`? (Diagnosis)

If your daughter has these symptoms, the best thing to do is to see a pediatrician. The doctor will first ask you about your child's symptoms. How long has this discomfort been present, at what times does it increase, and does it decrease with doing anything? They will also ask about how your child goes to the toilet and how they clean themselves. They may also ask about the types of soaps, shampoos, and laundry detergents they use at home.

The doctor will then do a physical examination of the baby. The main part of the examination is the outer part of the baby's vagina. You can stay in the room with the baby, and this examination is not painful for the baby. So there is nothing to be afraid of.

If the doctor suspects a bacterial infection or sees vaginal discharge, they will take a small sample (a `swab`) and send it to a laboratory for testing. This sample is taken with a small, thin object, smaller than a Q-Tip. It can tell exactly whether a type of bacteria is present or if it is another infection.

How is Vulvovaginitis treated?

In most cases, vulvovaginitis in young children can be relieved with simple home remedies, especially if it is caused by irritation:

• Soaking your baby in warm water without soap for a while (`Soaking in a warm bath`) will help reduce inflammation and itching.
• Avoid using things that cause irritation. Stop using scented soaps, bubble baths, and harsh shampoos.
• Teach your child to wipe from front to back after urinating and pooping.
• Teach your child to urinate with their legs spread wide and bend forward.Sometimes it can help to turn the person to the other side of the toilet and sit on it.
• Wear loose, non-constricting clothing. Underwear made of cotton is especially good.
• Let them sleep without underwear at night. This will allow for ventilation and reduce moisture retention.

To relieve symptoms, your doctor may recommend an emollient, such as a cream containing zinc oxide (such as Aquaphor®), or a steroid cream. However, you should be very careful when using steroid creams. Use them only as directed by your doctor, in the amount and for the duration prescribed.

Treatment for other causes:

• If it is a bacterial infection: The doctor will prescribe an appropriate antibiotic, for example one from the penicillin group.
• If it is due to pinworms: The doctor will prescribe deworming medication, for example, Mebendazole (Vermox®). Everyone in the household should take this medication. Also, all bedding and clothing should be washed and dried thoroughly.
• If a foreign object is lodged: If it's something like toilet paper, the doctor can usually remove it using sterile saline. If that doesn't work, you'll be referred to a pediatric gynecologist.
• Labial adhesions: About 80% of these cases resolve on their own without any treatment. If necessary, your doctor may recommend a topical estrogen cream, which is a cream that contains estrogen and is applied to the skin.
• Lichen sclerosus: The main goal of treatment for this is to control symptoms. Your doctor may prescribe topical steroids or other medications.
• Candida (yeast) infection: To treat a yeast infection, your doctor may prescribe a topical antifungal medication.
• Sexual abuse: If a sexually transmitted infection (STI) has caused vulvovaginitis, antibiotics will be prescribed. Also, if sexual abuse is suspected, the relevant authorities will be notified.

The most important thing is, don't just give your child medication on your own. Always seek medical advice.

How to prevent the development of `(Vulvovaginitis)`?

Although `Vulvovaginitis` is a common condition in young children, there are several things we can do to prevent it:

• Dress your child in loose-fitting underwear and clothing made from cotton. Avoid tight clothing made from synthetic fabrics.
• Use a mild, unscented soap or just water to clean your baby's vaginal area.It's enough to soap your skin once a day. Using soap too often can dry out your skin and cause irritation.
• After bathing, dry the vaginal area thoroughly. Do not leave it wet.
• Avoid using things that can cause irritation. Stay away from bubble bath, scented soaps, shampoos, harsh detergents, and fabric softeners as much as possible.
• Do not leave your child in a wet bathing suit for too long. Change the suit as soon as you finish bathing.
• At night, put your baby to sleep in a loose-fitting garment, such as a nightgown, without a diaper or underwear.

The best way to prevent this is to teach your child good hygiene habits . If your daughter is toilet-trained, teach her these things as well:

• Keep your legs wide apart when urinating .
• Lean forward to urinate . (Sometimes it can help to have the person sit on the other side of the toilet.)
• Always wipe from front to back. (This is very important!)
• Wash your hands thoroughly with soap before and after urinating . The same goes for after defecating .

Finally, things to remember (Take-Home Message)

As a mother, it's understandable to be concerned when your little girl's vagina becomes red, itchy, or has a discharge. But remember, vulvovaginitis is a very common condition in young girls. Most of the time, it's nothing serious, and is most likely caused by some kind of irritation.

First, try to stop using things like scented soaps and bubble baths. Teach your child good hygiene habits. If your child's symptoms persist or worsen despite these steps, be sure to see a doctor. A doctor can diagnose the condition and prescribe the most appropriate treatment. With the right treatment, your daughter will recover quickly.

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