Clinical Reference Systems: Pediatric Advisor 10.0
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DESCRIPTION

• Your daughter has pain, soreness, burning, or itching in genital area.
• She does not have pain or burning when she urinates.
• She uses bubble bath or bathes in soapy water.
• She has not reached puberty.

CAUSES

Most vaginal itching or discomfort is due to a chemical irritation of the vulva or outer vagina. The usual irritants are bubble bath, shampoo, or soap left on the genital area. Occasionally, it is due to poor hygiene. This chemical vulvitis almost always occurs before puberty. At this age, the lining of the vulva is very thin and sensitive. If the vagina becomes infected, there will be a vaginal discharge.

EXPECTED COURSE OF CHEMICAL VULVITIS

The discomfort goes away after 1 to 2 days of proper treatment.

HOME CARE

1. Baking soda, warm water soaks

   Have your daughter soak her bottom in a basin or bathtub of warm water for 20 minutes. Add 4 tablespoons of baking soda per tub of warm water. (Note: Baking soda is better than vinegar soaks for the younger age group). Be sure she spreads her legs and allows the water to cleanse the genital area. No soap should be used. Repeat this every 4 hours while your daughter is awake for the next 2 days. This will remove any soap, concentrated urine, or other irritants from the genital area and promote healing. After the symptoms go away, cleanse the genital area once a day with warm water.

2. Hydrocortisone cream

   Apply 1% hydrocortisone cream (a nonprescription item) to the genital area after the soaks.

3. Prevention of recurrences
   • Don't use bubble bath before puberty because it is very irritating. Don't put any other soaps or shampoo into the bath water. Don't let a bar of soap float around in the bathtub. Wash the genital area with plain water, not soap. If necessary, use baby oil to remove secretions from between the labia that don't come off with water. If you are going to shampoo your child's hair, do this at the end of the bath.
   • Keep the bath time less than 15 minutes. Have your child urinate immediately after baths.
   • Wear cotton underpants. Underpants made of synthetic fibers (polyester or nylon) don't allow the skin to "breathe." Discourage wearing underpants during the night so the genital area has a chance to "air out."
   • Teach your daughter to wipe herself correctly from front to back, especially after a bowel movement.
   • Encourage her to drink enough fluids each day to keep the urine light-colored. Concentrated urine can be an irritant.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

• The itching is not gone after 48 hours of treatment.
• A vaginal discharge or bleeding occurs.
• Passing urine becomes painful.
• You have other concerns or questions.