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Genital Irritation and Itching

Symptoms
  • Your daughter complains of pain, soreness, burning, or itching in the genital area.
  • There may be a whitish discharge present on the skin surface.
  • There may be an odor in the genital area.
  • She may have pain or burning when she urinates. She may only urinate small amounts because of the burning.
  • Symptoms of urinary tract infection (UTI) are not present: abdominal or side pain, fever, painful urination. It is sometimes difficult to rule out a UTI and may require a urine sample to be sent to the lab.

Causes
  • Most vaginal itching or discomfort is due to a chemical irritation of the genital area (vulva or outer vagina).
  • The usual chemical irritants are bubble bath, shampoo, or soap left on the genital area.
  • Occasionally, it is due to poor hygiene (not wiping properly after bowel movements).
  • Sitting around in a wet bathing suit can irritate the genital area.
  • This chemical irritation usually occurs before puberty. At this age, the lining of the skin in the genital area (vulva) is very thin and sensitive.
  • It is uncommon for prepubertal girls to develop a true vaginal infection unless there is a foreign body present (toilet paper).

Expected Course

Until treated, your child will complain of itching or burning in the genital area. The itching causes further irritation and eventual infection of the surface skin. When urinating, the urine may burn the already irritated skin, causing your child to complain each time she urinates. The discomfort goes away after 1 to 2 days of proper treatment.

This burning with urination is different from the burning caused by a urinary tract infection. Urinary tract infections will usually present with abdominal or side pain, increased urination, wetting at night in a toilet trained child, and sometimes fever. If treatment as described below does not help in 48 hours, a urine sample will be needed to check for a urinary tract infection.


Treatment
  • 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.

Prevention of recurrences
  • Don't use bubble bath 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) do not allow the skin to "breathe."
  • Discourage wearing underpants during the night so the genital area has a chance to "air out."
Antibiotic cream - If there is an odor, whitish discharge or extreme redness of the skin in your child’s genital area (outside the vaginal opening), use an antibiotic cream (Polysporin or generic brand) at least four times a day until better. The antibiotic cream should eliminate the odor and discharge after 5 days of use.

Hydrocortisone cream - After the odor and discharge have resolved, apply 1% hydrocortisone cream (a nonprescription item) to the genital area inside the labia. Hydrocortisone cream can be used to treat mild redness of the labia. Hydrocortisone may burn when first applied. If you are unable to use the hydrocortisone, continue the antibiotic cream until the redness is reduced.
  • Teach your child not to sit around in a wet bathing suit for too long a time.
  • Encourage her to drink enough fluids each day to keep the urine light-colored. Concentrated urine can be an irritant.
  • Proper Hygiene: Teach your daughter to wipe herself correctly:
    • After urinating, teach your child to gently pat herself and not to rub, as this can irritate the genital area.
    • After a bowel movement, teach your child to gently wipe herself and not to use the same piece to wipe her front.
    • Remember - "a separate piece for the front and a separate piece for the rear."

Call Our Office During Office Hours If:
  • The itching is not improved after 48 hours of treatment.
  • A vaginal discharge or bleeding occurs.
  • Passing urine becomes more painful.
  • You have other concerns or questions.

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