Vaginitis – A common summer symptom with swimming

Definition

  • Irritation of the vulva (girls’ external genitals) from soap or other irritants.

Symptoms

  • Genital itching and discomfort in pre-pubertal girls. This is not the same as a yeast infection and there should not be vaginal discharge. Pre-pubertal girls have a different pH balance which should prevent getting a true vaginal yeast infection. The pH difference also means the genital area is more sensitive to drying and irritation.
  • Usually, no pain or burning occurs when passing urine, but occasionally because the skin can be very irritated, the urine passing over the skin may cause some discomfort

Causes

  • Bathwater irritants are a common cause and include using bubble bath, bath bombs, shampoo, or soap in bath water, as well as cleaning genitals with a soapy washcloth. This can cause the genital area to become red, sore or itchy. Use only warm water to clean this area. After puberty, soap can be tolerated.
  • After swimming, continuing to run and play in a wet bathing suit after being out of the pool can cause irritation to the genitals. After out of the pool, it is helpful to wash off with clean water to remove chlorine and other irritants and put on dry, loose fitting, cotton underwear.
  • Occasionally poor hygiene can be the culprit. This is most common in younger children. Reviewing the importance of wiping front to back can be helpful.

Diagnosis

  • Usually, the diagnosis is easy with the right history and on examination we can see that there is mild or moderate redness to the vulvar area.
  • If there is consistent discomfort with urination, we often check urine to be sure there is no UTI.

Treatment

In addition to avoiding washing genital area with soap and taking off wet and tight clothing promptly, these other remedies may be helpful as well:

  1. Baking Soda Baths: Adding ¼ cup baking soda to 1 tub of bathwater and soaking for about for 10 minutes helps remove germs and promotes healing. During soaks, be sure she spreads her legs to allow water to cleanse the genitals. This can be repeated 2 times per day for 2 days.
  2. Ointments: After bathing, apply a small amount of over the counter 1% hydrocortisone ointment on the external genitals. Choose ointment rather than cream as cream has a higher alcohol content and can be more irritating to this area. This can be used 2 times/day for 2 days. When not using hydrocortisone, applying Aquaphor or Vaseline to the external skin may prevent burning as urine passes over irritated skin.
  3. Laundering and clothing: Use hypoallergenic and fragrance free detergent and avoid fabric softener for underwear and bathing suits. Using fragrance free wet wipes after using the restroom until discomfort resolves. Wearing loose fitting cotton clothing and nightgowns will help as well.

Call If...

⦁ Itching lasts over 48 hours using this care advice

⦁ Vaginal discharge or bleeding occurs

⦁ Passing urine becomes painful

⦁ You think your child needs to be seen

⦁ Your child becomes worse

AUTHOR

AHK Advanced Practice Providers

Our AHK APP’s include: Annie Croft, Pam Dietrich, Erin Moore, and Nikki Nutter,