Pre-Pubertal Vaginal Inflammation and Irritation: Understanding Pediatric Vulvovaginitis

First published December 2017
Updated May 2026

Vulvovaginitis, or inflammation and irritation of the genital area, may occur in females of any age – including newborns, toddlers, and children, but it most commonly occurs in girls who have not yet started puberty.

What causes vulvovaginitis?

There are several potential causes of vulvovaginitis. Young girls are more susceptible to vulvovaginitis because they have less of the hormone estrogen, which makes the vulvar skin thinner and more sensitive.

Common causes include allergic reactions, infections (bacterial, viral, fungal, pinworms), inadequate vulvar hygiene, vaginal foreign bodies (including toilet paper), and other skin conditions. Yeast is actually an uncommon cause of vulvovaginitis in girls who are toilet trained.

Sometimes, several causes may be present at once.

What are the symptoms?

Girls experiencing vulvovaginitis may have redness of the vulva, vulvar and/or vaginal itching, vaginal discharge or bleeding, and stinging or burning sensations. Some experience painful urination.

How is vulvovaginitis diagnosed?

Your child’s provider will ask you questions about her symptoms, any prior episodes, and any prior treatments. Then they will perform an exam of the external genitalia- the vulva, urethra, vaginal opening, and rectum. Typically, an internal exam is not necessary. They may perform a genital culture – this is done by gently touching the genitalia and vagina with a very small cotton swab. The swab is sent to the lab to see if any specific bacteria or yeast grow. An ultrasound or biopsy is rarely needed. Your provider may suggest an exam under anesthesia to evaluate further.

How is it treated?

Treatment varies depending on the identified cause. Fortunately, the symptoms may improve without treatment and at puberty when estrogen production begins. When a specific infectious cause or skin condition is identified, these can be addressed with targeted treatments. When a foreign body is suspected, these can be removed whether in office when able, or under anesthesia. Otherwise, the good news is that there are several things that can be done to manage and prevent pre-pubertal vulvovaginitis, no matter the cause.

Here are things you can do to help treat and reduce the risk of vulvovaginitis:

• Have your daughter wear white cotton underwear. She may also sleep without underwear at night
• Wear loose clothing, avoiding clothes that cause extra rubbing or pressure
• Change out of wet clothes or swimsuits as soon as possible
• Use mild, unscented soap and soak daily in clean, warm water. Do not use bubble bath products, bath bombs, baking soda, or vinegar.
• Avoid scrubbing the vulva including with a washcloth or loofah. Rinse soap completely off and gently pat the vulva dry. Avoid all irritants like soaps, lotions, detergents or fabric softeners with colors and fragrance. Girls should urinate with legs spaced wide apart and wipe from front to back after using the toilet.
• It is important to treat constipation and diarrhea – as these conditions may make vulvovaginitis worse.

In addition to these daily preventative measures, you may try petroleum jelly or a diaper ointment on the vulva if the area is irritated, red, or itchy. Symptoms should improve within 1-2 weeks of using the self-care tips above.

If your daughter’s symptoms do not improve or if she has recurrent symptoms, it’s best to see a pediatric gynecologist. You can request an appointment with Nationwide Children’s Pediatric Gynecology experts online or by calling (614) 722-2250. No referral is needed.