Kids' Health Teen Health Issues Vaginitis in Children and Teens By Vincent Iannelli, MD facebook Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years. Learn about our editorial process Vincent Iannelli, MD Medically reviewed by Medically reviewed by Lyndsey Garbi, MD on November 21, 2019 linkedin Lyndsey Garbi, MD, is double board-certified in pediatrics and neonatology. She is an assistant professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and chief pediatrician at Blueberry Pediatrics. Learn about our Medical Review Board Lyndsey Garbi, MD Updated on November 22, 2019 Print Table of Contents View All Table of Contents Symptoms Causes Treatments Prevention What You Need to Know Vaginitis refers to inflammation or infection of the vagina, but it can also affect the vulva, the area outside the vagina (vulvovaginitis). Ghislain & Marie David de Lossy / The Image Bank / Getty Images Vaginitis in teen girls most commonly occurs when the normal balance of yeast and bacteria in the vagina becomes disrupted for some reason, by direct chemical irritation or if a teen is sexually active. STDs can cause vaginitis. In addition, cases of vulvar irritation and inflammation may be linked to the increased popularity of waxing pubic hair. Vulvovaginitis in girls who haven't gone through puberty yet often has different causes. At this age, because of a lack of estrogen, which doesn't increase until puberty, the skin in and around the vagina can be thin, delicate and easily irritated. These younger girls may develop symptoms of vaginitis because they don't wipe once they become potty trained, wipe improperly (back-to-front instead of front-to-back), wipe too vigorously, or take bubble baths. Symptoms of Vaginitis The most common symptoms of vaginitis can include: Vaginal itching, soreness or irritationVaginal dischargeRedness and swelling of the vulvaBurning with urination (dysuria)Frequency (urinating more frequently)Bleeding (secondary to severe inflammation) Keep in mind that some vaginal discharge can be normal in teens, who may have a white, odorless discharge called "physiological leukorrhea." You wouldn't expect them to have other symptoms if they just had leukorrhea. What Causes Vaginitis Common causes of vaginitis can include: Prepubertal vaginitis: Often non-infectious and caused by poor hygiene techniques or irritation (bubble baths, harsh soaps, wet clothing, etc.). A retained piece of toilet paper can also lead to irritation and discharge.Yeast infections: Caused by Candida albicans. Yeast infections are more common if your child has recently taken an oral antibiotic. In addition to other symptoms of vaginitis, these children might have a thick, white vaginal discharge that is usually odorless. Keep in mind that vaginal yeast infections are much less common before girls go through puberty; they become more common in the later teen years.Bacterial vaginosis: Caused by an imbalance in the bacteria that normally live in the vagina, which can produce a fishy vaginal odor and a thin, whitish-gray vaginal discharge.Trichomoniasis: An STD that is caused by the Trichomonas vaginalis parasitic protozoa, which causes vaginal itching and a frothy, green vaginal discharge that has a bad odor.Chlamydia infections: An STD caused by Chlamydia trachomatis, which can range from being asymptomatic to having a burning sensation when urinating and/or a vaginal discharge. Unfortunately, finding the specific cause of vaginitis or even that a child has vaginitis can sometimes be difficult. Some may not be fully aware that their symptoms are caused by vaginitis and complain more of urinary symptoms when urine hits the inflamed skin. Other girls might be afraid they will be suspected of being sexually active or are just embarrassed to talk about these symptoms. A variety of tests can be done on vaginal discharge secretions to help doctors tell the difference between various types of vaginitis, although they may not be available to pediatricians unless they specifically take care of a lot of teenagers. For example, when a yeast infection is causing vaginitis, your pediatrician might be able to see budding yeast and pseudohyphae when looking at a potassium hydroxide wet mount of vaginal secretions under a microscope. A wet mount might also help to identify the clue cells of bacterial vaginosis or the parasites swimming around. Vaginitis Treatments For quick relief of vulvovaginitis, it can sometimes help to: Take a bath in plain warm waterApply a cool compress to the areaApply Vaseline or A&D diaper ointment to the areas of irritation In addition, remind girls of good hygiene habits, including wiping from the front to the back after a bowel movement to keep the bacteria away from the vulva. Other treatments for vaginitis depend on the specific cause. Antibiotics might be prescribed, usually, metronidazole or clindamycin, if symptoms persist and a bacterial infection is suspected. If a pubertal teen has a vaginal yeast infection, then she will likely need an oral medication like fluconazole. Topical antifungal medication, such as miconazole or clotrimazole cream, are also available if you think your teen will adhere to treatment. Lastly, trichomoniasis is typically treated with oral metronidazole and chlamydia with an antibiotic like azithromycin. Preventing Vaginitis In addition to avoiding bubble baths and practicing proper hygiene (wiping from front-to-back after urinating), you may help your child prevent vaginitis by teaching her to: Urinate with her knees spread wide apartChange out of wet clothing as soon as possible, including sweaty work-out clothesAvoid tight clothingWear loose-fitting, cotton underwearAvoid scented productsUse non-irritating, mild soaps and rinse them off well after bathing or showeringAvoid getting shampoo in the vulval areaWash and dry the vulval area gently when she showers or takes a bathAvoid douching, feminine sprays and scented tampons It may also help to wash your child's underwear with a dye- and perfume-free detergent and avoid fabric softeners. What You Need to Know About Vaginitis Vaginitis is a common problem, so it is important to learn more about it to hopefully prevent your child's first episode or at least know what to do if she has it. In addition to recognizing the symptoms and causes of vaginitis, it can help to know that: Teens should have some time to be interviewed alone without a parent or guardian so that they can be asked if they are sexually active.Sexual partners of teens with trichomoniasis and chlamydia should be treated, too, and they should all be tested for HIV.Lichen sclerosis is often misdiagnosed as vaginitis.Labial adhesions can be a complication of vaginitis, especially recurrent vaginitis in younger children.Pinworms can cause vaginitis, usually as a result of moving from the anus to the vagina.You can prepare a sitz bath for your child by mixing two tablespoons of baking soda in 4 to 5 inches of water in the bathtub. Pediatric gynecologists are available in many areas to help care for children and younger teens with chronic or recurrent vaginitis and other gynecological problems. Otherwise, for extra help or a second opinion, ask your pediatrician for a referral to an adult gynecologist who has some experience taking care of children. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Children's Hospital Colorado. Vulvovaginitis. Boston Children's Hospital. Vaginitis | Symptoms & Causes. Merck Manual Professional Version. Bacterial Vaginosis (BV). Revised September 2019. Merck Manual Professional Version. Candidal Vaginitis. Reviewed September 2019. Merck Manual Professional Version. Trichomoniasis. Revised July 2019. Texas Children's Hospital. What Is A Pediatric And Adolescent Gynecologist? May 7, 2012 Additional Reading Adolescent Medicine. Slap, Gail, MD. 2008. Berman's Pediatric Decision Making (Fifth Edition), 2011. Jasper JM. Vulvovaginitis in the prepubertal child. Clin Ped Emerg Med, 10 (2009), pp. 10-13 Katz: Comprehensive Gynecology, 5th ed.