A girl may have a number of symptoms that can cause her puss to become red, sore and itchy. This is called soap vulvitis, which can be caused by using too much shampoo or bubble baths, or from not washing properly after using the toilet.
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Vaginitis
Vaginitis is inflammation (redness, swelling, and irritation) of the vulva (the area around the outside of your vagina). It can be caused by infections or by irritation from chemicals like perfumed soaps, shower sprays, douches, tight clothing, wet diapers or swimsuits, or by things that stick to the skin. It can also be caused by changes in hormone levels or by the presence of a parasite called trichomoniasis.
Girls of all ages can get vaginitis. It’s most common before puberty when the vulva and vagina are developing. It can also be caused by a yeast infection, usually from the naturally occurring fungus Candida albicans, or by bacterial vaginosis, when one kind of bacteria grows too much and upsets the balance of other types of microbes in the vagina.
It’s possible to spread certain kinds of vaginitis — like trich, which is caused by a parasite, or STIs, including genital herpes and trichomoniasis — to sexual partners. Some STIs, like genital warts and chlamydia, can also be passed through vaginal, oral or anal sex.
Vaginitis can be treated with over-the-counter creams, suppositories, or vaginal tablets. You can find them at your local drugstore, but it’s best to get a prescription from your doctor or gynecologist. They can check your vulva for signs of irritation, take a sample of discharge, or do a pelvic exam. Your doctor may also recommend you change your personal hygiene routine to avoid irritation and encourage healing. This might include taking sitz baths, using loose cotton underwear, wiping properly after use of the toilet, and not showering or douching for a few days.
Vaginal Foreign Object
Children, especially girls, curious about their bodies may insert objects into the vulva or vaginal canal. This can include small toys, tissue paper and other items. In some cases, these objects can become stuck or may cause a blockage in the urethra (the tube that carries urine from the bladder to the outside of the body). This condition occurs more often in young children, but girls of any age can develop this problem. It is usually easy to diagnose and treat in the pediatric setting. Depending on the object, it may be possible to remove it in the office by separating the labia and gently looking inside with a speculum or forceps. A more serious object or one that is very difficult to find, such as a battery or twig, may require sedation or examination under anesthesia for removal.
A foreign object in the vagina can produce a variety of symptoms, including pain during urination and foul-smelling vaginal discharge. The most common type of object found in the vagina is a forgotten tampon. In other cases, the object may have been inserted intentionally for sexual pleasure or as part of a form of abuse.
Health care professionals generally recommend a pelvic exam with a speculum or a scope with a light and camera (vaginal foreign body resectoscope). X-rays, CT scans and MRIs can also help find an object. Medications such as contrast liquid can be used to make objects show up better in pictures.
Bladder Infection
A bladder infection, also called a urinary tract infection (UTI) or cystitis, happens when bacteria enter your urethra and spread into your bladder. Typically, this happens when bacteria from the gut, especially E. coli, travel up the urethra toward the bladder. UTIs may happen for other reasons, too. It is possible to have a bladder infection without any pain or burning when you pee, a condition known as asymptomatic bacteriuria.
People of all ages and sex can get a bladder infection. But girls, because they have shorter urethras than males, are more likely to develop one than men and boys. Girls can help prevent UTIs by wiping from front to back after using the bathroom, and by choosing cotton underwear over nylon. They should also avoid bathing or using loofahs, and they should urinate as soon as they feel the need to, rather than waiting to go to the bathroom later.
If a girl gets a UTI, she’ll probably need to take antibiotics for one or two weeks to cure it. Doctors prescribe a variety of antibiotics, including the sulfonamides (sulfamethoxazole/trimethoprim) and fluoroquinolones. Taking the full course of antibiotics, even when you’re feeling better, helps ensure that the infection is completely treated and won’t return. In addition, over-the-counter pain relievers can be used to ease any pain and discomfort. Drinking plenty of water to stay hydrated can also help.
Yeast Vulvitis
Fungus lives in many places in your body, including the mouth, digestive tract and vagina. It doesn’t usually cause a problem, but sometimes the “good” bacteria can’t keep the yeast under control. When this happens, you might have a yeast infection. These infections are called candidiasis and are very common in girls. They happen mainly in girls who are menstruating or who use estrogen-containing hormone therapy and less often in premenopausal women who don’t take any estrogen.
The most common symptom of a yeast infection is itching in the vulva and vagina area. You might also have a clumpy, curd-like, or watery vaginal discharge. Yeast infections are more common in girls who have been taking antibiotics, have diabetes or have a weakened immune system (such as from HIV infection or a disease like cancer or some medications, such as steroids). Yeast infections are also more common if you wear tight or synthetic underwear.
Your doctor might test for a yeast infection by asking you to pee in a cup and then swab your vulva and vagina for a culture. If she thinks you have one, she might prescribe an antifungal medicine that comes in the form of a pill, cream, tablet or suppository. You might need to take it for 1-6 days. Follow your doctor’s instructions and the symptoms should go away. You can also buy over-the-counter yeast infection medicines in a drug store to treat them at home.
Labial Fusion
In early childhood, a girl may develop fusion of the inner lips of her vulva, called labia minora. The fusion can be mild and is a normal part of development in early childhood. It usually goes away by puberty. In more severe cases, the fusion can cause dribbling after urinating as urine gets trapped behind the adhesions. This can lead to a urinary tract infection and vulvovaginitis.
The condition is associated with low estrogen and it is most common in prepubertal girls. However, it can also affect women in reproductive age with no discernable predisposing factors such as vulvar infections, dermatitis and female circumcision.
A gynecologist can diagnose the condition and recommend treatment. The gynecologist can usually see the fusion by performing a pelvic exam. The gynecologist will then break up the adhesions and restore the separation between the labia.
This is typically done by using an oestrogen cream or ointment. A small amount of the ointment is applied to the center of the fusion on a daily basis until the fusion breaks up and separates. The oestrogen will help to stimulate the labium minora and promote growth and healing. The oestrogen cream or ointment will need to be applied for up to 6 weeks before the fusion can be completely broken down. Once it is, the ointment should be stopped so that the labium can begin to heal properly.
Pinworms
Pinworms are a common affliction of kids, but they’re not dangerous. They affect girls by moving into the area around the anus, causing itching and restless sleep. If the itching breaks the skin, a bacterial skin infection can develop. Girls may also experience vaginal discharge.
Infection spreads through contact with a female pinworm as she moves in the area and lays her eggs, usually at night. Pinworm eggs become infective within a few hours, and they can survive on surfaces or fingers for two weeks. The microscopic eggs can be picked up by someone else, who then accidentally ingests them in the mouth or by touching their hands to the anus. They can also be transmitted by shaking contaminated clothing or sheets. Once in the body, the eggs travel through the intestines and hatch into adult worms.
Strict handwashing practices, especially after using the bathroom and changing diapers, can help prevent pinworms. Children should shower daily and avoid sharing towels, washcloths or bed linen. They should also wash toys frequently and thoroughly. Encourage them to clean their fingernails and work on not biting them, which can transfer egg-containing germs. Washing bedding and towels in hot water and drying them with a high heat can destroy the eggs. Your pediatrician can recommend treatment based on the child’s age and severity of symptoms. Taking all household members into treatment at the same time can help prevent spreading the parasite to others.