The genital area (vulva) is sensitive to the drying effect of soaps and shampoo. Itching in this area can also be caused by poor hygiene, such as sitting for long periods of time in a bubble bath or not wiping properly with a toilet paper or cloth.
Symptoms include a bad-smelling discharge and pain when you urinate. Itching may also be a sign of sexually transmitted infections (STIs).
Vaginitis
A girl can have vaginitis if something disturbs the normal balance of bacteria and other microbes that live down there. Symptoms include itching and a change in discharge. The color, thickness and odor of the discharge can vary depending on what’s causing it. Healthy vaginal discharge is usually thin and watery. It can get thicker toward the end of a woman’s menstrual cycle. Some kinds of vaginitis can cause the discharge to be clumpy, look like cottage cheese, or have a strong fish-like smell (BV).
A doctor can usually diagnose vaginitis by doing an exam and asking about symptoms. They may send a sample of the discharge for testing. They might also prescribe medicine to treat the infection or irritation.
Noninfectious vaginitis can be caused by allergic reactions to or irritation from chemicals in hygiene products, such as vaginal sprays, douches, spermicides, soaps, detergents and fabric softeners. It can also be caused by hormone changes. Infections or irritation that don’t respond to treatment can lead to serious vulvar and vaginal problems, such as scarring, atrophic genitourinary syndrome of menopause or bacterial vaginosis.
Bacterial vaginosis is a condition that’s often treated with anti-biotics and over-the-counter feminine care products. Some types of bacterial vaginosis are more serious and require prescription medication or other treatments.
Fungal vaginosis can be more difficult to treat, but is also usually easy to diagnose. A gynecologist can usually spot a fungal infection from a physical exam, or by sending a sample for a culture.
Other causes of vaginitis include STIs and hormonal changes. These are more likely to happen after puberty, but can also be a sign of sexual abuse or problems with the immune system. Girls who have had long-term vulvodynia or vulva atrophy, due to having their uterus and/or ovaries removed, might also develop vaginitis. In these cases, a doctor might prescribe estrogen pills or creams to restore the hormone levels. Girls might also need to change their hygiene routines or stop using certain irritants, such as perfumed soaps, douching or deodorants. A gynecologist will take into account a girl’s age, health history and family medical history when recommending treatments.
Vaginal Foreign Object
A foreign object inserted into the vagina may produce symptoms such as pain, blood-stained or foul-smelling discharge. The insertion of such objects into the female orifice is common in the pediatric and adolescent age groups, often representing developmentally appropriate exploration of body orifices or as an unintended consequence of vigorous wiping with a cloth. Such insertions can go undetected for extended periods of time, especially in girls with poor perineal hygiene. Some of these objects are designed for use in the vagina, such as tampons and vaginal suppositories, while others may not be and are inserted either accidentally or intentionally.
The underlying cause of this problem is often unknown. However, the presence of a foreign object in a pre-pubertal girl should raise suspicion for sexual abuse. It is known that abused children will frequently insert objects into their anuses and/or vulvae, particularly when the abuser is not present.
Often, a foreign object is a small item such as a marker cap or crayon. Alternatively, it can be a larger object such as a piece of string or a broken safety pin. In most cases, a thorough history and exam will reveal the cause, although some children may not be able to provide a complete history due to their anxiety or nonverbal status.
Some girls do not recall the object they inserted into their vagina, even when presented with painful or odoriferous discharge. It is important for all children to be taught the correct names of their body parts so they are able to describe any problems to their parents and health care providers. This will help them feel more comfortable talking about their bodies and may increase the accuracy of their responses.
For many girls, the foreign object can be removed at home, or in the outpatient setting if no complications are present. However, in adolescents and adult women with difficult to remove or ill-defined objects, anesthesia may be required. The health care provider will also perform a pelvic exam and will examine the hymen for signs of injury or penetration, which can occur with some large or unwieldy objects that cannot be easily grasped. In some cases, x-rays, CT scans or MRI may be performed to locate the object.
Bladder Infection
A bladder infection, also called a urinary tract infection or UTI, happens when bacteria enter the urinary tract (kidneys, ureters, bladder, and urethra) and grow. It can happen in the bladder only (cystitis), in the urethra only (urethritis), or in both (pyelonephritis). It is more common for girls to get these infections, because of their shorter urethra tube and closer proximity to the back passage (anus) where bacteria live.
UTIs can be serious if left untreated, especially in pregnant girls. They can also cause kidney infections, which can be life-threatening.
If a girl thinks she has a bladder infection, her doctor will do a physical exam and talk with her about her symptoms. A sample of her urine will then be tested to see if it contains bacteria, blood cells, or pus. This test is called a urinalysis.
Girls who have a fever, pain or burning when they pee, or the need to pee often and right away should call their doctor. They may need a urinalysis or a cytoscopic exam, in which a thin, long tube with special lenses is inserted into the bladder to check for an infection.
Girls should drink plenty of water to help flush out the bacteria that can cause an infection. They should avoid bubble baths or soap on the genital area and only use clean warm water when they wash. They should wear cotton underwear instead of nylon, because nylon can encourage bacterial growth. They should be taught to always “go” when they feel it and not to hold it, because pee that stays in the bladder gives bacteria a chance to grow. They should be careful when wiping, and to wipe from front to back, not the other way around. They should also be taught to change diapers often, because dirty ones can encourage bacterial growth. If a girl gets an infection, she’ll take antibiotics to kill the bacteria. She’ll probably take them for 3 to 7 days, or longer if she has another health condition. It’s important to finish taking the antibiotics, even when you feel better, because not finishing increases the risk that the bacteria will mutate and become resistant to the medicine.
Vaginal Boils
Boils aren’t limited to the groin area, but can form on the inner lips and folds of the vulva (also known as the labia majora). Unlike a pimple, which forms from infected hair follicles, a boil usually shows up as a large, pus filled bump that can be painful. These bumps, which are also called Bartholin’s cysts, can develop when the duct of a gland in that area becomes blocked.
They usually develop in the skin folds or on the genitalia where chafing or rubbing from tight underwear can occur, Dr. Dweck says. They’re most often caused by the bacteria Staphylococcus aureus, but can be brought on by other types of bacteria or even fungi. Like a rash or infection, a vaginal boil can be contagious and spread through direct skin-to-skin contact with someone who has one, or by sharing towels or clothing that’s been touched by an infected person.
The most common treatment for a vaginal boil involves applying warm compresses and taking oral antibiotics to eradicate the underlying infection. A healthcare professional can swab a boil for bacterial cultures, which can help identify the bacteria responsible and guide medication selection. Women with weak immune systems, such as those with HIV/AIDS or diabetes, are more likely to suffer recurrent boils because their bodies don’t have the strength to fight off bacterial infections.
Over-the-counter pain medications can be taken to control discomfort, and a girl can avoid irritation and rubbing of the boil by wearing loose fitting clothing. She should also clean the boil regularly with soap and water, and wash her hands before and after touching it. If a boil is particularly painful or doesn’t go away with at-home care, it may need to be drained or lanced by a healthcare provider.
A girl should see her ob-gyn or a dermatologist if she notices any new lumps or bumps on her vulva, pubic or groin areas. These aren’t always serious, but it’s better to be safe than sorry, especially if you suspect an STI. In that case, your doctor will perform a sexually transmitted infection test or pap smear.