A girl's puss is the front top of her vulva. Puss can be red, itchy and irritated. It can also get dirty or infected.
It's normal for a girl to have vaginal discharge. It helps her vulva stay clean and fight infections. The color and texture of her discharge may change during the month.
Vaginal Discharge
Vaginal discharge is a clear, white or off-white fluid that comes from glands in the uterus (the top end of the body) and cervix (the bottom part). This is made by the cells that line the uterus, cervix and the vulva, or female genitals. It helps clean and lubricate the vulva, and keeps away germs and infections. It can also tell you when it’s time to have sex and can be an early sign of pregnancy.
Normal discharge never causes itching or has a foul smell. It may change in color and texture over the course of a month. It’s thinner and milky-white during ovulation, when an egg is released, then gets thicker and cottage cheese-like as the menstrual cycle progresses. It also decreases after menopause, when estrogen levels drop.
When a girl has abnormal vaginal discharge, she should see her doctor right away. She may need a pelvic exam and a Pap test to check for signs of infection.
A Pap test is usually done by a nurse or gynecologist and requires a small sample of cells from the cervix. The Pap test checks for abnormal cell changes that can be caused by sexually transmitted diseases, such as gonorrhea and chlamydia.
Other problems that can cause abnormal vaginal discharge include douching, feminine hygiene sprays, certain soaps or bubble baths, antibiotics, diabetes and pregnancy. These can upset the balance of healthy bacteria that lines the vulva. A doctor can give a girl medicine to treat the condition, such as antifungal pills or creams for yeast infections, antibiotics for bacterial vaginosis or “trich,” and drugs to treat infection from genital herpes (HSV). Girls should try to keep the vulva area as clean as possible and avoid using any products that might cause irritation.
Itching
Few things are more annoying than an itchy vulva or vagina. But if there’s a serious problem down there, the itching can be a sign that you need to see a doctor.
The most common cause of itching in the vulva is irritation. This can happen when there’s a lot of soap on the skin, like after taking a bubble bath or using soapy shower gel. Itching can also be a side effect of some skin conditions, such as eczema and psoriasis.
If you’re itching in the vulva area, try using non-scented soaps or body wash. It’s best to avoid scented body sprays, lubricants or douches, since these can irritate the area even more. Changing underwear often and wearing loose clothing that doesn’t rub against the genital area can help too. And putting on a cornstarch-based unscented powder can keep the area dry.
Another possible cause of itching in the vulva area is yeast infection. Yeast is a fungus that’s naturally found in the vagina, but sometimes it can overgrow. When that happens, girls may notice itching and a thick, whitish discharge that smells like sour dough. Yeast infections can also occur during times of hormonal changes, such as before your period or during pregnancy.
If you have any of these problems, it’s important to talk to your doctor. The doctor will ask you lots of questions, and may want to do a pelvic exam to see if the itching is caused by something serious. They may also take a sample of the itchiness and send it to the lab to be tested for things like chlamydia, gonorrhea or bacterial vaginosis. If any of these are a problem, the doctor will give you medicine to treat the disease.
Redness
Vulvovaginitis, which is redness and irritation of the skin of the vulva and vagina, can occur at any age. It is most common in girls who have not started puberty, since they have lower levels of estrogen. This makes their vulvar skin thinner and more sensitive to irritation. It may be caused by infections, irritation from wearing tight clothing or soaps, poor hygiene or other skin conditions. It can cause itchiness in the vulva area, vaginal discharge and itching, painful or burning urination or bleeding and scaly skin on the labia (lips of the vulva).
Soap vulvitis is the most common cause of itching of the genital area in girls who have not started puberty. The vulva is very sensitive to the drying effects of soaps, especially bubble baths and shampoos. Itching can also be caused by wearing tight clothes or a swimsuit that rubs the skin in this area and not washing it thoroughly after using the toilet. Itching may also be caused by poor hygiene, such as not rinsing the genital area after going to the bathroom or wiping from back to front. Itching can also be caused by a pinworm, which is a parasite that lives in the skin and can become trapped under the skin.
Other causes of vulvovaginitis include yeast infections, which occur when a type of yeast that normally lives in the body gets out of control and starts multiplying. This infection often occurs after taking antibiotics, and can affect people of all ages. It is also possible for the skin to be irritated by a virus called molluscum contagiosum, which causes patches of small, shiny bumps on the skin.
Swelling
The vulva and labia have a rich blood supply, so even a minor injury to the area can cause pain and swelling. Bruises, from an injury to the outside of the vulva, are common, especially when girls fall on playground equipment or the crossbars of a bike. Sometimes, straddle injuries can cause bleeding into the labia, resulting in a pocket of blood (hematoma) that goes away on its own or needs to be drained by a doctor. A Bartholin’s cyst, a firm, noncancerous lump that can appear in girls in their 20s, also causes pain and swelling in the vulva area.
Other things that can lead to a girl’s puss getting swollen:
Chemicals in soap, bath products, perfumed lotions, and laundry detergent can irritate the sensitive skin in and around the vulva and vaginal opening, leading to itching and swelling. If a product you use is the culprit, try not using it for a few days and see if the irritation clears up. Using unscented body wash, wearing cotton underwear, and not douching can help limit irritation as well.
If you have a swollen vulva, see a healthcare professional as soon as possible to get it checked out and treated, says Sherry Ross, M.D. A swollen vulva can look puffy or red and feel tender to the touch, with other symptoms such as discharge, itching, and odor appearing depending on the underlying cause. A swollen vulva is most likely caused by an infection, but a pelvic exam or blood tests may be needed to determine the exact cause. If the vulva is very painful or accompanied by a fever, see your doctor immediately.
Vaginitis
Vaginitis is an infection or inflammation of the vulva, and it can be caused by bacteria, yeast or viruses. It can be a painful condition and may have different symptoms. It is common and affects females of all ages, although girls are more likely to have the condition as they get older. Depending on the cause, doctors can treat it with medicine or recommend lifestyle changes.
A healthy vagina contains many types of microbes, including both “good” and “bad” bacteria, which normally balance each other out. But sometimes these microbes become out of balance, leading to infections. Infections are the most common causes of vaginal pain and discharge. There are several types of vaginal infections, such as bacterial vaginosis (BV), a yeast infection or a sexually transmitted infection, like chlamydia, gonorrhea or trichomoniasis.
Yeast infections are caused by one of several species of the fungus candida, which naturally live in the vulva in small numbers. An overgrowth of this fungus is what leads to a yeast infection. A yeast infection can be caused by a number of things, including antibiotics, pregnancy or some health problems, such as diabetes.
Bacterial vaginosis is the most common type of vaginitis. It occurs when a change in the type of bacteria that normally live in the vulva upsets the balance, leading to inflammation and thickened or cloudy discharge. It can also cause a fishy or unpleasant odor.
Other types of vaginal irritation or infections can be the result of chemicals in soaps, sprays or products that come into contact with the vulva, such as feminine washes and powders, perfumes, lubricants, douches, spermicides, laundry detergents, bleaches or fabric softeners. Hormonal changes, such as those that occur during puberty or during menstruation, can also cause vaginitis.