Vulval skin care for children

  • While your child is young, the skin around the vulva (external female genital area) can be quite thin and sensitive, and this can lead to it being easily irritated. Occasional itching around the vulval area is common.

    Sometimes, irritation to the skin can cause pain (Vulvovaginitis). The symptoms are usually not serious and can be alleviated at home, by following some simple steps.

    Thrush is not common before puberty, although it can be common in babies. Threadworms can also cause itching, redness and even pain around the vaginal area.

    Care at home

    There are many simple ways to try to reduce your child's symptoms if they have itch or irritation around the vulva. Although they have not been studied, these suggestions may also help to improve symptoms.

    Clothing and laundry

    • Wear cotton underwear.
    • Wear loose-fitting pants or skirts to allow ventilation and avoid tights and leggings.
    • Avoid tight pyjamas. A loose nightdress can allow air to circulate.
    • Ensure that underwear and swimsuits are rinsed well to remove laundry detergent. 
    • Avoid laundry rinse aids in the washing machine.

    Hygiene

    • Do not over-wash the area. Treat the skin of the vulval area very gently.
    • Avoid hot baths.
    • Avoid using very hot water in the bath or shower as it can worsen irritation symptoms. Do not use soap for washing while symptoms are present. Alternatives include using a pH neutral wash. This can be used on an ongoing basis.
    • Do not use bubble bath or perfumed soaps or creams and avoid getting shampoo on the vulval area.
    • Try daily baths to prevent mild infections in the vulval area. Vinegar baths may also help to relieve itchiness. Add half a cup of white vinegar to a shallow bath and soak for 10 to 15 minutes. Your child can have vinegar baths from once a week to twice a day, depending on how uncomfortable the symptoms are.
    • Encourage your child to urinate (wee) when they first feel they need to go to the toilet and avoid 'hanging on'.
    • Rinse the genital area well and gently pat dry.
    • Use soft, uncoloured, unscented toilet paper.
    • Do not use nappy wipes to clean the area, use a Chux towel. Wet the Chux with tap water to clean. If needed, a cool compress may help to relieve discomfort.

    Physical activities

    • When symptoms are present, avoid activities that put direct pressure on the vulva (e.g. bicycle riding or horse riding).
    • Remove sports clothing soon after exercise.
    • Avoid letting children sit in wet bathing suits for long periods of time.

    Relieving itch

    • Encourage your child to not scratch the area.
    • Apply a cool compress (Chux towel, wet with tap water) to the itchy area to relieve symptoms after exercise. These can be place in the underpants like a sanitary pad. 
    • Do not use medication on the genital area that has not been prescribed for this area, because the skin is more sensitive than other skin.
    • A mild hydrocortisone 1 per cent cream may be applied to the red/itchy areas one to two times a day until the symptoms have cleared. 
    • A non-fragranced moisturiser cream or barrier cream such as zinc cream can be applied to the area to relive dryness and itch throughout the day.

    When to see a doctor

    If your child's itch and irritation remain after trying the suggestions above, see your GP. Also see the GP if your child has:

    • pain or burning when urinating
    • bleeding or discharge from the vaginal area
    • fever or abdominal pain

    Key points to remember

    • Vulval skin is very delicate and needs to be treated gently. 
    • Occasional itching around the vulval area is common.
    • Thrush is uncommon before puberty.
    • Vinegar baths and a cool compress may help relieve itch.
    • Avoid bubble baths or perfumed soaps and creams.

    For more information

    Common questions our doctors are asked

    How can I get my child to stop scratching?

    It's hard to get a child who is feeling itchy to not scratch, but it is important to discourage scratching so they don't irritate the skin further. Try placing a cold, damp, cloth against the itchy area to relieve the itch, or give your child a vinegar bath. See your GP if nothing seems to help.

    How do I know if my child has thrush?

    It is very rare for children to get thrush before they start menstruating, so vaginal or vulval itching is not likely to be thrush. Vulvovaginitis is more likely. If your child has a thick, white discharge from their vagina (with a ‘cottage cheese’ appearance and yeasty smell) then it may be thrush. If there is a discharge, see your GP.


    Developed by The Royal Children's Hospital Dermatology department. We acknowledge the input of RCH consumers and carers.

    Reviewed March 2018.

    This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.


Disclaimer  

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.