Vaginal irritation in girls about 3-8 years old is very common for lots of reasons. They are not always careful about hygiene and that area is very sensitive at this time in their lives. Typical symptoms include pain and itching of the vulvar area (between the 2 lips), pain at the onset of urination, and occasionally discharge.
Irritation occurs for a lot of reasons. One of the biggest irritants is soap. Families often make the mistake of scrubbing really well when girls start to complain of itchiness because of the assumption that the area was “unclean.” This just makes things worse. So no bubble baths and no soap between the legs. Soap on the bottom is fine but none up front – just plain water rinsing. Girls with really long hair might want to stick to showers because sitting in a bathtub full of shampoo can be a problem. Soap can also be irritating to boys so anyone complaining of mild pain or irritation of the penis should avoid soaps as well.
Also teach young girls to wipe front to back. Do some observed potty time to make sure of proper wiping technique. Some get in a hurry and wipe too little and some get a little too enthusiastic and wipe too hard. Have young girls spread their legs some to pee. If they don’t, urine can be trapped in the folds and be irritating. Look for constipation as this can often lead to “streaks” in the underwear.
Avoid prolonged exposure to tight fitting clothes, like swim suits, leotards and tights. Wear loose fitting clothes at night or even remove underwear at night.
Despite all of these steps vaginal irritation usually occurs with some regularity to young girls. Treatment includes removing the irritants. Use Sitz baths which are plain water baths, in addition you can add 1-2 tablespoons of baking soda (not vinegar) to help with irritation. Do this up to 4x per day for a couple of days. Make sure she spreads her legs and rinses the area well. Do not scrub with clothes or sponges. Just rinse. Vaseline can be applied after baths and throughout the day. If very itchy a small amount of over the counter cortisone can be applied. Repeat the rinsing baths whenever irritation occurs.
When should she be seen by her health care provider? If there are day or night accidents outside of her norm, if she has a fever, frequency of urination, vomiting, extreme pain with urination, or is acting sick. All of these would be more concerning for bladder infections. In addition, if you have tried the baths and symptoms are not improving she should be seen. Finally signs of trauma – bleeding, cuts or bruising are never associated with simple vaginal irritation and should be evaluated by a pediatrician.