|: Vaginal Discharge Common In Young Girls
DEAR DR. PAUL: My four year old daughter seems to
have a lot of discharge. Even though she is bathed every day,
but the end of the day her panties are messy, almost greenish
tinged. I don't know if it is normal for this age, or should I
PEDIATRICIAN DR. PAUL Answers: This is common problem
in girls less than 8-9 years of age. Although it is impossible
for me to make an exact diagnosis, I will describe the various
possible causes of vaginal discharge known as "vulvovaginitis".
The exact treatment will depend on the cause. The term vulvovaginitis
refers to inflammation of the female external genital area. Inflammation
can occur in any of the following ways:
Irritation from bubble baths or the use of strongly scented soaps.
Other products than can irritate the area include soaps, detergents
or softeners used to wash the underwear. Wearing tight fitting
nylon underwear can also result in irritation.
Another cause of vaginal irritation in young girls has to do with
the way the anal area is wiped with toilet paper. We recommend
that wiping be done from "front to back" rather than "back to
front", as the latter way can spread fecal matter and bacteria
to the genital area.
Pinworms can cause vulvovaginitis: by coming out of the rectal
area the tiny worms can cause vaginal irritation. With pinworm
infestation, there are usually associated signs making it easy
to make the diagnosis, such as extreme itchiness and irritation
of the rectal area.
Mechanical pressure or rubbing
Constant or repeated rubbing, pressure or abrasion in the genital
area can result in vulvovaginitis. Examples include regular masturbation
and frequent or prolonged contact with play equipment(saddles
on play horses) or sitting in sand boxes.
Not infrequently, irritation results from applying too much pressure
on the genital area when drying it with a towel after a bath.
The best way to dry a girl's genital area is by gently patting
with a towel and avoiding rubbing movements.
Infection is another cause of vulvovaginitis. The bacteria usually
come form the rectal area. It is important to distinguish that
a genital infection is not the same as a urinary tract infection.
The latter is an infection of the urine originating in the bladder
or kidneys, and not the result of inflammation of the external
If a young girl inserts a toy or other article into the vagina,
this it can lead to an infection resulting in a foul smelling
It is shocking to find that some sexually transmitted infections
have been detected in young girls; a sign that sexual abuse has
occurred. This is a part of pediatrics that I dislike.
In the case of an infection, the treatment varies depending on
the germ that is causing the infection ranging from creams to
In most cases, the problem is minor and the source can easily
be determined by going through the checklist of possible causes.
On a final note, it is important to teach and practice proper
genital hygiene and wiping techniques, and to avoid the possible
irritants in order to prevent vulvovaginitis in the first place.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
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