“Big Girl Panties—And the Vulvovaginitis that sometimes results from them”
Potty training is always a very exciting time in any household. Parents are excited to be done paying for diapers, and young children are very proud to wear their “big boy” or “big girl” underwear. Children with long standing issues of skin irritation related to wearing diapers finally have some relief as well.
However, there are some things we have to remember when young children—particularly young girls—begin controlling their bladders and managing their own toileting/ wiping.
Often times, there are lots of things that our young ladies would rather be doing than going to the potty—whether it is playing on the playground or watching a movie or participating in activities in daycare or preschool. Frequently, children don’t want to stop to use the restroom. They will hold their urine until the very last minute. By the time little girls finally do rush to the restroom, they have often begun to leak a small amount of urine. The urine that leaks then will irritate the external skin around the urethral and vaginal openings—causing a condition called (vulvo)vaginitis.
Vaginitis can be caused in several other ways as well. The same little girls that hold their urine until they have to rush to the restroom also have a tendency to wipe quickly and incompletely or improperly to get back to the activities they would rather be doing. In addition, younger children simply don’t have the dexterity to adequately clean themselves after voiding (or stooling), and they often incorrectly wipe from front to back. This will leave urine, and possibly stool, around the urethral and vaginal openings, further irritating the area.
Aggressive cleansing with soap in the vaginal region or bubble baths or wearing wet bathing suits for extended periods of time can also cause the redness and irritation associated with vaginitis
Vaginitis is quite common, as most little girls hold their urine or rush to wipe at some point. The symptoms of vaginitis are typically pain or discomfort during urination, or complaints of pain or itching or burning in the “private parts”, often after urination. On visual inspection, the area around the urethral/ vaginal opening can often be red and irritated..
The first time your daughter experiences any of the symptoms of vulvovaginitis, it is important to have her evaluated by her pediatrician—so that her urine can be tested to confirm that she does not have a urinary tract infection, and a history and physical exam can be done, so that any other significant illness can be ruled out as well.
The treatment for vulvovaginitis is often very simple:
For the acute symptoms, we recommend 5-10 minute “sits” baths in lukewarm, plain, fresh (with no soap) water 2-3 times a day for 2-3 days. In addition, after each visit to the toilet using a moistened washcloth to wipe, followed by a layer of Vasoline, can help the symptoms of burning and pain until the irritation resolves.
To help prevent further episodes, it is important to teach girls good toileting hygeine:
- Teach young ladies to use the restroom as soon as they need to go, and avoid holding urine unnecessarily
- Teach young ladies to wipe properly, from front to back; and help them do so until they have the dexterity to do it properly
- Teach young ladies to clean their “private parts” by thorough rinsing with fresh water and avoiding soap in this area
- Teach young ladies to avoid bubble baths
- Teach young ladies to change out of wet bathing suits/ clothes as soon as possible
