Common Gynecological Issues in Children: Itching and Discharge

Problems such as itching, redness, burning sensations, and discharge are among the most common reasons for pediatric gynecology consultations. However, it is important to note that not all burning sensations are inflammations and not all discharges are pathological. Fungal infections are rare in children aged 3 to 9 years.

Non-Specific Vulvar Irritation

Symptoms: Greenish, foul-smelling discharge with little to no discomfort for the child, yellow-green stains in underwear.

Causes: Poor hygiene, unfavorable toilet posture, irritation from soaps or bath additives.

Treatment: Improve hygiene (wash the vulva once a day), correct toilet posture, use zinc-free ointments for a few days. No antibiotic treatment is necessary.

Non-specific vulvar irritation, or vulvovaginitis, is the most common diagnosis. The sweat glands of the vulva produce a lot of secretions. Girls often adopt a poor posture on the toilet, allowing some urine to enter the vagina. This urine accumulates at the vaginal opening and, when mixed with local germs, produces foul-smelling discharge.

Vulvar Synechiae

Symptoms: Persistent sensation of urine leakage, frequently wet underwear.

Cause: Skin irritation due to the warm, moist environment of the diaper, excessive or insufficient hygiene, leading to repeated irritations.

Treatment: Improve hygiene, avoid irritating substances, and apply an estriol-based ointment if necessary. Synechiae are often asymptomatic and usually resolve spontaneously with puberty.

Vulvovaginitis Due to a Foreign Body

Symptoms: Persistent foul-smelling discharge, increasing discomfort.

Diagnosis: Inflammation of the vulva, purulent or brownish discharge, presence of a foreign body detectable by ultrasound.

Treatment: Removal of the foreign body and vaginal irrigation by a qualified professional.

Vulvovaginitis Due to Pinworms

Symptoms: Nocturnal itching around the anus, waking up at night with crying and vaginal pain.

Diagnosis: Mild redness around the anus, scratch marks, presence of pinworms or pinworm eggs on tape applied in the morning.

Treatment: Administration of an anthelmintic medication, repeated after 14 and 28 days, and treatment of the entire family.

Lichen Sclerosus

Symptoms: Intense vulvar itching, white and cracked skin, sometimes with bleeding.

Diagnosis: Redness and white discoloration in a figure-eight pattern around the vulva and anus, sometimes with fissures and bleeding.

Treatment: A 12-week treatment with a corticosteroid ointment or a calcineurin inhibitor.

Lichen sclerosus is a chronic inflammatory disease common in children. Often mistaken for diaper dermatitis or fungal infections, it can cause permanent anatomical changes if untreated. Early management often stops the disease's progression.

Consultations are often very helpful in addressing these issues. I am here to help.

Best regards,

Dr. Sandra Yene Amouguii