Redness of the inner labia in a girl. Gynecological diseases of little girls

First of all, they are associated with inflammatory diseases, weakening of the immune system, insufficient or excessive care of the girl's external genital organs. Let's try to understand the causes of painful conditions and give advice on their treatment.

Synechia

Most often, babies up to 2-3 years old have synechiae. Synechiae (from the Greek word "synecheia" - continuity, connection, adhesion) is called congenital or acquired fusion of the labia minora, less often - the labia majora and labia majora. Most often, fusion occurs over the outlet of the urethra, thereby disrupting the normal outflow of urine. This condition causes discomfort to the child.

Why do synechiae appear? There are several reasons for this.

1. Excessive activity during intimate hygiene of a girl - problems can arise with too active and frequent washing with soap... In babies, the mucous membranes of the genitals are very thin, and with frequent washing, especially with soap, the protective film is washed off, which can lead to injury and inflammation. During healing, adhesions occur at the site of the inflamed tissues of the labia.
   Of course, this does not mean that synechiae occurs due to washing at all and the girls do not need to be washed. It's just enough to wash the baby with soap only after a bowel movement (preferably with a special baby soap with an approximate pH value). The rest of the time, it is enough to wash the girl only with running water without soap, in the direction from the pubis to the anus.
2. Another common cause of the formation of synechiae is, and sometimes the presence of synechiae directly indicates the need for an examination of the urinary system. Dangerous microbes in the urine enter the mucous membranes and cause their inflammation, and at the site of inflammation, the labia are fused. In this case, a doctor's consultation, urine analysis and urine culture are required.
3. The causes of synechiae can be female genital infections- with vulvitis and vulvovaginitis (see below).
4. Synechiae can become one of the manifestations allergies, because it affects not only the skin, but also the mucous membranes. From the environment of a baby with manifestations of allergies (rash, bronchial asthma, allergic rhinitis), it is worth removing all potentially dangerous allergens, cosmetics, diapers and other provoking factors.
5. Complications of pregnancy and childbirth the mother can also be a factor provoking synechiae.

How can you recognize or suspect synechia? If the structure of the labia seems suspicious to you, show the child to the pediatric gynecologist - the doctor will dispel your doubts and at the same time tell you what to look for. Track the process of urination of your daughter - is there any straining, discomfort, whether the baby is capricious during urination. Crying and unwillingness to sit on the pot can also be a signal.

It is necessary to make it a rule to regularly examine the genitals of the baby after hygiene procedures. At the slightest manifestation of redness, rashes, peeling or discharge, you should seek the advice of a doctor. Due to untreated synechiae, with the growth of the body, the external and internal genital organs may not form properly, which may even result in impaired fertility.

At the reception, the doctor will carefully examine the baby, if necessary, take smears, cultures of flora for sensitivity to antibiotics in case of detection of infections and analysis for genital infections - chlamydia, ureaplasma, gonococcus, Trichomonas, gardnerella.

If treatment is necessary, then usually before it starts, an examination for enterobiasis is carried out - does the girl have worms, and also exclude allergies. Then the effectiveness of the treatment is increased.

There are two methods of treatment - conservative and surgical. Many doctors believe that the surgical method is possible only in extreme cases. In all the rest, it is necessary to apply methods of non-surgical separation of synechia.

Topical treatment consists of various estrogen creams combined with homeopathic or healing ointments. These drugs are applied with a thin layer on the seam line twice a day for two weeks, and then for another week or two - once a day. During the treatment with the cream, you need to make light pressure movements in the area of ​​\ u200b \ u200bthe fusion from top to bottom to help the parison of the labia. Most often, synechiae are separated, and after that, to prevent relapses, ointments with vitamins A and D are prescribed.

It is believed that the use of disposable diapers does not interfere with treatment, but strict conditions for wearing them must be observed.

If, after a month of treatment with creams with estrogen, the synechiae are not separated, it will be necessary to perform mechanical dissection with preliminary treatment with 5% lidocaine ointment. After that, treatment with creams with estrogen continues for a month so that there is no recurrence.

During this period, proper care is very important for the child. It is recommended to wash the girl in the morning and evening and after each bowel movement. In the evenings, you will need sedentary baths with a decoction of chamomile, St. John's wort, sage, oak bark or eucalyptus for 5-7 minutes for a week or two. After the baths, it is necessary to blot the genitals with a cotton napkin, apply a gauze napkin with Levomikol ointment to the place where the synechiae were. Then you need to wash the baby, and in the evening lubricate the external genitalia, especially the labia minora, with baby hygiene oils.

It is necessary to monitor the color of the skin in the perineal area: the appearance of a bright pink strip may indicate this recurrence. Synechiae tend to relapse up to 6-9 years.

Vulvitis and vulvovaginitis

Inflammation of the labia (vulvitis) and labia with the vagina (vulvovaginitis) - in second place among children's gynecological diseases. Most often they occur against the background of a decrease in a girl. The main microbes responsible for the development of inflammation are usually streptococci, enterococci, staphylococci and Escherichia coli - that is, the conditionally pathogenic flora of the child.

For the development of inflammation, predisposing factors are needed that reduce the body's resistance - frequent diseases of the throat and nose, childhood infections and other factors. Microorganisms can be brought in with feces by improper washing, dirty hands, someone else's clothing, water from open reservoirs. In addition, persistent vulvovaginitis can be a sign of vaginal foreign bodies.

Unfortunately, even babies can have vulvovaginitis caused by a sexually transmitted infection - Trichomonas, chlamydial and others. Most often, pathogens come from the mother - in utero or during childbirth; some of them can be passed on in everyday life - through washcloths, shared towels.

Often the causes of vulvovaginitis are pinworms - small worms that cause. As a result of the crawling of female pinworms into the genital crevice or scratching of the perianal region by the child himself, mucous membrane injury and inflammation occur.

Why is this disease so dangerous? Vulvovaginitis affects the physical and emotional state of the child, with improper treatment or its absence, it can take on a persistent, chronic course, which can threaten the transition to the internal genital organs.

In girls over 2-3 years old, the main cause of vulvitis can be attending kindergarten or elementary school. The reasons are simple - numerous stresses and a decrease in local immunity, hence the frequent morbidity in general and gynecological in particular. All factors create favorable conditions for suppressing the protection of the vagina and vulva and the reproduction of microbes in them.

Parents should remember that during the period of adaptation to new conditions, the girl needs immunity support and protection from stress. Typically, this is maintaining a healthy balance of intestinal microflora, diet and daily routine, the use of multivitamins and hardening procedures. In addition, foci of chronic infection - tonsillitis, adenoids, caries - play a significant role in the development of problems in the genital area. All these lesions need to be treated.

Vulvovaginitis is manifested by swelling of the skin of the external genital organs and their redness, there may be itching, peeling of the skin and discharge of varying intensity and color, with or without odor. When urine comes in contact with the skin, itching and burning are aggravated by irritation. The girl begins to be capricious, to eat and sleep poorly.

A doctor's examination is needed to make a diagnosis. If there is a suspicion of an infection, then there is also a smear. If necessary, culture with antibiotic sensitivity can also be done. In addition, a study of the perianal scraping will be carried out in order to exclude enterobiasis (pinworms), the level of glucose in the blood is determined, and a general urine test is prescribed. If vulvovaginitis recurs, this is a reason to be examined by an ENT specialist, allergist, dermatovenerologist, in order to exclude foci of chronic infection and allergies.

The approach to the treatment of vulvovaginitis should be individualized. Therapy can be local or general. The complex of local effects includes anti-inflammatory ointments, various antiseptic solutions, baths, strict adherence to personal hygiene measures. If the process recurs, then local antibiotics are prescribed in suppositories, creams, irrigation solutions or tablets. Common remedies include immunostimulants, vitamins, and proper nutrition. In addition, it is worth reinforcing the treatment by maintaining the intestinal microflora.

In order to prevent a recurrence of the disease, preventive measures must be followed - often change underwear, bathe the baby every day, wash only from front to back, without using soap if possible. If a girl wears disposable diapers, it is necessary to change them regularly and not abuse them, wearing them as needed. The girl must have a hotel towel, washcloth, bed linen, which are washed and washed separately from adult things.

Candidiasis (thrush)

This unpleasant disease usually develops in preschool girls and schoolgirls. Thrush is caused by a fungus of the genus Canida, which causes damage to the genital tract. Infection can occur during childbirth, and later - in a household way. Candida live on the surface of the skin and mucous membranes and are activated in conditions of decreased immunity, both local and general, and infection may appear even after several months or years from the moment of infection.

Most often, thrush manifests itself in girls from 4 to 8-9 years old. This is due to the fact that admission to a kindergarten or school is a pronounced stress for the child, the new team carries a new active microbial load, which greatly strains the immune system. The rhythm of life also changes - sleep, daily routine and especially nutrition.

Typically, candidiasis is manifested by severe itching in the genital area, redness and swelling of the labia, scanty white discharge or cheesy plaque on the genitals. You cannot treat candidiasis on your own - this can lead to a chronic infection.

Paretskaya Alena
pediatrician, member of the Association of Consultants
on natural feeding, member of the IACMAC association,
young child nutrition specialist,
head of the "Children's Doctor" project

Toddler: girl care
A woman's reproductive health largely depends on how she was cared for in childhood. Gynecologists believe that little ladies could avoid many diseases in the future if their parents were responsible for sexual hygiene. Taking care of the genitals of girls is more difficult than that of boys, and in order to properly carry out hygiene procedures, as well as to know when to see a doctor, heed our advice. And one more thing: do not listen to the stories and advice of other mothers and your girlfriends, as their daughters may have completely different problems.
A bit of anatomy
In girls, the distance from the entrance to the vagina to the anus is small, so intestinal microorganisms, if the rules of washing are not followed, easily enter the vagina, causing inflammation.
In addition, babies have a wide and short urethra (urethra), the outer opening of which is open and also more accessible to infection.
The vaginal microflora in girls differs significantly from that in women and has a different pH value (an indicator of acid-base balance); until puberty in the vagina, babies do not have lactic acid bacteria that protect against infection, so the only protection should be proper care for intimate places. For the same reasons, medicines and treatments for women (suppositories and douching) for girls will not work.
And although the baby has important anti-infectious barriers (a narrow entrance to the vagina, the presence of a hymen), the genitals, due to anatomical and physiological characteristics until puberty (at this age, estrogen begins to be produced, which supports the protective microflora and stimulates local immunity in the vagina) have low resistance to various kinds of infections and, therefore, require especially careful but careful care.
Intimate problems
In the first days after birth, primordial lubricant can accumulate in the folds between the labia, which will serve as a substrate for the multiplication of pathogenic bacteria, so it must be removed. With a cotton swab or disk moistened with boiled water, carefully wash all the folds between the labia from front to back. If the grease is not completely removed, moisten a cotton swab with sterile vegetable oil (boil olive or sunflower oil for 15-20 minutes in a water bath) and remove the grease from all folds of the genital crevice also from front to back.
Redness in the external genital area may indicate an infection that migrated to the baby from the mother when passing through the birth canal. If by the end of pregnancy a genitourinary infection or thrush has not been treated, then during childbirth the baby will receive a fungal or bacterial infection instead of beneficial microorganisms. In addition, redness and itching of the external genital organs can be one of the manifestations of allergic diathesis.
Synechiae are adhesions between the labia, they are found in the first days of life. This is a congenital malformation that can cause acute urinary retention, which necessarily requires the consultation of a pediatric surgeon, since surgical intervention may be required. At a later age, the resulting synechiae is most likely the result of a postponed (or untreated) infection of the genital tract, as well as a congenital urinary tract infection. And the usual non-observance of hygiene rules, improper washing, sometimes even irritation of the labia caused by a wet and not replaced diaper in time, can cause synechia, because with inflammation, scars form and the edges of the labia minora grow together. Therefore, remember that even a small woman requires special care.
Leukocyturia is an increased content of leukocytes (blood cells) in the urine, which indicates an inflammatory process. Leukocytes can enter the urine not only from the urinary tract, but also from the vagina. In this case, a possible cause of leukocyturia can be gynecological infections in the mother, but more often everything is explained by non-observance of the rules of sexual hygiene.
On the 3-4th day of life, babies have colorless or grayish-white vaginal discharge, sometimes they can be bloody - these are manifestations of the genital crisis of newborns. The absence of vaginal discharge may indicate a continuous hymen or fusion of the labia (congenital synechiae). On the contrary, discharge from the genital tract not during the period of sexual crisis (that is, in girls over one month of age) should alert attentive parents. For example, a baby who has undergone a respiratory viral infection may have vaginal discharge, but, most likely, after 5-7 days they will stop by themselves. Girls who are predisposed to infections of the ENT organs (otitis media, sinusitis, pharyngitis) can often have a discharge from their genital tract, because the mucous membrane is the same everywhere.
You may notice that the crumbs have a whitish coating in the fold between the labia minora and the labia majora - this is the accumulated secretions of the sebaceous glands - a completely normal and harmless phenomenon. Plaque often remains even after washing: you just need to remove it with a cotton swab moistened with sterilized vegetable oil from front to back.
Your daughter needs a consultation with a pediatric gynecologist if she has:
1. Synechiae, both congenital and acquired (their treatment can be conservative and operative).
2. Leukocyturia and bacteriuria.
3. Discharge from the genital tract not during the period of sexual crisis.
4. Redness of the skin or mucous membrane of the external genital organs.
5. Itching and burning of the genitals (itching can be guessed if the girl has become restless, often puts her hands in a diaper or panties).
6. Suspicion of an abnormal structure of the genitals.
Sexual hygiene rules
Examine your daughter's genitals only with clean hands with short-cut nails and do not forget to wash your hands with soap and water before washing the baby.
It is advisable to wash the girl after each urination and always after each bowel movement under running water both from the tap and from the bucket in the direction from front to back. You need to hold the baby with the tummy up so that the water first rinses the crotch area, and then the anus, flowing down. For under one year old, try to use only boiled water.
After bathing, washing or changing a diaper, wipe all folds of the genital crevice with a cotton swab soaked in sterilized vegetable oil. Before bathing in the tub, be sure to wash your baby under running water.
In no case should you wash the girl after a bowel movement by placing her in a basin or a bath, since feces always contain a large number of microorganisms, if they enter the vagina, inflammation will quickly develop.
Do not use soap when washing: it dries out the skin, destroys the protective layer and can disrupt the microbiocenosis. Use a special pH-neutral baby soap once a week and, if necessary, after a bowel movement. In this case, wash only the outer surfaces of the labia majora with soap, preventing soap from getting into the genital crevice. Never use sponges and washcloths for washing - they injure delicate baby skin.
To treat the perineal area, you should not use powder: the smallest particles of this agent (and even more lumps) can scratch the delicate mucous membrane of the genitals as a result of friction, especially under the diaper. It is categorically impossible to use the powder if the baby has a tendency to skin irritation (atopic or diaper dermatitis, diaper rash and wetness).
Any moisturizer (milk, cream) is applied in a thin layer on the baby's previously cleansed skin, that is, after washing. In the genital area of ​​girls, the cream is applied to the outer surface of the labia majora, around the anus and on the buttocks. Use moisturizers only as needed so as not to disturb the natural oil balance of your baby's skin.
Notes for parents
Sleeping with the baby in the parental bed saves the mother a lot of energy, especially when breastfeeding. In this case, it is unacceptable for parents to sleep without underwear: even if you do not have any diseases, the alien flora is not good for the child. Remember: the baby should lie on her diaper, and not on the sheet shared with her parents, and, of course, not naked.
The girl should always be wearing romper or panties; do not leave naked a baby who is actively crawling or already walking around the apartment, because keeping the house completely sterile will still not work.
Don't let your baby be naked in the sandpit or on the beach: be sure to wear a disposable diaper, tight panties, or tight-fitting shorts. Children's underwear should only be made from natural materials, since synthetic fabric does not provide a healthy state and comfort to the skin and mucous membranes of the genital organs.
The baby needs her own soap, washcloth and towel. Always wash baby's underwear separately from adults, and wash underwear separately from suits and overalls.
However, all these recommendations apply to males as well - it is equally important for boys to keep their intimate places clean.
So, very carefully, dear parents, treat your baby's sexual hygiene from birth. You now know the hygiene rules, follow them - it's easy. And remember: the reproductive well-being of your daughter depends on your care, and you will rejoice in your grandchildren in the future! Good luck!

Redness of the labia in a child is mainly manifested and becomes the first symptom in the development of a gynecological disease in girls under 9 years of age. Pathology must be quickly eliminated. The genitals that have changed color can lead to serious complications and affect the reproductive function of the future woman.

Vulvitis is an inflammation that develops in the vagina. The name comes from the vulva.

It unites several groups of external organs of the reproductive system:

• lips (small and large);
• entrance to the urethra;
• clitoris;
• the entrance to the vagina.

Vulvitis rarely occurs as an independent ailment, more often it goes as a concomitant. The name of pathology in medicine is vulvovaginitis. The disease is classified according to several parameters.

Duration:

1. Acute form: month.
2. Subacute: there is an alternation of improvement and deterioration, lasts up to 3 months.
3. Chronic: Lasts for many years.

Patient age:

• infancy: up to one year;
• childhood: up to 8 years old;
• prepubertal: from 8 years to the onset of menstruation;
• puberty: after menarche.

The nature of the disease:

1. An infectious species is caused by pathogenic and conditioned microbial formations.
2. A non-infectious species is caused due to injury or placement of foreign bodies in the vagina, a burn, an allergic reaction, or improper metabolism.

The disease can have other classifications. Infectious diseases can be specific and non-specific. In addition, vulvitis is divided into primary and secondary processes. The focus of infection may come from other pathologies that have struck the child's body.

Symptoms and clinical picture

The main symptom of acute vulvitis is redness on the labia in a child. In addition, edema appears. The irritation spreads to the entire groin area, rises to the thighs.

Vulvitis symptoms:

• burning sensation in the perineal area;
• pain when urinating;
• erosion and ulcers (non-specific form);
• discomfort during movement and touch.

The child changes behavior: becomes irritable, whiny, restless. The girls try to touch and brush the labia. All sensations are uncomfortable. A special symptom of the disease is the release of leucorrhoea.

Their nature depends on the form and type of the disease:

1. Infectious species, the reason is E. coli infection. The discharge is yellow and green, and the odor is similar to feces.
2. Staphylococcal form. Leucorrhoea, yellow, viscous, viscous consistency.
3. Candidal appearance. The discharge is whitish, thick and similar in structure to cottage cheese.

Sometimes doctors detect a change in the standard set of signs:

• enlarged lymph nodes;
• high temperature;
• nervousness;
• lack of sleep;
• increased excitability and irritability.

This indicates the transition of pathology to an acute form of the course. Another type of vulvitis arises from the action and infection of children with pinworms. In such situations, appetite decreases, pains in the abdomen appear, and the anal areas thicken. The buttocks turn red.

The chronic form is characterized by a decrease in the activity of symptoms. Puffiness decreases, the skin does not redden so brightly, discharge and itching remain.

Diagnostic methods

The main examination procedures are carried out by a pediatrician, but the treatment and maintenance of the therapeutic complex is entrusted to a gynecologist. The pediatric genital disease specialist will review the history and analyze the child's complaints.

There are enough methods for determining the causes of vulvitis to find an effective way to eliminate the disease.

The main stages of verification:

1. Visual inspection: detection of redness, swelling, examination of the discharge.
2. Instrumental methods: vulvo-, vaginoscopy. Vaginoscopy is required to remove foreign objects.
3. Laboratory: microscopic examination of a smear, bacterial culture on the flora of the vaginal mucosa. The possibility of allergy to antibiotic drugs is being tested.
4. Experimental methods (PCR): study of the content of microflora scrapings.
5. Standard: general analysis of the composition of urine, blood.
6. Additional: feces for the presence of bacterial formations and helminths, bacterial filling of urine.

In case of complex course of the disease, doctors work in a group. Other pediatric specialists such as endocrinologist, allergist, gastroenterologist help.

Therapeutic measures and prevention

The complex of drugs is aimed at eliminating the focus of inflammation. At the same time, the reasons that caused the disease are removed. Treatment is based on the implementation of various procedures.

Hygiene:

1. Baths with herbal tinctures: medicinal chamomile, St. John's wort flowers, calendula.
2. The girl's external female organs are washed with solutions with antiseptic compounds. Potassium permanganate and Furacilin are suitable.
3. Sanitation of the area of ​​the internal cavity of the vagina using special devices (irrigator).
4. Anti-inflammatory drugs. Treatment with ointment and gel mixtures, the use of suppositories, sedatives.
5. The bacterial form requires the intake of antibacterial compounds.
6. Fungal forms are supplemented with local agents.
7. Vulvovaginitis - Surgical Measures.
8. Worm infestation is based on deworming.

The child's body requires general strengthening measures. Doctors will prescribe multivitamins, means to enhance immunity. Antihistamines can help with allergies.

To eliminate the possibility of developing inflammation, a preventive set of measures is carried out. Children are taught to be neat from an early age. The implementation of basic hygiene procedures will guarantee cleanliness and the impossibility of penetration of viruses and microbes.

Hygiene is based on the usual sponge care before bed after cleansing the intestines (bowel movements). Girls are taught to wash so that the water does not drain into the body. Individual hygiene products are bought for babies: soap, washcloths, towels. They are taught to use only their own accessories. Change them, rinse and dry.

In addition to observing hygiene rules, girls are advised to be attentive to clothing and nutrition. Fabrics must be of good quality, loose and clean. Nutrition is balanced and healthy.

Following simple rules will allow you to avoid inflammation of the vagina, not to know what vulvitis is.

Vulvitis is an inflammation of the female external genital organs due to trauma or an infectious process. Vulvitis can affect the vestibule of the vagina, labia, clitoris, and the outer part of the urethra. The disease ranks first among all gynecological infections in girls 1-8 years old. It is about 65-70%.

Primary vulvitis in girls is more common due to the anatomical features of the genitals. With prolonged and recurrent vulvitis at a young age, menstrual irregularities and reproductive problems may occur in the future.

Causes of occurrence

At birth in girls, the genitals are sterile. Gradually, opportunistic microorganisms appear on their mucous membranes. Initially, the vaginal environment has a slightly alkaline or neutral pH. There are no lactobacilli in the smear, leukocytes and mixed microflora are present. Lactobacilli appear by puberty. Gradually, the vaginal environment is oxidized, glycogen begins to be produced. It becomes similar in composition to the microflora of sexually mature women in girls with the appearance of menstrual cycles.

The immediate causes of vulvitis are nonspecific or specific infections:

• viruses (adenovirus, influenza, papillomavirus);
• fungi;
• protozoa;
• chlamydia;
• gonococci.

Ways of transmission of infection:

• in newborns, infection can occur when passing through an infected birth canal;
• at a young age, the household route prevails (in places of mass use, if hygiene rules are not followed);
• with sexual experience in adolescents - sexually.

Often, vulvitis occurs in the presence of helminthic invasions or the penetration of foreign objects into the genitals (grains of sand, insects, blades of grass).

Secondary vulvitis in girls develops as a result of the spread of infection to the vulva from other foci (with tonsillitis, caries).

Fungal infection of the vulva is due to:

• taking antibiotics;
• endocrine disorders;
• weakening of immunity.

When an allergic reaction occurs to certain irritants (fragrant detergents, pads, chocolate, citrus fruits), atopic vulvitis develops. It is not common.

The mucous membrane of the genitals can be damaged by frequent diligent washing with soap, wearing tight underwear, and improperly selected diapers.

Genital anomalies also predispose to vulvitis:

• lack of posterior adhesion;
• abnormal development of the external genital organs;
• low location of the urethral opening.

Signs and symptoms

Symptoms of vulvitis in children are in many ways similar to other infections of the genital organs (colpitis, vulvovaginitis).

Signs of the disease:

• burning and itching;
• pain in the genital area, which becomes more intense when urinating;
• swelling and redness of the clitoris, labia, vulvar mucosa;
• sometimes there are erosion and ulcers on the mucous membrane.

Vulvitis in girls is characterized by vaginal discharge (leucorrhoea). They can be different, depending on the type and cause of the disease. They are mostly clear, but sometimes they can be purulent or bloody. If Escherichia coli is the cause of the disease, then the leucorrhoea has an unpleasant fecal odor and a greenish-yellow color. If the infection develops when the vulva is affected by staphylococci, they are viscous and yellow. Vulvitis of a fungal nature is accompanied by a cheesy, white discharge.

Sometimes the disease can be accompanied by general symptoms:

• temperature increase;
• enlarged lymph nodes;
• nervousness;
• sleep disturbance;
• irritability.

If pinworms provoke vulvitis, girls' anal folds thicken and redden, abdominal pains appear, and appetite worsens.

When the disease becomes chronic, the swelling and hyperemia become less pronounced, and itching and leucorrhoea persist. With relapses of vulvitis, complications such as cystitis, cervical erosion, urethritis, and vaginal atresia may develop.

Diagnostics

The disease can be diagnosed by a pediatrician. But the child's gynecologist should examine, observe and treat the child. He examines the genitals, uses instrumental vaginoscopy and vulvoscopy.

To identify the causative agent of the infection, laboratory diagnostic methods are prescribed:

• bacterial culture and microbiological examination of a smear;
• scraping by PCR method;
• general analysis of blood and urine;
• analysis of feces for worms;
• scraping for enterobiasis;
• allergy tests.

A selection of effective treatments

Treatment of vulvitis in girls consists of a set of measures depending on the etiology of the infection.

Note! It is possible to treat a child at home only if the disease is mild without complications.

Power and mode

In an acute process, girls need to be provided with bed rest. At the time of illness, you should change the diet. Reduce the intake of foods that promote the formation of acids and spices (fried, meat broths, smoked, pickled vegetables, sour fruits). In the diet, you need to increase alkalizing foods (milk, fresh and boiled vegetables). If vulvitis is of an allergic nature, a hypoallergenic diet is indicated. It implies the exclusion of allergenic foods from the diet:

• nuts;
• eggs;
• citrus;
• chocolate;

After an acute period, to restore the microflora of the vagina and intestines, you can diversify the menu with fermented milk products.

Local therapy

It is indicated to eliminate hyperemia and swelling of the genitals, relieve unpleasant symptoms of burning and itching. For this, disinfectants are used in the form of trays, irrigations, lotions.

Local antiseptics:

• A solution of potassium permanganate (light pink);
• Chlorhexidine;
• Miramistin;
• Furacilin;
• Quinosol.

Herbal infusions:

• calendula;
• chamomile;
• sage;
• nettle;
• succession;
• oak bark.

At the address, read the instructions for use of Ambrobene solution for inhalation.

Inflamed areas can be effectively treated with ointments:

• Tetracycline (after 8 years);
• Oletetrinova;
• Sangiviritin 1%;
• Erythromycin.

Apply the ointment carefully to previously washed and dry genitals. Long-term use of ointments is not recommended. If the inflammation persists, you need to show the child to the doctor to correct the treatment.

With a recurrent nature of the disease, estrogens (Folliculin, Estriol) are topically applied to accelerate the reparative processes.

Systemic treatment

When the nature of the vulvitis and its causative agent are determined, the doctor may prescribe drugs for oral administration.

Candidal vulvitis is treated with antimycotic agents:

• Levorin;
• Fluconazole;
• Itraconazole.

In parallel, the sites of inflammation are locally treated with antifungal ointments (Clotrimazole, Decamine ointment).

If Trichomonas is detected within 7-10 days, the following are prescribed:

• Metronidazole;
• Tinidazole;
• Ornidazole.

With prolonged Trichomonas vulvitis with relapses, Solkotrichovac is injected intramuscularly (3 injections of ½ ml every 14 days). Re-injection is carried out in a year - ½ ml once.

Gonococcal infection is treated with antibiotics of the cephalosporin group:

• Cefatoxime;
• Cefix;
• Ceftriaxone.

In the presence of chlamydia and mycoplasma, antibiotics of a broad spectrum of action are prescribed:

• Sumamed;
• Doxycycline.

Vulvitis against the background of helminthic invasions begins to be treated with anthelmintic drugs:

• Nourished;
• Pirantel;
• Levamisole;
• Albendazole.

Normalization of the general condition

Be sure to take desensitizing agents with vulvitis to relieve swelling and itching:

• Suprastin;
• Tavegil;
• Zyrtec.

Enzymatic agents for the normalization of digestion:

• Bactisubtil;
• Creon;
• Wobenzym.

Immunomodulators to increase the protective functions of the body:

• Immunal;
• Immunoflazid.

Folk remedies and recipes

Traditional medicine methods can be highly effective in treating vulvitis in girls. Recipes:

• Insist 1 spoon of St. John's wort in 200 ml of boiling water for 1 hour and strain. Take orally three times a day, 50 ml.
• Pour 1 spoon of dried viburnum flowers with a glass of water. Leave in a water bath for 10 minutes. Filter and drink 1 spoon three times a day.
• To relieve itching and burning, externally use baths and washing with a decoction of chamomile or oak bark (2 tablespoons per 1 liter of water).

Prevention measures

Preventive measures against this disease should be based on careful caring for the genitals of girls and instilling hygiene rules from an early age:

• For babies, change diapers and diapers immediately after contamination.
• After each evacuation, wash the perineum from front to back.
• Wash underwear with a hypoallergenic product, rinse it well.
• Change your panties twice a day.
• The soap should not be used to wash the perineum more than once a day. Its pH should be neutral.
• Linen should be made of natural fabrics that do not contain aggressive dyes.
• Do not use aromatic oils, powders, creams.
• Have separate hygiene items (washcloth, towel).

It is better to prevent any disease than to spend great efforts to treat it. Vulvitis in girls often occurs due to improper care of the genitals. Therefore, from an early age, parents should pay great attention to the hygiene of the child, timely identify infections and treat them. This will help avoid unpleasant consequences for women's health in the future.

Video. Doctor Komarovsky about the causes of vulvitis and vulvovaginitis in girls:

- Acute or recurrent inflammation of the mucous membrane lining the external genitalia. Vulvitis in girls is manifested by itching and burning in the vulva, swelling and hyperemia of the labia and surrounding skin, discharge of a different nature from the genital tract. The diagnosis of vulvitis in girls is made on the basis of examination data, vulvo- and vaginoscopy, smear microscopy, bacteriological culture of genital secretions, PCR scrapings, etc. Local therapy of vulvitis in girls includes sessile baths, UFO of the vulva, the use of ointments; systemic therapy is determined by the etiology of the inflammatory process.

General information

Vulvitis in girls is an inflammatory process in the external genital area, which involves the labia, clitoris, external opening of the urethra, and the vestibule of the vagina. In childhood, there is often a combined inflammatory lesion of the vulva and vagina - vulvovaginitis. In girls from 1 to 8 years old, vulvitis and vulvovaginitis rank first in the structure of gynecological pathology. Inflammatory processes account for 65-70% of all genital diseases in pediatric gynecology. Recurrent vulvitis and vulvovaginitis in girls can cause menstrual, sexual, reproductive disorders in adulthood. In addition, prolonged and sluggish inflammation can disrupt the coordinated interaction of the hypothalamic-pituitary-ovarian system.

Causes of vulvitis in girls

The anatomical and physiological characteristics of the genitals in childhood predispose to the development of vulvitis in girls. First of all, it should be noted that the genital tract of newborn girls is sterile; on the 5-7th day of life, the mucous membrane is colonized by conditionally pathogenic microflora. In the first years of life, the contents of the vagina are scanty, have a slightly alkaline or neutral reaction (pH 7.0); in the smear, leukocytes of mixed flora (rod and coccal) are found, lactobacilli are absent. By the beginning of puberty (8-9 years), lactobacilli appear, the vaginal epithelium begins to produce glycogen, the reaction of the vaginal environment becomes acidic (pH 4.0-4.5). And only with the appearance of menstruation, the vaginal microflora of adolescent girls approaches in quantitative and qualitative composition to the microbiocenosis of women of reproductive age.

The penetration of infection is facilitated by a decrease in local anti-infectious protection, which is in the process of formation (the level of secretory immunoglobulins A, lysozyme, phagocytosis, the complement system), insufficient bactericidal functions of the skin, hormonal rest.

The immediate cause of vulvitis in a child is most often an infection: nonspecific (opportunistic aerobic and anaerobic flora, viruses, yeast, protozoa) or specific (gonococcus, chlamydia, mycobacterium tuberculosis, diphtheria bacillus, etc.). A specific infection in childhood can be transmitted in various ways: at an early age, the household route is predominant (if hygiene is not observed, through care items and common places); for girls who have experience of sexual relations - the sexual route. Vulvitis in newborn girls can be caused by transplacental infection or infection during childbirth, when the child passes through the seeded birth canal.

Often, girls' vulvitis develops as a result of helminthic invasion (enterobiasis), the ingress of a foreign body (blades of grass, grains of sand, insects, foreign objects), masturbation, impaired body reactivity in secondary infection (for example, pharyngeal diphtheria, chronic tonsillitis, caries, etc.).

The onset of mycotic vulvitis in girls is facilitated by antibiotic treatment, hypovitaminosis, immunodeficiency, endocrine disorders (primarily diabetes mellitus). The vulva and vagina in girls can be affected by influenza viruses, herpes, parainfluenza, adenovirus, cytomegalovirus, papillomavirus, etc. Less commonly, girls have allergic (atopic) vulvitis as a reaction to some nutritional factors (citrus fruits, chocolate, etc.), aromatic soaps or detergents with additives, sanitary napkins. In infants, diaper dermatitis can cause inflammation.

The maintenance of vulvitis can be determined by abnormalities in the structure of the girl's genitals (low location of the urethral opening, absence of posterior adhesions, gaping of the genital fissure, abnormalities in the development of the external genital organs), as well as functional features (neurogenic bladder, vaginal-urethral reflux). The constant wearing of diapers, microtrauma of the external genitals with tight underwear, non-observance of intimate hygiene, and the wrong technique of washing the child play a role in the course of vulvitis in girls.

The mucous membrane of the genital organs in girls is very thin and vulnerable, therefore, frequent and diligent washing, especially with soap, can easily lead to a violation of the integrity of the epithelial integument, a decrease in the local immune barrier and the development of vulvitis.

Classification of vulvitis in girls

Vulvitis in girls can have an acute (up to 1 month), subacute (up to 3 months) and chronic course (more than 3 months). Depending on the causative factor, vulvitis in girls is divided into infectious and non-infectious.

Infectious vulvitis in girls, in turn, is represented by nonspecific inflammations (caused by conditionally pathogenic flora normally present on the child's vulva) and specific inflammatory processes (gonorrheal, chlamydial, trichomaniac, herpetic, ureaplasmic, diphtheria, tuberculous, etc.).

Primary non-infectious vulvitis in girls includes cases of disease associated with foreign bodies, helminthic invasion, masturbation, changes in the body's reactivity in diabetes mellitus, dysmetabolic nephropathy, intestinal dysbiosis, allergic diseases, acute viral and childhood infections.

Most often, girls of preschool age have nonspecific vulvitis with a chronic course.

Symptoms

Signs of acute vulvitis in a child are characterized by redness and swelling of the labia and clitoris. Hyperemia and maceration can spread to the skin of the pubis, groin, and thighs. With vulvitis, girls are worried about itching and burning in the perineum, aggravated by urination, touching, movements. Young children express their physical sensations by worrying and crying; older girls constantly touch and comb their genitals, complain of discomfort, itching, soreness. Sometimes, especially with specific forms of vulvitis in girls, erosions and sores appear on the genital mucosa.

A characteristic symptom of vulvitis and vulvovaginitis in girls is the presence of discharge from the genital tract (leucorrhoea). The discharge can be of a different nature: it is more often watery and transparent, but it can be bloody or purulent. So, with vulvitis caused by E. coli, girls have yellow-green discharge with an unpleasant fecal odor. With staphylococcal vulvitis, girls have yellow and viscous leucorrhoea, with candidal vulvitis - white, thick, curdled consistency.

In some cases, vulvitis in girls may be accompanied by general symptoms - a temperature reaction, an increase in lymph nodes. The child's behavior becomes nervous, poor sleep, irritability, tearfulness, and increased excitability are noted. With vulvitis caused by pinworms, girls have hyperemia and thickening of the anal folds, abdominal pain, and decreased appetite.

With chronic vulvitis in girls, hyperemia and edema decrease; itching and discharge from the genital tract persist. The recurrent course of vulvitis in girls is often accompanied by complications: synechiae of the labia minora, vaginal atresia, urethritis, cystitis, cervical erosion, imbibition (discoloration of the vulva).

Diagnosis of vulvitis in girls

Vulvitis in girls can be diagnosed by a pediatrician, but further examination and observation of the child should be carried out by a pediatric gynecologist. To clarify the etiology of vulvitis in girls, it is important to study the history (concomitant diseases, provoking moments) and complaints.

Examination of the genitals reveals hyperemia and swelling of the vulva, maceration of the mucous membrane, discharge from the genital tract. Instrumental research methods - vulvoscopy and vaginoscopy - help diagnose vulvitis and vulvovaginitis in girls. Vaginoscopy is especially indispensable for removing foreign bodies from the vagina.

To determine the etiology of vulvitis in girls, a microscopic examination of a smear and a bacteriological culture of secretions for microflora and antibiotic sensitivity are performed. If you suspect the specific nature of vulvitis in girls, scrapings are performed by PCR. The general analysis of urine and blood, blood sugar, general and allergen-specific IgE, bacterial culture of urine, scraping for enterobiasis, analysis of feces for helminth eggs, feces for dysbiosis are mandatory.

If necessary, the child is consulted by other pediatric specialists: pediatric endocrinologist, pediatric allergist, pediatric gastroenterologist, etc.

Treatment of vulvitis in girls

Therapy of vulvitis in girls is aimed at stopping the inflammatory process and eliminating the cause of the disease. Particular attention is paid to the hygiene of the genitals: sedentary baths with infusions of herbs (chamomile, calendula, St. John's wort, etc.), washing the external genital organs with antiseptics (solution of potassium permanganate, furacillin), sanitation of the vagina using a thin vaginal irrigator are carried out. To eliminate itching and discomfort, anti-inflammatory ointments and suppositories, sedatives are recommended.

With bacterial vulvitis in girls, the appointment of antibacterial drugs is indicated; with fungal - antifungal agents inside and topically in the form of ointments and creams. With vulvovaginitis caused by the presence of a foreign body, it is removed. In the case of helminthic invasion, the child is shown deworming. In the complex of treatment of vulvitis in girls, it is necessary to sanitize chronic foci of infection. As a general strengthening therapy, multivitamins, immunomodulators, eubiotics are used. With severe itching or an allergic reaction, antihistamines are prescribed.

Of the methods of physiotherapy for vulvitis in girls, UFO of the vulva, ultraphonophoresis with gels, ointments and antiseptic solutions, darsonvalization have proven themselves well.

Prevention of vulvitis in girls

The issues of preventing vulvitis require the education of correct hygiene skills among young parents and girls themselves. Genital hygiene in girls should be carried out daily - always after a bowel movement and before bedtime. External genital care involves washing the vulva, perineum and anus with water from front to back. It is recommended to use neutral baby soap (pH 7.0) no more than 2-3 times a week. Girls should have separate bath accessories (washcloths, towels).

To prevent vulvitis in girls and girls, you should refuse to wear synthetic underwear, tight-fitting tight clothing; timely replace sanitary pads, monitor the nutrition of children, treat concomitant pathology, etc.