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Vulval and vaginal problems in prepubertal females

Vulval and vaginal problems in young girls often result in pruritus vulvae (itch affecting the female genital area). Causes and treatments differ slightly between prepubertal females and mature women.

The prepubertal vulva is thin, delicate, and has a neutral pH, meaning it is easily irritated. Older women are somewhat protected by oestrogen-induced labial fat pads, thickening of the skin, and pubic hair.

What causes pruritus vulvae?

The main cause of pruritus vulvae in prepubertal females is contact irritant dermatitis due to the presence of chemical and/or mechanical irritants.

Prepubertal pruritus vulvae may also be a symptom of other vulvar or vaginal problems. These include:

Often several factors are present, and it can be difficult to determine the exact cause.

How is a diagnosis made?

Mostly the diagnosis is made by careful history and clinical examination by an experienced doctor. The doctor will need to examine the affected area and take swabs for microbiological examination. Other areas of the skin will be examined to determine the likelihood of a more widespread skin disorder being the cause.

Sometimes, a skin biopsy is necessary to determine the exact nature of the skin condition.

Patch tests are sometimes performed to see whether any contact allergy is present such as to a fragrance, medicament or other material.

What treatment is available?

Prepubertal vulvar and vaginal problems can be treated and prevented by instituting good hygiene measures and by avoiding things that may cause irritation or infection. Some basic general practices include:

Bland emollients such as sorbolene cream or petrolatum can be used. Hydrocortisone cream is generally safe, but if it seems to irritate, discontinue its use and seek advice from your doctor. Dermatological or infectious causes may be treated with medicines prescribed by your doctor.

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Author: Vanessa Ngan, staff writer

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If you have any concerns with your skin or its treatment, see a dermatologist for advice.