Advice about Girls' Genitals
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Advice about Girls' Genitals
My four-year-old daughter has been suffering from sore genitals,
with varying degrees of soreness, for months now. Sometimes her
outer labia look quite red and irritated and a crack forms just
above where the labia join together. We've seen her with her
hand down her pants, but she doesn't seem to play with herself
excessively. We have questioned her, and carefully examined her
environment, to rule out any possibility of abuse by others. I
took her to her pediatrician, who seemed puzzled by my daughter's
condition, as if she'd never seen anything like it. She called
in another pediatrician in the practice, who was equally at a
loss. They didn't know what to suggest.
Things we have tried include reminding my daughter to wipe after
she pees (it seems unlikely that traces of urine could have
caused the problem, but they certainly don't help it heal);
reminding her to touch herself gently; putting Aquaphor on the
area; and mostly recently, I tried some cream intended for women
with yeast infections (which seemed to help a bit). Could this
be a yeast infection? Any other ideas?
I don't want my little girl to be sore
I can't speak directly to what your little girl is experiencing
but I'll share that when my 2 y/o girl says she's sore or is
showing any irritation there, I fill a peri bottle (squirt
bottle) with warm water and a squirt or two of calendula tincture
which we then squirt on the area. This is what my midwife had me
do for my healing after childbirth. Calendula is very healing to
the skin and can give quite rapid relief. My daughter
specifically asks for it when she feels the need.
good luck and speedy healing
I don't know why the doctors acted so puzzled. It's either a
yeast infection or something is irritating her. If she uses
bubble bath, stop using that and make sure that area is kept
clean (clean underwear and showering gently with a hand held
shower). Also try adding some salt (regular table salt is
fine) to her bath and let her sit in it for a while. This acts
like a saline solution and may soothe the soreness.
mom of three girls
I don't know what insurance you have, but at Kaiser in the East
Bay there is a Pelvic Pain Clinic. There are doctors and NPs that
specialize in pelvic pain. Dr. Renee Perry, at Oakland, recently
saw me and diagnosed a condition that has plagued me for decades
(and I'd always been told was ''all in my head'' or had simply
baffled other OB/Gyns). If you have Kaiser, I highly recommend
getting your daughter a referral to Dr. Perry or see if she can
recommend a pediatrician with expertise in this area. It's not a
big field, but there ARE people who study it exclusively. And
their center has many options for treatment, from medication to
physical therapy to acupressure (depending on needs). Best of
luck - my pain started when I was little too. I feel for your
also ouchy in my girl parts
I work full time & my daughter is in preschool. It's hard to
be aware of everything that goes on. You might try to spend a
vacation week together where you really watch what she's doing
and also maybe treat her genital area. See if a focused week
can help get her back in better shape.
Could your daughter be allergic to latex/other synthetics in
clothing or additives in soaps? I must wear cotton underwear and
my outer clothing must also have lots of natural fabric in it. If
clothing is too tight in the genital area that can create
problems too. Also, I have to use detergent that is unscented and
Dove soap for sensitive skin (suggested by dermatologist).
Oh,and make sure the toilet paper is unscented too.
I am going to just lay this out there,with no delicate preamble...It took my daughter
two years of abuse (from age 2 to age 4) to finally disclose what was happening. It
was a very close, very loved, very trusted relative. Like you, I saw raw, chapped-
looking labia....I would give an identical description... about 6 months prior to
disclosure. Like you, I gently asked some pretty direct questions and got no real
answers. But I KNEW something was not right. This is most often the case...not
You cannot force disclosure. You could try reading a few books for kids to her on
subject of child sex abuse. It may encourage a dialogue if, in fact, she is being
''messed with'' by someone. The ones I would recommend are ''A Very Touching Story''
and ''Please Tell'' and ''My Body is Private''. These are ones that my kids have
to very favorably. I would also talk with someone who is experienced professionally
with this sort of thing. That, actually, would be my first course of action. If you
you have any questions you'd like to ask of me, feel free to email. Best wishes to
and your girl.
If your pediatrician can't help, can you ask your own
gynecologist about this? At the very least, your pediatrician
may be able to recommend something to try. If you do use a cream
meant for vaginal yeast infection, at least use one with the
lowest percentage of the
active ingredient you can find. I have a vague memory of my own
doctor telling me that those creams are too strong for little girls.
(But our pediatrician did approve it for diaper rash caused by
Your pediatrician left you with no ideas and sent you on your
way? You must pester her or get another opinion. Of course you
don't want your daughter being examined by multiple doctors (the
LAST thing you'd want is for her interpret anything as shaming
her, of course), but you've got to get to the bottom of this.
You may get some good idea here, but really this belongs to a
medical provider. Some doctor has seen it before -- I'm sure
she's not the first girl in the world with this situation.
Good luck. And again, please be careful with any messages you
could inadvertently give her (or misinterpretations she could
have) with your concern over this -- that could cause her more
damage than the condition itself.
- A therapist who sees adults who had issues like this one
You are going to get a lot of extreme responses from your description, but to me it
sounds like vaginal fissures. You can google them (but: no one seems to know the
why's/wherefores). I started getting them after the birth of my second child (in my
40's), and because I had never had them before or heard of them, they puzzled me
a lot. Also, they hurt like the dickens. (They look like paper cuts, and they feel
them too.) Also, they wouldn't go away. Also, they appeared for no real reason (ie.,
irregardless of activity levels in that area) -- except, for me, they are definitely
associated with yeast infections, even very slight ones. The thing, the only thing
helped me is this: shower daily, don't use soap (or other products) around vaginal
area, and spray front to back with plain warm water (a hand attachment thingy is
very useful and effective). Pat gently dry. I do this daily as part of my shower, and
has totally cleared up the problem for me. Which is relieveing to no end, I can't
begin to tell you. Good luck with your little girl! Poor thing.
Fissureless at last
My daughter had similar issues - her genital area was always
inflamed - started when she was about 1 1/2 and still in
diapers. We discovered that by switching to lactose free milk it
cleared up - we kept her on it for a long time and then when she
was about 9 slowly reintroduced regular milk and she has had no
problems since. - the doctor thought that it was causing a
reaction in her urine, inflaming the area. She was able to eat
other dairy without problems (altho we did limit/monitor - tried
to keep to yogurt and yogurt products). Its an easy try. We also
tried yeast medication but switching the milk was a quick easy
My preschooler had several episodes of similar symptoms. We took her in for possible
UTI's (negative) and we think it was yeast, in the end. Yeast cream (not just a
feel better cream'', but a ''kill-it'' cream, like Monistat, but only rubbed on the
genitals, not using the applicator) really helped. Also, I have had similar symptoms
lately (age 42), with the soreness and ''cracks'' that you describe. This is new for
and I am attributing it to yeast from eating too much sugar. When I cut down on
sugar, it goes away. So I bet this is a yeast issue, and I bet cutting down on sugar
bit, and using the Monistat will help a great deal. Good luck; you're not alone!
I had a really bad allergic reaction to laundry detergent last
year. It shows up where your clothes hug the skin the tightest,
especially in the crotch, and near the armpit where the arm
meets the chest. So maybe she's having an allegic reaction to
your detergent. Try rinsing her panties in hot water AFTER they
have been washed to get all of the detergent out. Have her wear
looser panties, and also undyed panties (white cotton probably
is the best choice). Perhaps she could avoid wearing panties at
certain times like when she sleeps or when she is home.
Hello in response to your daughters irritation, i have a friend
who has a two year old who got constent yeast infections. I
think you should have your daughters doctor check her for
yeast. if she is still in pullups or diapers this could
verywell be the reason. If it is found to be yeast you need to
ask them for ways to treat it and maybe even try changing your
daughters diet for a while to help prevent further infections.
Plain yogurt is very helpful if eaten and it can also sooth the
area if you want to place it on her like an ontiment to the
outter areas. since she is so young i wouldn't suggest
inserting anything inside the area. Check with your
Having sore genitals for months on end is too long! I can only imagine the
you child is in. I don't know what the problem is, but either ask your pediatrician
refer you to a specialist (dermatologist?) who can identify the problem or seek the
advice of a third pediatrician.
Best of luck
You know, a few conditions come to mind when reading your post.
One of them is called ''lichen sclerosis et atrophicus'' and can
definitely cause pain and cracking in this sensitive skin.
Usually the labia appear pale rather than inflamed though. It
is so hard to diagnose this sort of thing without actually
seeing it. My advice to you is to ask for a referral to a
pediatric dermatologist. Given the fact that 2 different
pediatricians seemed to be scratching their heads over this, I'm
actually amazed that you haven't been referred already. Please
don't just wait and see if it resolves on its own (unless it
already has of course!). You'll probably gets lots of
suggestions of things to try but I'd be reluctant to do much
until you see a specialist. This area is so sensitive sometimes
you can inflame the area with a ''remedy'', and then its really
hard to tell what you're dealing with. Oh, and if they won't
give you an appointment right away, ask your pediatrician to
call and explain the situation.
Both our girls have had the same issue over the past two years.
We have found two things that where the source of their problem.
We found that wiping the wrong way after the went pooping, causes
irritation, so we help them wipe again. The other thing that
seems to be the cause is contaminated sandboxes or dirt with the
feces of cats. They can carry little worms (this is what the
doctor told us), the eggs of these worms can be ingested by
mainly kids since their hands go in their mouths easily. Since
the worms will be in your childs feces it can irritated their
private parts. There are medicines (we got pills) to kill them
and the irritation will go away in a day. Just make sure everyone
in your family takes them even if you don't have symptomes since
you could potentially spread it around again. And clean your
bathroom really well too. Also, we make them wash hands way more
now than before and haven't had this issue for the past 6 months.
Hope this helps, good luck!
My almost 3 year old daughter has vaginitis. She complained
that it was painful when she was voiding. She even asked me to
put medicine. That's when I checked her private area and found
that the area was really red and even her skin was torn
open...It looked really painful...I took her to doctor's office
and he just said she has vaginitis. I don't know if it is
really common at her age...Anybody with same experience with
toddler with vaginitis???
I'm willing to bet she has a yeast infection. Talk to a
nutritionist or get info on line, then you can treat her
accordingly by eliminating certain foods. It's VERY common in
females of all ages. Good luck,
My daughter was having problems with vaginal irritations too. We
first tried conventional yeast infection meds...no luck. Then
anti-fungal meds (all with doctors consult). We even tried
probiotics that did nothing. She never ate lots of yeasty things
so that wasn't the issue. What finally worked after many months
of the on-again, off-again irritation was getting her into the
bathtub every night, no exceptions, no bubbles in the bath.
She's 5 now, and we've been doing this for ~2 years, and it
seems to work. We can even skip the bath once in a while now.
Also- with the water situation, we only fill the tub about 5
inches, and then bail the water for our perennials.
Vaginitis is not uncommon in toddlers. Some things that can
-bubble baths, or baths with ''perfumed'' soap.
-wearing tight, nylon clothes for long periods of time (like
bathing suits or tights/leggings).
-not changing underwear right away after accidents.
-wiping the wrong way when going potty (from back to front).
-pinworms (the doctor can tell you how to test for them if they
Applying a diaper rash cream can help with healing and
prevention. A good one is Diaper Rash and Thrush Relief by
Motherlove - you can buy it at Whole Foods.
Also, if your doctor didn't explain all these things to you, I
think you need a new pediatrician. I highly recommend Katya
Gerwein at Bayside Medical Group in berkeley/oakland.
hope this helps.
A couple of things come to mind...
the first is fecal contamination. From wiping or for some other reason, maybe
poop got in there.
the other is harder.... and it is something I have dealt with... perhaps she is
sexually abused. People really are reluctant to consider this one (I know I
it may be worth considering. The main reason I mention this is your
her genital area. Sounds like what my daughter was experiencing at about the
same age. I asked her if anyone was bothering her private parts and she said
in a very faraway voice. I knew pushing the issue wouldn't help, so I became
vigilant and paranoid. I missed it anyway. She was being ''molested''
(understatement) while the family slept by her teenaged half-brother. She told
mos after I had asked. Just throwing it out there... Hope that isn't it.
My daughter also had trouble with this, and still does
occasionally (she just turned 5). What helps is to make sure
baths are frequent, use a very gentle soap to wash her private
parts (we use Cetaphil, which comes in a dispenser bottle), and
then after the bath, I gently apply some Aquaphor to the vaginal
area if it's reddened. Aquaphor is a diaper-rash ointment that
comes in a large tube; it's clear and thick, and feels kind of
I'm hoping other people will have good advice about this, because my four-year-
old daughter has a similar problem, though she doesn't generally complain about
hurting. Her outer labia get all red and sometimes crack (it *looks* painful!).
keep asking her if she has any idea why this is happening, and she never does.
only theories we've come up with are that she likes to touch herself (and maybe
hands aren't always clean when she does so) and she usually forgets to wipe
peeing, so there's probably a bit of pee in her underpants. I worried about
anyone else could be touching her, but we don't see how anyone could possibly
have access to her, and we've questioned her about this (while trying not to
her out) and nothing has turned up. I took her to the pediatrician, who had no
what it was, and suggested not using soap on her girl parts in the bath. We
that for a while, and also tried Aquaphor, which helped a bit, but didn't get
Mother of another little girl with sore girl-parts
If your child is in daycare, you might ask how they help her wipe
after she pees. We found that our daycare providers were using
baby wipes even after our daugher was no longer in diapers and
which left the vaginal area too moist. Once they switched to
toilet paper, the vaginitis cleared up.
My daughter cries when her private parts are being washed with
soap. She says it hurts a lot. I myself am sensitive to some
soap, and I think I know the kind of pain she is talking about,
but I now use only baby wash for her, and it doesn't seam to
help. Is it normal? Is there any milder soap that would be better
than baby soap? Should I have her see a doctor? Any input would
be very much appreciated.
How about skipping the soap all together? The inner folds of
female genitalia are better off without soap. Water does just fine.
I'm nurse-midwife and often need to tell women to stop using soap.
it's a self cleaning oven!
I suggest showing her how to wash herself and using more water
than soap. A hand held shower should help.
No soap is necessary in the genital area, and definitely no
scrubbing. It's a self cleaning body part... Give your daughter
a bubble free bath (bubble bath can be very irritating down
there). The water alone should get her vagina as clean as it
needs to be.
Mother of 3
I have been sensitive all my life to soaps on the vulva, and on
checking it out, I've found that I am not alone, and that water
alone is perfectly adequate for washing the female genitals. My
OB/GYNs have always made a general recommendation not to use soap
there. I'd suggest washing very gently with water only from now
on. Also, if her vulva is irritated by washcloths (or has lasting
irritation from soaps used in the recent past), a shower nozzle
on a flexible hose can be used with lukewarm water and a gentle
water flow to wash without a washcloth. Who knows, maybe she'd
find it fun! (I learned this trick following childbirth. If you
don't have that kind of shower nozzle, a bottle such as a bike
water bottle can be used to create a similar gentle flow by just
filling it with plain bath water or lukewarm water from the sink,
and using it on the toilet or in the tub.)
Either way, being gentle is key. I'll say from experience that a
chronically irritated vulva can become a multi-year chronic itch,
from the irritation alone (no disease involved). Not an
experience I recommend.
Sticking to Water
my 3 year old little girl is the same way, but when we saw the
pediatrician her advice was simple: just wash with water, and it
will be fine.
I would still consult with her doctor to make sure she doesn't
have a yeast infection, or you could look if she has a rash and
just treat with desitin.
You might try Cetaphil liquid soap. It's extremely mild.
Soap stings me down there too. Through trial and error I've
found that olive oil based soaps do not sting. I like the brand
Kiss my Face, and also the EO line of liquid soaps, which you can
get at Elephant Pharmacy I think. They are gentle and they smell
nice too. I don't think you should be using a wash cloth or
anything rough like that. Hope that helps.
I would strongly suggest you see a doctor to rule out any other
issues. We have used cetaphil soap for our son who has very
sensitive skin. We were told that the ''baby soaps'' actually
have so many frangrances that they irritate the skin. You may
also want to consider Aveeno products.
I don't think vaginas need to be washed with soap, just water.
You could try having her wash herself. 4 is old enough for that. Also,
maybe don't use soap in those areas all the time. Just a nice long soak
in the water that is probably full of soap from washing the other parts of
her body would probably do the trick.
I never washed my kids private parts with soap... or my own for that matter!
This sounds unhealthy to me!
fresh and clean mamma
Plain water is best. Soap or cleanser of any kind can be very
irritating to the female genital area at any age.
At 4 years, she might also resist having parents too involved
in her personal bathing ritual. Have you tried ''delegating'' and
trusting her? She should well be able to simply pour water from
the shower head to her privates, or to dab them front-to-back
with a soft wet washcloth.
I second everyone's advice that water is sufficient but wanted
to add that using soap on female private parts can upset the
natural bacterial balance and cause yeast infections.
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