Let's now talk about non-specific causes of vulvovaginitis.
Sometimes you can see vulvovaginitis in young girls
specifically because they are now starting to toilet on their own
and do their own hygiene regimen.
This can sometimes lead to poor hygiene.
So it's important to emphasize good hygiene in these patients.
Also, you should encourage young girls to wear white cotton underpants
as sometimes colored or dyed underwear can cause irritation.
Avoidance of bubble baths and shampooing in the bath
or using harsh soaps is advised as this can irritate the vulva,
which is sensitive.
Loose fitting underpants and pajamas are necessary.
If a young girl is in gymnastics, ballet or perhaps figure skating,
those outfits and costumes can be very tight and cause chronic irritation.
And in addition girls can sit in plain water
and it helps protect the vulva and perineum
and also encourages good hygiene.
This is sometimes referred to as a sitz bath.
I also want to bring your attention to labial agglutination.
This is happens in a hypoestrogenic state
and what happens is the labia actually stick together.
This can be very painful.
In the first picture here you'll see evidence of a labial agglutination.
However, after treatment you can see that the labia can be separated.
This is a cartoon representation of what labial agglutination looks like.
You can see here that maybe there is a clitoris and the labia are fused.
You can try to separate them gently with the q-tip.
If they don't separate naturally don't force it.
These patients require estrogen therapy and typically they'll get better
and their labia will actually fall apart on their own.
Okay, let's review everything that we've discussed.
Don't forget that little girls are vulnerable to sexual abuse.
The most common foreign body in a young girl causing vaginitis
is toilet tissue.
Young girls lack estrogen making their vulva prone to irritation.
All abused in young girls needs to be reported to the local authorities.
Good hygiene and appropriate clothing
can prevent non-specific vulvovaginitis.
Thank you for listening and good luck on your exam.