What causes pruritus vulvae?
The main cause of pruritus vulvae in prepubertal females is poor hygiene and the presence of chemical and/or mechanical irritants. • Poor hygiene is usually the result of a back to front wiping motion after urinating or bowel movement. This contaminates the vulva with faeces and faecal pathogens. An infection may readily develop as at this age the vulva is thin, delicate, and has a neutral pH, which makes it an excellent medium for bacterial growth. • Soaps, bubble baths, laundry detergents, shampoo, and chlorinated pool water are all potential chemical irritants. Mechanical irritation may occur from scratching the area, harsh wiping with toilet paper, or rubbing from tight-fitting underwear. The prepubertal vulva is particularly vulnerable because of the lack of oestrogen-induced labial fat pads, thickening of the skin, and pubic hair. Prepubertal pruritus vulvae may also be a symptom of other vulvar or vaginal problems. These include: • Primary skin disease such as contact dermatitis
