Benign bacteria develop within the vagina following the estrogen reproduction onset in puberty and these bacteria called lactobacilli settle in the vagina become dominant in vaginal flora and prevent pathogenic (disease-causing) bacteria settle into the vagina. Absence of hair and low amount of fatty tissue in genital region before puberty prevent infection. This means, vagina is unprotected and easlily affected form infection before puberty, treating the infections may be more difficult. Considering the discharges which develop during childhood, initially the family should be warned about hygene, although the parent is careful with this issue, same attention may not be given by the babysitter or at nurseries. Genital region should be cleaned with wet cotton from anterior towards posterior. Narrow and tight clothes as well as synthetic clothes should be avoided. Again, excessive cleaning of the genital region by using soaps, paper towels, foamy bathes, detergents used for washing the clothes may facilitate infections. Urination by opening the legs reduce the infection risk. If these considerations are not taken, vaginal culture or a prober antibiotic may be used. It should not be forgotten that unnecessary usage of antibiotic in any period of female life may trigger vaginal infections. But, factors which lead vaginal infection during childhood are different than women in reproductive age. The most common factor before puberty is anaerobic bacteria and often cause smelling discharge. Then comes the bacterias which cause upper respiratory tract infection, this condition should also be questioned in medical history of the patient. Fungal (candida) infections are rare in prepubertal period but parents start initial treatment by supplying generally fungicides from pharmacies. Fungal infections are also rarely related to usage of antibiotic, diabetes and cortisone usage.
Some intestinal worms (Enterobius vermicularis) can cause vulvovaginal infections. Herpex simplex is also within rare factors.
In addition to the hygenic precautions in prevention of infections after puberty with estrogenized vagina, lactic acid based nourishment (yoğurt) is important. In addition to the vaginal infections, sexually transmitted diseases are important in this period, too. Adolescents are more susceptible to sexually transmitted diseases.
Attention: Foreign bodies, tumors, and congenital uterine abnormalities should be considered especially in recurrent vaginal infections and further examination should be performed. Urinary incontinence problems should be taken into account in the assessment.
Human Papillomavirus (HPV) infections in adolescents may appear as genital warts or cervical dysplasia (the precursor lesions of cervical cancer). Cervical dysplasias in adolescents usually resolves spontaneously within 1 year. However, it is important to vaccinate adolescents against HPV, the vaccine in most of the developed countries is afforded by state and not pose any risk.