Oestrogen deficiency | Thin skin, lack of cornification, alkaline pH |
Poor hygiene practices | Faecal contamination due to wiping the bottom forwards |
| Faecal contamination from soiled underwear |
Infection | Sexually transmitted infections (eg, gonorrhoea, chlamydia, Trichomonas vaginalis) |
| Other bacteria (eg, Haemophilus influenza, Staphylococcus aureus, anaerobes, streptococci) |
| Fungal infection (eg, candida albicans) |
| Viral infection (eg, herpes simplex) |
Infestation | Threadworm |
Local irritants | Bubble bath, synthetic underwear, allergies to soaps |
Constipation with soiling | Leakage of faeces leading to irritation or infection |
Dermatitis | Eczema, psoriasis, lichen sclerosis |
Foreign body | |
Sexual Abuse | |
Anatomical anomalies | Double vagina with fistula, ectopic ureter |
Rare causes | Crohn’s disease with fistula, pelvic abscess, tumours (eg, lymphangioma, sarcoma botryoides) |