Young girls with vulvitis experience red, itchy skin on the outside of their vagina. And according to a new study published in Therapeutic Advances in Urology, these girls may also experience urinary tract infections (UTIs).

“Vulvitis is a common condition affecting women and girls of all ages,” said Dr. Steve J. Hodges, lead study author and associate professor of urology at Wake Forest Baptist, in a press release. “We found that girls with vulvitis were at least eight times more likely to have a lab-diagnosed UTI than girls without vulvitis, suggesting that vulvitis is a major contributor to UTIs in young girls.”

One-hundred and one girls with UTI symptoms (frequent urination, pain, and bed-wetting) participated in Hodges study, where he and fellow researchers analyzed cultures of the girls’ urine and swabs from their genital area. Researchers found that more than half of the girls believed to have a UTI were also showing signs of vulvitis. With the urine cultures, Hodges was able to confirm 35 percent of the total girls participating in the study had proven UTIs, 86 percent of whom had vulvitis too.

How does this happen? Hodges said vulvitis-induced inflammation can create UTI-causing bacteria. It’s then possible for this bacteria to ascend to the bladder, causing a UTI. However, this research doesn’t necessarily confirm a direct link between the two conditions. “Given this association, we recommend that practitioners always assess young girls for the presence of vulvitis, and if present, work diligently with parents and patients to treat and prevent its recurrence,” Hodges said.

In addition to young girls, post-menopausal women are also at an increased risk for vulvitis and possibly a UTI, according to the Cleveland Clinic. Though truthfully, any woman of any age can be affected by the condition. Cleveland Clinic cites many causes for the conditions, including colored or perfumed toilet paper, vaginal sprays or douches, soap, bubble baths, pool water, an allergic reaction to spermicide, and other skin conditions such as eczema or dematitits.

The symptoms to be aware of are extreme and constant itching, burning sensations, vaginal discharge, and small, red cracks in the skin. Some women may notice swelling and blisters too. A doctor will be able to determine an actual infection after he conducts a pelvic exam.

Both Hodges and the Cleveland Clinic recommend practicing better hygiene to avoid both conditions altogether. That means using unscented beauty products, as well as wearing loose fitting cotton underwear. Anything too tight is a risk factor for vulvitis.

Source: Hodges S, Krane L, Russell G, Sherertz R, Gorbachinsky I. Altered perineal biome is associated with vulvovaginitis and urinary tract infection in preadolescent girls. Therapeutic Advances in Urology. 2014.