Itching around the urethral area in a toddler can be caused by several things, and while it’s often not serious, it’s definitely worth keeping an eye on. In a 22-month-old girl, common causes might include:

• Irritant contact dermatitis: This can happen if soaps, bubble baths, or even laundry detergents irritate the sensitive skin around the urethra.

• Yeast infections: These are fairly common in young children, especially after antibiotics or in warm, moist environments.

• Urinary tract infections (UTIs): These can cause itching, burning, and discomfort, even in toddlers. Other signs might include fever, fussiness, or changes in urination.

• Pinworms: These tiny parasites can cause itching around the anus and vaginal area, especially at night.

• Poor hygiene or infrequent diaper changes: This can lead to irritation or infection in the diaper area.

It’s best to avoid scented products and ensure gentle hygiene. But since toddlers can’t always express what they’re feeling, and because symptoms can overlap, it’s a good idea to check in with a pediatrician. They can rule out infections or other conditions and recommend the right treatment.

Most Likely Diagnoses:

• Irritant diaper dermatitis is the most common cause of genital and perineal itching in toddlers. It results from prolonged exposure to urine, feces, and friction, and typically involves the diaper area, including the perineum and periurethral skin. Early findings include dryness and erythema, with later maceration and possible secondary infection. The use of soaps, wipes, or infrequent diaper changes can exacerbate symptoms.
• Candidal diaper dermatitis often complicates irritant dermatitis, especially after antibiotic use or with persistent moisture. It presents as beefy red erythema with satellite pustules, often involving skin folds, and can cause significant itching.
• Pinworm infestation (Enterobiasis) can cause perianal and sometimes periurethral itching, especially at night. Pinworms may migrate to the urethral or vulvar area, leading to localized pruritus.
• Atopic dermatitis (eczema) may involve the diaper area in infants and toddlers, presenting as pruritic, erythematous, and sometimes lichenified patches. Pruritus is a hallmark feature.
• Nonspecific balanitis or vulvovaginitis due to poor hygiene, moisture, or irritants is common in this age group and can present with localized itching and erythema.
• Allergic contact dermatitis from exposure to wipes, soaps, or diaper materials can mimic or overlap with irritant dermatitis and is characterized by pruritic, erythematous, sometimes vesicular lesions.