Pediatric and Adolescent Gynecology

Labial adhesions

What are labial adhesions?

Labial adhesions occur when the inner lips of the female genitals (labia) temporarily grow together (“adhere”). They are most common in young girls aged 3-months to 6-years.

What causes labial adhesions?

Usually, irritation of the skin makes the labia start to grow together. Poor genital hygiene and bacteria that are always present in the area are usually the cause. Keeping the area clean is important to treat adhesions and to prevent them from coming back.

What is the treatment?

Surgery is almost never needed. The best treatment for labial adhesions is estrogen cream or steroid ointment followed by preventive measures.

Apply the cream:

  • 2 times a day
  • Use a pea-sized amount
  • Put the cream in the middle of the adhesion and apply slight pressure with your finger
  • For 2-8 weeks as directed by the clinician

With this treatment, the adhesions become thin and usually separate on their own.

Hygiene

Teach good hygiene:

  • Wash hands before and after toileting.
  • Wipe from front to back after urinating. Consider toilet paper wipes or damp gauze.
  • Urinate with knees spread apart and stay seated on the toilet until finished urinating to allow all the urine to come out.
  • Take a bath (not a shower) every day. Soak in a frog-leg position in a bathtub of plain water for 10-15 minutes daily.
  • Wash the genital area very gently during a bath, use a mild bar soap such as DoveŽ, and make sure to wash between the folds (labia). Rinse well after a bath with clean water. No bubble baths.

Avoid irritation:

  • Wear white cotton underwear and avoid wearing underwear at night.
  • Avoid harsh laundry detergents and bleach, and make sure underwear is rinsed thoroughly. Avoid fabric softeners and dryer sheets.
  • Do not use bubble bath or add anything else to bath water unless prescribed by your health care provider.
  • Use a mild, hypoallergenic bar soap, such as Dove. Avoid deodorant soaps.
  • Avoid tight jeans or pants, pantyhose, and tights.
  • Avoid sitting in a wet bathing suit after swimming – rinse off after swimming and change as soon as possible into dry clothing.
  • Make sure all soap is washed off after bathing, and do not allow a bar of soap to float around in the bathtub.

After the adhesions are gone

  • It is important to keep the labia from adhering again.
  • Continue good hygiene.
  • Apply ointment every night until breasts start to develop at puberty.
  • Without this continuing treatment, the adhesions are very likely to come back.
  • Labial adhesions do not cause future gynecologic problems.

If symptoms return after you have been treated

  • Do not use cream without calling the office.
  • Do not use creat in an on-again/off-again way.
  • Call the office if the adhesions recur in spite of efforts to prevent them.