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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.
Causes
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.
Treatment
Surgery is almost never needed. The best treatment for labial adhesions is estrogen cream (PremarinŽ) 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.
Rarely, it is necessary for the clinician to separate the labia in the office. Using the Premarin cream at home will make the area of adhesion very thin so that separation can then be done easily in the office using a numbing cream (topical anesthetic).
After the adhesions are gone
- It is important to keep the labia from adhering again.
- Put a thin layer of A & D ointment on the area every night.
- Continue this treatment until puberty, when breasts start to grow.
- Without this continuing treatment, the adhesions are very likely to come back.
- Labial adhesions do not cause future gynecologic problems.
Hygiene
For good hygiene, teach your daughter to:
- 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.
After treatment
- Continue good hygiene
- Apply A & D ointment every night until breasts start to develop at puberty. With help, your daughter may learn to do this herself.
- Check the area every few months if she is applying the cream herself to be sure that the adhesions aren’t coming back.
If symptoms return after you have been treated
- Do not use PremarinŽ cream without calling the office.
- Do not use PremarinŽ in an on-again/off-again way.
- Call the office if the adhesions recur in spite of efforts to prevent them.
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