HealthyChildren.org from the American Academy of Pediatrics says ordinarily the lips of skin (labia), surrounding the vaginal opening, are separated. In rare cases, they grow together blocking the opening, partially or completely. This condition is called labial adhesions.
This occurs in about two percent of girls up to age six in the United States reports BabyCenter.com. While it can be unsettling for parents, in most cases it shouldn’t cause worry.
Usually labial adhesions don’t cause symptoms, but HealthyChildren.org says they can lead to difficulty with urination and increase a girl’s susceptibility to urinary tract infections. If the vaginal opening is significantly blocked, urine and/or vaginal secretions will build up behind the obstruction.
The Center for Young Women's Health (CYWH) says it’s not clear why some develop labial adhesions. It’s thought low levels of estrogen, that girls normally have during childhood, can result in the condition.
Hygiene is also thought to play a role in some cases. Covenant Care Pediatrics says irritation from urine or stool may inflame the labia, making them more likely to form adhesions. Irritants such as soaps, bubble baths or diaper rashes may inflame the skin as well.
In most cases, nothing needs to be done. BabyCenter.com advises unless the adhesion is causing problems, it's best to leave it alone. HealthyChildren.org goes on to say the majority of adhesions resolve on their own as the child gets older and require no treatment.
For more serious labial adhesions, HealthyChildren.org says, at first, your doctor will attempt to spread the labia gently. If the connecting tissue is weak, this mild pressure may expose the opening. But if the connecting tissue is too strong, an estrogen cream may be prescribed for parents to apply to the area. Then very gently and gradually spread the labia apart over a period of time.
CYWH says estrogen-containing creams are safe to use for this treatment. Only a very small amount is used, for a limited time. A few girls may develop temporary small breast buds or darkening of the labia. These conditions aren’t dangerous and disappear once treatment stops.
It’s possible but rare that very thick adhesions won’t respond to treatment. CYWH says if adhesions don’t improve with estrogen cream, discuss other options with a health care provider.
Unfortunately, this condition might continue on and off throughout childhood. But upon puberty when estrogen levels rise, the condition should disappear.
To prevent possible labial adhesions, Covenant Care Pediatrics says avoid irritants such as bubble baths and strong soaps and keep the area clean. Promptly remove stool and urine from diapers. Quickly treat diaper rashes. Be sure older girls are wiping from front to back.
Labial Adhesion. Babycenter.com by BabyCenter, L.L.C. Web 18 Oct 2011.
Labial Adhesions. Healthychildren.org by American Academy of Pediatrics. Web 18 Oct 2011.
Labial Adhesions: A Guide for Parents. YoungWomensHealth.org by Center for Young Women's Health, Children's Hospital Boston. Web 18 Oct 2011.
Labial Adhesions. CovenantCarePediatrics.com by Covenant Care Pediatrics, PC. Web 18 Oct 2011.
Reviewed October 20, 2011
by Michele Blacksberg RN
Edited by Jody Smith