Labial adhesions are frequently seen in infants beyond 3 months age and incidence peaks in the second year of life and onset rarely seen beyond 3 years age.
Inflammation of the labia minora combined with low estrogen in prepubertal girls provides a possible explanation for adhesions, especially in the setting of poor perineal hygiene, trauma & vaginal infection.
Exposure to Strong detergents, Bubble baths, Harsh chemicals like Dettol are risk factors for labial adhesions
Labial adhesions are diagnosed on a routine genital examination. It may be asymptomatic or cause a pulling sensation, difficulty with urination, vaginal pain or discharge, recurrent urinary tract infections, or recurrent vaginal infections.
No treatment is necessary if the adhesions are asymptomatic as the adhesions may resolve when estrogen production increases at puberty
Management of Symptomatic Labial Adhesions
Labial adhesions should be treated if they are associated with recurrent infections or pain.
Initial treatment of symptomatic labial adhesions with topical medications (eg, estrogen, estradiol (0.01%) cream(EVALON*) or betamethasone 0.05% cream) is desirable. It should be applied twice or thrice daily using a fingertip at the point of midline fusion where there is a thin white line. Frequency is decreased once separation starts and is continued for few weeks. Once labia separate, an Emollient is applied 3-5 times daily for several months for a complete healing and to minimize the chances of recurrence.
If medical care does not help, then a manual or surgical separation may be considered by a Pediatric Surgeon/Urologist.
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Post Pic credits Sick Kids Hospital