Baby Girl Labial Adhesion

VAGINAL (HYMENAL) SKIN TAGS (Birth-3 Months)

What is happening inside my baby’s body?

A vaginal skin tag is a small piece of skin that appears to be protruding from the vagina. The skin can look swollen and red, or it can look the same as the skin elsewhere on the body. A vaginal skin tag is often discovered with a diaper change: suddenly a piece of tissue seems to appear that wasn’t there before.

Vaginal skin tags are normal. The skin is often sensitive to maternal hormones during fetal development, so the tag grows rapidly while the baby is in the womb. Once the baby is delivered, the maternal estrogen slowly leaves the baby’s body. As this happens, the skin tag usually shrinks down until it is nearly – or entirely invisible.

What can I do?

Routine care should be taken while cleaning during diaper changes. The skin tag is no more sensitive than the rest of the genital area. When cleaning, you do not need to wipe more carefully here than anywhere else.

When does my doctor need to be involved?

Your doctor needs only to be involved if the skin tag bleeds. This is very rare and usually occurs only when the skin is irritated with overly vigorous cleaning.

What tests need to be done, and what do the results mean?

No tests are done with skin tags.

What are the treatments?

Almost all vaginal skin tags disappear with time. There are no creams or ointments for vaginal skin tags, no special medicines to make them shrink down faster. If a prominent tag remains for several years, then you may choose to have it removed surgically for cosmetic purposes.

What are the possible complications?

The only complications of vaginal skin tags are irritation and bleeding due to excessive rubbing or cleaning. This is uncommon and goes away when the vigorous cleaning stops.

LABIAL ADHESIONS (Birth-12 Months)

What is happening inside my baby’s body?

The inner and outer lips of the vagina are called the labia. While they form as two separate pieces during fetal development, they can attach at their ends prior to delivery. Occasionally they stick together too much. When the inner lips are joined together in this manner, it is known as a labial adhesion.

It is estimated that between one-quarter and one-third of all girls are born with some degree of labial adhesion. Most are minor – extending only a millimetre or two – and often go unnoticed by both parents and doctors. The larger adhesions can extend from the back part of the vagina, near the anus, all the way up toward the clitoris.

The adhesions are usually caused by inflammation or irritation of the labia. The surface becomes sticky and a small scar forms. Girls can have labial adhesions at birth, but it is much more common for them to appear between three months and six years of age.

Most labial adhesions disappear on their own over time. Hormones such as estrogen help to dissolve the adhesions, so a girl going through puberty will often notice that the adhesion has resolved on its own.

What Can I do?

If you notice an adhesion, then bring it to the attention of your doctor. There is very little you can (or need to) do to care for the adhesion, short of applying cream if a doctor prescribes it.

When does my doctor need to be involved?

Most labial adhesions do not require medical attention. However, if the adhesion is large, covering the majority of the vaginal opening, then there is an increased risk of infection or bleeding. Your doctor should be involved anytime infection or bleeding occurs.

What tests need to be done, and what do the results mean?

Tests are done only if there is a suspicion that the urine is infected. Large adhesions can cause urine infections by providing a place for urine to pool inside the vagina. Stagnant urine, just like any other stagnant fluid, is more likely to breed infection. Think of the still pond at the park covered with pond scum as opposed to clean flowing water in a stream.

If a urinary tract infection (UTI) is suspected, then your doctor will order a urinalysis and a urine culture. If the urinalysis shows signs of infection, or if the urine culture grows bacteria, then a UTI is present. A UTI must be treated with antibiotics.

What are the treatments?

Labial adhesions can be treated with direct application of an estrogen cream. Because hormones help to dissolve the adhesions, locally applied estrogen works quickly and easily. If the adhesion returns, then the estrogen is reapplied. Estrogen creams are typically used only when the adhesion is significant enough to cause potential bleeding or infection.

What are the possible complications?

Labial adhesions are known to recur even after several rounds of treatment with cream. Repeated use of estrogen cream can result in a change of the pigmentation (colour) of part of the labia. Given the location of the tissue, the loss of pigmentation is generally not considered a significant side effect.

If a UTI occurs, the UTI itself can cause fever, burning with urination, foul-smelling urine, and frequent urination.