Labial Adhesions

Labial Adhesions (Labial Agglutination)

Your child's lips on the vulva have temporarily closed together.  This is called labial adhesions or labial agglutination.  This generally occurs because young girls have a low estrogen level, resulting in thinner skin (normal in children), combined with some sort of irritation such as diaper rash or stool.  This often causes no problem and will resolve with time. However, sometimes your healthcare provider will recommend treatment because the adhesions have almost closed off the vaginal opening and may make it difficult for normal urination.  These instructions are meant to help you take care of this condition.

1. Use the estrogen cream initially twice a day for 2 weeks, the once a day until instructed by your child' doctor
2. You must hold the labia apart with one hand, while applying the cream with the other hand, one rtes grey line where the labia are closed together.
3. Always use your finger to apply the cream
4. Apply the cream in a downward stroke over the grey line while applying some pressure.  The pressure is as important as the cream.
5. Call if your daughter develops redness from this medication or if she stops urinating.
6. Once the labia have opened your will decrease the estrogen use and switch to a bland ointment, such as a bland nondedicated ointment, to keep it from recurring.  We have your alternate daily between estrogen and the bland ointment for 1 week and then switch to the bland ointment daily after each bath.  
7. Here are some helpful hints to help it from recurring and keep your daughter's bottom healthy.

• Review common wiping from front to back
• Review frequent hand washing
• Use gentle bars of soap with no perfumes, dyes, or deodorants.  Use only sparingly.  Avoid using soap on the vulva.
• Use gentle detergent with no perfumes or dyes
• Use toilet paper with no perfumes or dyes
• Avoid bubble baths
• Change to dry bathing suit after swimming
• Change diapers frequently to avoid irritants on the skin
• Use 100% white cotton underwear
• Have your daughter urinate with her legs apart