From the Research
Vaginal tags in newborns typically require no specific treatment as they are benign and usually resolve spontaneously within a few weeks to months after birth. These small, flesh-colored protrusions at the vaginal opening are remnants of embryological development and are considered normal anatomical variants. Parents should be reassured about their benign nature and advised to maintain normal hygiene with gentle cleansing using warm water during diaper changes. No medications, creams, or surgical interventions are necessary. If the tags persist beyond 6-12 months, become irritated, bleed, or change in appearance, a pediatrician should evaluate them. The spontaneous resolution occurs because as the infant grows, hormone levels change and tissue remodeling takes place naturally. Attempting to remove these tags is not recommended as it may cause unnecessary pain, bleeding, or infection in the newborn. Regular well-child visits will allow the pediatrician to monitor these tags if parents have ongoing concerns. According to a recent study 1, approximately 30% of hymenal tags may persist at three years of age, highlighting the importance of monitoring but not intervening unless necessary.
Some key points to consider in the management of vaginal tags in newborns include:
- Maintaining good hygiene to prevent infection
- Avoiding any attempt to remove the tags, as this can cause harm
- Monitoring the tags for any changes or persistence beyond 6-12 months
- Educating parents on the benign nature of these tags and the importance of regular well-child visits for monitoring. As noted in an older but relevant study 2, hymenal tags usually disappear spontaneously as the estrogen effect diminishes, further supporting a wait-and-see approach. However, the most recent and highest quality evidence should guide clinical decision-making, and in this case, the study from 2021 1 provides the most up-to-date information on the natural history of hymenal tags.
In terms of morbidity, mortality, and quality of life, the approach of not intervening unless necessary is prioritized because it minimizes the risk of complications such as infection or bleeding, and it avoids causing unnecessary pain or distress to the newborn. This approach is in line with the principle of first doing no harm and is supported by the available evidence. Therefore, the recommended management for vaginal tags in newborns is to leave them alone and monitor them, unless they persist, become irritated, or change in appearance, in which case a pediatrician should be consulted.