From the Research
Labial adhesion in infants should be treated when it causes symptoms or complications, such as urinary tract infections, urinary retention, post-void dribbling, vaginal irritation, or discomfort. For asymptomatic cases, watchful waiting is recommended as most cases resolve spontaneously with rising estrogen levels during puberty. When treatment is necessary, the first-line approach is topical estrogen cream applied to the fusion line twice daily for 2-4 weeks, as supported by the study published in 2018 1, which reported a 90.6% success rate with topical estrogens and minimal adverse events. Key points to consider when treating labial adhesion in infants include:
- Topical estrogen cream is the preferred initial treatment, with a recommended duration of 1-3 months 2, 3
- Betamethasone 0.05% cream may be used as an alternative if estrogen therapy fails 2
- Manual separation under topical anesthesia may be considered for persistent cases, but this is rarely necessary 4
- Parental education on proper application technique and vulvar hygiene is essential to prevent recurrence and promote successful treatment 2, 1
- The goal of treatment is to alleviate symptoms, prevent complications, and improve quality of life for the infant, while minimizing the risk of adverse events and promoting spontaneous resolution of the condition during puberty.