| Labial adhesions occur when the labial skin around the vagina becomes irritated and sticks together. It is most common in young girls between the ages of 3 months and six years and is usually not a cause of concern. The adhesions may be mild, in which only part of the vaginal opening is closed, or they can cover the complete vaginal opening.
Mild cases can be treated by applying a bland ointment or diaper rash cream to the labial skin each day and gently separating it over a few weeks. Severe cases, especially if it is blocking urine or vaginal secretions, usually require treatment with a topical estrogen cream (Premarin) and gradual separation of the labia. It is important to apply the cream only to the area of the adhesion (using a cotton tip applicator can be helpful), rub it in, and then try to gently separate the adhesion.
An estrogen cream is usually applied twice a day for about 4 weeks and then once a day for another three weeks. By this time, the labial adhesions should be healed and you may stop using the estrogen cream. Although the adhesion is gone, it is still necessary to use another barrier cream or ointment each night so that the labia do not become stuck together again. This is usually continued for another 6-12 months.
Forced separation should usually be avoided, as it is very painful and it is will re-occur. If the estrogen cream isn't working and it is being applied correctly, then you should consider separation as an outpatient surgical procedure, in which she can be sedated, especially is the adhesions are causing her to have difficulty urinating.
While prolonged use of an estrogen cream can cause the breast development or other signs of puberty, it is not common with the short time of treatment recommended above, especially if you are sure to concentrate the cream on the area of the adhesion and avoid other skin surfaces. Also, wash your hands well after applying the cream and stop it if you do notice signs of breast development, etc.
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