Approximately 70% of hymenal tags have resolved by three years of age. Some authors suggest that the regression is due to aging and the waning effects of estrogen which is relatively high during the neonatal period. Occasional complications include bleeding and infection. New hymenal tags may develop postnatally from cleavage of a congenital hymenal septum or as a result of the extension of an intravaginal ridge or external vestibular hymenal ridge. Hymenal tags may represent a remnant of a vaginal septum present earlier in fetal development. The tags are most commonly found in the superior (ventral) and inferior (dorsal) positions of the hymen and, less commonly, in the lateral position. Occasionally, there may be two or more hymenal tags. The condition is usually isolated and solitary. The tag is pink in color and has a smooth surface. The study population consisted of 36% blacks, 33.6% white non-Hispanics, 29.9% Hispanics, and 0.5% Asians.Ĭlinically, a hymenal tag presents as an elongated projection of hymenal tissue extending from the hymenal rim, intravaginal ridge, or external vestibular hymenal ridge. A prospective study examined the genitalia of 211 girls between one month and seven years of age (mean age of 21 months) who presented for child care or non-gynecologic complaints with no history of sexual abuse and found hymenal tags in six (2.8%) of the girls.

Sixty-nine hymenal tags were observed in 59 (13%) neonates, with 10 neonates having two hymenal tags. In another study, 468 female neonates born at the University of Texas Medical Branch in the United States had their genitalia examined during the neonatal period before discharge. In one study, of the 974 female neonates admitted to the newborn department of the Beilinson Medical Center in Israel, 56 (5.75%) neonates were found to have hymenal tags during routine physical examinations within the first 24 hours of life. The incidence of hymenal tags is estimated to range from 6% to 13% of newborn girls. Hymenal tags are often overlooked unless specifically sought for. However, there have been very few reports and photo images published on this condition. Hymenal tags are not uncommon in newborn girls. The rest of the physical examination was normal. The mass measured 18 mm long and 5 mm wide. A smooth, pink mass was seen extending from the hymenal ring (Figure 1). Her weight was 6.8 kg, length was 64 cm, and head circumference was 41.7 cm. On examination, the infant looked alert and was not in distress. The infant came from a loving and supportive family. The mass was asymptomatic and there was no history of bleeding from the mass or of sexual abuse. The infant was exclusively breasted and thriving. The labor was smooth and there was no history of birth trauma or vaginal bleeding. Her birth weight was 3.02 kg (between 25th and 50th centile), length was 51.1 cm (between 50th and 75th centile), and head circumference was 35.4 cm (75th centile). The Apgar scores were 6 and 9 at one and five minutes, respectively.

The mother was not on any medications during the pregnancy. The infant was born to a gravida 2 para 1 27-year-old mother at 39 weeks of gestation, following an uncomplicated pregnancy and normal vaginal delivery. A four-month-old Chinese infant girl presented with a protruding vaginal mass which was first noted at birth.

Hymenal skin tags