Key Takeaways

• Clitoral adhesions occur when the clitoral hood scars and sticks to the glans, limiting retraction and exposure.

• They most commonly develop after local inflammation, smegma buildup, infection, trauma, or inflammatory skin disease such as lichen sclerosus.

• Typical symptoms include pain, itching, hypersensitivity, difficulty with sexual activity, and palpable scar tissue.

• First‑line treatment may include topical corticosteroids, hormonal creams, office lysis under local anesthesia, and hygiene measures.

• If conservative care fails, surgical lysis is an option; postprocedure hood retraction exercises and pelvic floor therapy can help reduce recurrence.

What Are Clitoral Adhesions and How They Develop

What makes the clitoral hood stick to the glans? Clitoral adhesions are an abnormal fusion where the hood becomes fixed to the glans, restricting retraction and limiting exposure. They usually develop after local inflammation or when smegma or other exudate collects under the hood and heals with scarring. Contributing factors include conditions such as lichen sclerosus or lichen planus, previous trauma or surgery, infections, and hormonal changes that affect skin moisture and elasticity. Adhesions range from a small tether with partial glans exposure to extensive scarring that hides the glans. Severity is classified by how much of the glans can be exposed after attempting hood retraction. Identifying and treating ongoing inflammation is important because persistent inflammation promotes fibrosis and recurrence; addressing the underlying cause helps guide whether conservative or surgical treatment is best.

Common Symptoms and When to Seek Care

After explaining how clitoral adhesions form, it helps to know the typical symptoms that prompt evaluation. Common complaints include localized pain or hypersensitivity of the clitoral hood and nearby tissue, difficulty retracting the hood to expose the glans, itching, dryness, and a palpable band of scar tissue where the hood adheres. Sexual activity can cause rawness, discomfort, or changes in arousal and orgasm — symptoms may range from reduced sensation to marked hypersensitivity. Symptom severity varies, and you should seek care when pain, persistent changes in sensation, impaired sexual function, recurrent irritation, visible scarring, or failure of self‑care occur.

Underlying Causes and Risk Factors

Why some people develop clitoral adhesions and others do not depends on a mix of factors. Inflammatory skin diseases such as lichen sclerosus thin and scar the clitoral hood, increasing adhesion risk. Hormonal changes around menopause reduce tissue elasticity and moisture, making fusion more likely. Trauma from surgery or injury can leave scar tissue that binds the hood to the glans. Recurrent inflammation from infections, topical irritants, or poor hygiene can trap smegma and keratinized debris beneath the hood, complicating healing and promoting recurrence.

Non‑Surgical Treatments and Self‑Care Strategies

How are clitoral adhesions managed without surgery? Non‑surgical care aims to reduce inflammation, gently separate stuck tissue, and support healing while teaching self‑care to lower recurrence risk. Common options and strategies include:

• Office‑based non‑surgical lysis performed with local anesthesia to stretch the clitoral hood and free adhesions.

• Topical corticosteroids (for example, clobetasol) applied to reduce inflammation and help separate tissue, though scarred areas may respond less well.

• Topical hormonal therapy (estradiol and/or testosterone) when appropriate to improve tissue health and reduce dryness or irritation.

• Pelvic floor therapy and attention to hygiene as ongoing self‑care to support function and lower recurrence risk.

• After any release, regular gentle self‑retraction and careful cleansing to maintain exposure and monitor healing.

Surgical Options and What to Expect

If non‑surgical measures do not restore comfortable hood mobility or relieve symptoms, surgical lysis can provide a more definitive release of clitoral adhesions. Surgical lysis is more invasive than office lysis but often leads to higher satisfaction and improved clitoral sensation. It can be done under local anesthesia in an office or minor‑procedure setting; the goal is to free the corona circumferentially while preserving nerves, and sutures are usually not required. Debridement of keratin pearls or trapped smegma may be performed at the same time. Postprocedural care focuses on hygiene, gentle hood‑retraction exercises, and pelvic floor therapy to reduce recurrence and restore mobility. Reported outcomes include significant pain reduction and improvements in arousal, orgasm, and validated sexual function measures, supporting surgical lysis when conservative care fails.