Fissures and lesions in the intimate area

What are fissures and lesions in the intimate area?

Fissures are small tears in the mucous membrane; lesions include any form of tissue damage. Both occur on the vulva, vagina, or anal area. Since the mucous membranes are highly vascularized and sensitive, even small tears often cause stabbing pain, burning, or bleeding.

What are the causes of cracks and sores in the intimate area?

Fissures and lesions in the intimate area usually arise from a combination of mechanical friction, too dry mucous membranes, infections, or hormonal changes. Common triggers are intercourse without sufficient moisture, sports, unsuitable intimate hygiene, skin diseases, or a weakened vaginal flora, for example due to antibiotics, stress, or menopause.

What symptoms do fissures and lesions cause?

The symptoms of fissures and lesions in the intimate area are described by many affected individuals as very unpleasant. Typical are pain during urination because the urine runs over the injured mucous membrane, pain during intercourse, and pain when sitting, especially on hard surfaces. Additionally, itching, burning, and a general sore feeling in the intimate area can occur. Increased or altered discharge is also possible, especially if an infection is involved or overlays the existing lesion. In some cases, cracks or small ulcers are visible on the speculum, sometimes the injury only manifests through the pronounced sensation of pain and burning.

Typical complaints are:

• Pain when urinating
• Pain during sex (dyspareunia)
• Pain when sitting or walking
• Itching, burning, oozing, or discharge
• Redness, swelling, or visible cracks

These symptoms often recur when the mucous membrane is dry, irritated, or inflamed.

What complications can occur?

If fissures and lesions are not carefully treated, several complications can develop. One of the most important is infection of the injured site. Through the opened mucous membrane, bacteria, fungi, or other germs can enter and cause vaginitis, cystitis, or – in the anal area – even an anal abscess. Inflamed fissures are usually significantly more painful and heal more slowly. In addition, persistent pain when sitting, during bowel movements, or during sexual intercourse can significantly impair quality of life. If fissures repeatedly tear open or are very deep, there is also a risk of scar formation, which can permanently change the elasticity and resilience of the tissue. Delayed healing is also possible, especially if the original cause – such as dryness or mechanical over-irritation – is not addressed.

Untreated fissures can lead to:

• Infections (Vaginitis, bacterial colonization, fungal infection, cystitis, anal abscess)
• severe pain increase
• delayed healing
• Scar formation for deep cracks

Therefore, early, targeted treatment is crucial.

How can fissures and lesions in the intimate area be treated?

The treatment of fissures and lesions in the intimate area depends on the type, cause, and severity of the lesion. Basically, it is important to keep the affected area clean without further irritating the mucous membrane. Gentle intimate hygiene with mild, pH-adjusted products and clear water is usually sufficient. The area should not dry out but at the same time be protected from further mechanical stress. Tight clothing and synthetic fabrics that cause friction and heat buildup should be avoided as much as possible to promote skin breathing and prevent additional irritation.

Important measures:

• Rest, no sex until healed
• Clean, gentle intimate hygiene
• Moisture buildup with hyaluronic acid preparations
• Wound protection and low-bacteria care
• Treatment of possible infections

In many cases, topical preparations such as creams, ointments, or gels are used, which depending on the findings may contain corticosteroids, antibiotics, antimycotics, or antiseptic agents. These are mainly used when there is inflammation of the mucous membrane, a bacterial or fungal infection, or chronic irritation. In severe cases or with pronounced inflammation, it may be necessary to additionally use oral medications. For deep or chronically recurring fissures that do not respond sufficiently to conservative measures, surgical treatment may be considered in exceptional cases. In selected situations, physiotherapeutic treatment can help as a supplement, for example, in muscular tension in the pelvic floor that can increase pain and hinder normal healing.

In medical therapy, depending on the cause, the following are used:

• Hyaluronic acid preparations (Gels, creams, vaginal suppositories)
• CANNEFF® VAG SUP or CANNEFF® SUP (CBD + Hyaluronic Acid)
• antibiotics/antimycotics for infections
• pain-relieving creams or suppositories
• surgical measures for chronic or deep cracks (rare)
• Physiotherapy for muscular causes

Why do CANNEFF® Suppositories with Hyaluronic Acid & CBD work so well for fissures?

A particularly effective option in the treatment of fissures and lesions in the intimate area are CANNEFF® Suppositories. The formulation of these suppositories is specially designed to protect, soothe, and regenerate the damaged mucous membrane in the intimate area. CANNEFF® Suppositories improve local moisture and suppleness, support the natural rebuilding of the mucous membrane, and simultaneously have anti-inflammatory, antioxidant, and pain-relieving effects. This effectively reduces irritation, local inflammatory reactions, and pain while sustainably promoting the physiological regeneration of the sensitive tissues.

This combination is effective because it:

• helps close cracks faster
• reduces pain
• soothes inflammation
• hydrates and protects the mucous membrane
• stabilizes the healing process

CANNEFF® Suppositories are non-hormonal, safe, well tolerated, and suitable for both vaginal and rectal fissures.

How are CANNEFF® suppositories used and dosed?

CANNEFF® suppositories are applied once daily before bedtime. For complaints in the vagina, CANNEFF® VAG SUP vaginal suppositories are used; for complaints in the anal area, CANNEFF® SUP rectal suppositories are used. Hands should be washed thoroughly before and after application. The suppository is gently and as deeply as possible inserted into the vagina or anus. It then melts due to body heat and evenly distributes the contents on the mucous membrane.

When should one see a doctor for fissures and lesions in the intimate area?

A doctor's visit is always recommended if a fissure or lesion is very painful, oozing, bleeding, or shows signs of inflammation, if the symptoms persist for more than a few days, or if fever, abnormally changed discharge, or pain when urinating occur. The same applies if fissures recur repeatedly or if there is suspicion of a sexually transmitted infection. In these cases, a gynecologist or another medical specialist should examine the findings to clarify the exact cause and determine the appropriate therapy. This helps to avoid complications and specifically support healing.

In the end, the fact remains: fissures and lesions in the intimate area are usually well treatable if they are detected early and treated according to their cause. A combination of gentle care, suitable local preparations, and – where appropriate – suppositories with hyaluronic acid and cannabidiol such as CANNEFF® VAG SUP or CANNEFF® SUP can significantly help to relieve pain, regenerate the mucous membrane, and restore well-being in the intimate area.

Sources

Agrawal, S., LaPier, Z., Nagpal, S., Oot, A., Friedman, S., Hade, E. M., Nachtigall, L., Brucker, B. M., & Escobar, C. (2024). A randomized, pilot trial comparing vaginal hyaluronic acid to vaginal estrogen for the treatment of genitourinary syndrome of menopause. Menopause (New York, N.Y.), 31(9), 750–755. https://doi.org/10.1097/GME.0000000000002390

González-Isaza, P., Sánchez-Prieto, M., & Sánchez-Borrego, R. (2023). Chronic vulvar fissure: approach with cross-linked hyaluronic acid. International urogynecology journal, 34(7), 1495–1499.https://doi.org/10.1007/s00192-022-05401-4

Edwards L. (2004). Vulvar fissures: causes and therapy. Dermatologic therapy, 17(1), 111–116.https://doi.org/10.1111/j.1396-0296.2004.04011.x