An Em Update| Perineal Pyramidal Protrusion

I first feel like I need to say a big warm thank you to everyone and their sweet comments on my last child update, and on Sunday night's instagram post. I often feel way in over my head with this entire parenting world, but I'm so grateful for a loving community of people who read this blog, and share their love and support for our family. It really means the world to me. 

A couple weeks ago we went to the dermatologist for Em and her skin growth that she has in her diaper area. The dermatologist agreed that it needed to come off, but that she wasn't anxious to do it anytime soon, and then she told us to come back in January. She also took a picture and measured it to make sure it didn't get any worse. 

We went home thinking all was fine until yesterday when I got a voicemail from the dermatologist saying that they had, "an update on Em's condition", and to call them back soon to discuss the next steps. I obviously went straight to freaking out, and thought that they were going to tell me that she was in fact growing a male anatomy, and that we were going to have to decide if we wanted her to be a boy or a girl (I realize I'm a psychopath by the way...)

So I call back, preparing for the worst, and the doctor tells me that when we left that day, she honestly had no idea what Em was growing down there and so she and all the other dermatologists had to put their heads together, and pour through medical journals until they could come up with that it was, because they'd never seen it before. I'm obviously just so comforted at this point in the conversation. She told me that after hours of researching, they've decided that it's called a "perineal pyramidal protrusion", most likely caused by constipation, and that they're typically found around 14 months, which is about the time we noticed Em's.

This made a ton of sense since Em has been on Miralax for constipation for about a year and a half now, and when I googled the name of it, the picture that showed up is exactly what Em has. The doctor told us that it likely formed when Em had a very large bowel movement at some point, and then the skin protruded out because of the force of the poop. So glamorous, I know. The good news is that there is no harm with it being there, and that these "protrusions" actually resolve themselves and go away over time. So as of right now, no surgery needed. We'll go back in January for a follow up appointment, but after that, we likely won't need to go back unless something happens to it that requires medical attention. 

Thank you for indulging me in way more than I'm sure you wanted to know about my daughter. Although, I'm sure some mom is going to google this condition at some point, find this post, and then she'll thank me. So I'm writing this for that mom... and posterity, because they'll all want to know about this as well. 


  1. I'm glad it isn't super serious! Sounds like a weird form of a hemroid. Love that picture of her and that cute mushroom top!

  2. Hooray for it going back to normal at some point. Hooray for no extra anatomy. ;)

  3. There were no other alternatives they could give her, prune juice, flax seeds, diet changes? Dairy and carbs are constipating. High does of fiber, fish oils also help with constipation. I would talk to your doctor about some of these other options.

  4. My daughter has one too but she git it early around 7 months . She was not constipated and lately she will cry in great pain everytime she goes no.2. We need to see her pedia ASAP!

  5. hi, so i’m 36 and i’ve had this my whole life. it never went away. there is shockingly little information about it in adults on the internet. i didn’t let it stop me from becoming a naked performer, but i’m pretty tired of it at this point (36) and i’d like to have it removed. :(

  6. Hi, my daughter has this, did Ems go away on its own? I’m very worried. Thank you