My daughter turned 2 in September. My doctor didn't want to open it because of potential trauma about messing with her privates, but he did say he often does do it with boys because it is easier and the skin just "pops" away. This happens in boys too where the skin on top fuses to the part below. Another reason he doesn't pop it open is because if the skin is raw after broken open, it can essentially fuse together again. That made sense to me. He also mentioned the specialist, but that was a LAST RESORT if the creme didn't work. Again, there would be no rush. It took 2 weeks for me to see that the lesion was in fact getting much thinner. I would put a healthy dose on a Q tip and explain the this medicine will help make her not hurt anymore. Actually I had my husband help on at least 1 application at night to keep her occupied. As I was applying, I'd push ever so gently with the Q tip, but hardly at all. Trust me, give the creme a couple weeks. I don't think 1 week is enough except to see thinning of the membrane. I was totally paranoid about this, but my husband is Ph.D and I trust our pediatrician completely and this was a good first course of treatment that really worked well.