Lichen sclerosus is an uncommon, long-term skin condition where small patches of skin become thin and colorless. The condition can affect any part of the body but most often occurs in the skin around the genitals.
Most cases of lichen sclerosus occur in women who have been through menopause, but men and children can also sometimes be affected.
Lichen sclerosus can be managed with the right treatment. In this article, we take a look at the treatment options, along with the symptoms and causes of the condition.
Lichen sclerosus is a skin disorder that causes small areas of skin to become thin and discolored so that white patches develop.
The skin can crack and become sore, which can cause pain, itching, and discomfort. These feelings may be distressing.
Lichen sclerosus can affect the skin on the arms, back, breasts, and other parts of the body, but it is usually the skin around the genitals and anus that is most often affected. Having lichen sclerosus in these areas can sometimes lead to pain during sex or when going to the bathroom.
The most common symptoms of lichen sclerosus are:
- small, shiny spots that develop into white patches of thinned, crinkled skin
- itching
- blisters
- bleeding
- soreness and discomfort
- scarring
In mild cases of the disease, there may be no symptoms.
Lichen sclerosus is a rare disease. When it does occur, it mostly affects women who have been through menopause aged between 40 and 60 years.
It is unclear exactly how many women develop the condition. Researchers think that the number could be anywhere between 1 in 300 to 1 in 1,000 women.
Men are six times less likely to develop the condition than women.
Children are the least likely to be affected by lichen sclerosus. When it occurs in children, it is usually in girls who have not yet reached puberty.
The exact causes of lichen sclerosus are not known, but doctors think there are different reasons why some people develop the disease.
Possible causes and risk factors include the following:
- hormone imbalances
- immune system problems, such as an overactive thyroid gland
- a family history of the disease
- previous damage to the skin because of other skin conditions
Lichen sclerosus is not contagious and cannot be spread from one person to another, even through intimate contact, such as sexual intercourse.
Lichen sclerosus can cause the skin to crack and bleed. When the area around the genitals is affected, it can be particularly painful and sore.
In severe cases of lichen sclerosus, scarring can cause the walls of the vagina to shrink and tighten, making sexual intercourse very difficult and painful.
Lichen sclerosus does not cause cancer. However, women whose genitals are affected are at a higher risk of developing some forms of skin cancer. This cancer risk accounts for less than 5 percent of women with the condition, however. Developing cancer is more likely to happen to a woman if she has not managed her symptoms through treatment.
Anyone who develops symptoms of lichen sclerosus should see a doctor as soon as possible.
Early diagnosis of lichen sclerosus means that treatment can begin immediately. Prompt treatment can prevent the condition from worsening and make it more manageable.
A doctor will often be able to make a diagnosis by carrying out a physical examination of the affected areas. They may want to examine a small sample of skin under a microscope to ensure that the condition is lichen sclerosus.
Occasionally, lichen sclerosus may have no symptoms. When this is the case, a doctor may only diagnose the condition when they are examining the affected area for another unrelated reason.
Currently, there is no known cure for lichen sclerosus. However, there are many effective ways to relieve and manage symptoms to ease and minimise discomfort.
Lichen sclerosus can sometimes clear up on its own. This usually happens when it is on parts of the body other than the genital and anal areas.
There are many ways to treat lichen sclerosus around the genital areas, however. Some of these methods are outlined here, but there may be other more recent treatments available. As a result, it is important to discuss treatment options with a doctor.
The most common treatment for lichen sclerosus is applying a steroid cream or ointment directly to the affected area. Steroids can be very effective in controlling inflammation, which helps to reduce itching, soreness, and scarring, and can prevent the condition from getting worse.
Sometimes, a doctor may recommend surgery. For example, scar tissue can sometimes make the entrance to the vagina narrow, and, as a result, sex becomes difficult. Surgery will widen the opening to the vagina, reducing discomfort.
When the foreskin of a male is affected, a doctor may suggest a circumcision.
Some general self-help measures can make the condition more comfortable to live with. These include:
- applying an appropriate moisturizer to the affected areas
- avoiding scented bathing products and detergents that can irritate the skin
- using a lubricant during sex
- avoiding rubbing or scratching the affected areas
- wearing loose-fitting clothing and underwear made of natural fibers
Symptoms in young girls often clear up entirely once they reach puberty.
A doctor should always diagnose lichen sclerosus before a person starts any treatments.
Women with the condition should have regular check-ups.
Lichen sclerosus is a long-term condition that can last for many years.
Lichen sclerosus that occurs on parts of the body other than the genital area are more likely to clear up without treatment.
In most situations, it is possible to manage symptoms with simple early treatments. These treatments include steroid cream and self-help measures.