Vaginal Health

The Lowdown on Lichen Sclerosus

February 16, 2018

Skin changes in the genital region can be alarming, especially if you’re sexually active. However an itchy spot or odd looking patch of skin however aren’t always signs of a contagious disease. There are loads of dermatologic diseases which cause such symptoms. One of them is a condition called lichen sclerosus. It mainly affects women, especially after menopause, but men and even kids can develop it as well.

Lichen sclerosus is rarely serious but it’s worth being aware ofat the very least so that in the event that you develop it you do not fear or put off visiting a doctor for fear you’ve got a sexually transmitted disease. Its cause is unknown, although an overactive immune system can play a role. Some scientists believe, for instance, that an infectious disease called a spirochete might cause the fluctuations in the immune system which lead to lichen sclerosus.

Additionally, it is possible that some individuals have a genetic tendency toward the disease, and studies indicate that abnormal hormone levels might play a role. Here’s what it is helpful to understand about this relatively uncommon skin disease.


Mild cases usually begin as glistening white spots on the skin of the vulva in women or around the foreskin of uncircumcised men. Additionally, it sometimes affects the area around the anus. In girls, it can show up on other parts of the human body –particularly the upper chest, breasts, and upper arms–but that is uncommon: Fewer than 1 in 20 women who have vulvar lichen sclerosus have the disorder on the skin surface.

If the disease worsens, itching is the most common symptom, which in rare cases can be extreme enough to interfere with sleep and daily activities. Rubbing or scratching to relieve the itching may lead to bleeding, tearing, painful sores, blisters, or tenderness –so much so it’s a good idea to refrain from having sex, wearing tight clothing or tampons, riding a bike, or any other activity that might cause friction or pressure on the affected areas.

In severe cases in girls, lichen sclerosus may result in scarring that results in the inner lips of the vulva to shrink and disappear, the clitoris to be coated with scar tissue, and the opening of the vagina to lean. 

In males who have severe lichen sclerosus, the foreskin may scar, tighten, and psychologist over the head of the penis, which makes it hard to pull back the foreskin and diminishing sensation in the tip of their penis. Occasionally, erections are painful, and the urethra (the tube through which urine leaks ) can become narrow or blocked, resulting in burning or pain during urination, and even bleeding during intercourse. When lichen sclerosus develops around the anus, the distress can result in constipation. This is very common in kids.


When lichen sclerosus impacts skin in parts of the body other than the genitals, it rarely has to be medicated. The symptoms tend to be very mild and will usually disappear with time.

But, lichen sclerosus of the skin ought to be treated, even when it does not cause itching or pain, to avoid the scarring which can interfere with urination or sexual intercourse or both. The disease has also been linked to specific cancers. It doesn’t lead to cancer, but epidermis that is affected by lichen sclerosus is far more likely to develop cancer.

About 1 in 20 women with untreated vulvar lichen sclerosus develops skin cancer. It is important to get appropriate treatment and to see your doctor every 6 to 12 weeks to track and treat some changes that might signal skin cancer.

Topical corticosteroids are usually the first-line of defense against lichen sclerosus to both cure the illness and to restore the skin’s normal texture and strength. But, steroids won’t reverse any scarring that may have already occurred. And because they’re very strong, it’s important while using them daily to test back with a doctor frequently to test skin to get side effects once the drug is used daily.

Once signs are gone and skin has recovered its strength, the drug may be used less often, but might nevertheless be needed a few times weekly to keep lichen sclerosus in remission.

If the disease doesn’t clear up after a couple of months of using a topical steroid cream or ointment, a doctor may proceed to prescribing a medicine that modulates the immune system, for example Protopic (tacrolimus) or Elidel (pimecrolimus). And for men and women who can not tolerate different medications, retinoids may be helpful. Sometimes, also, other factors, such as reduced estrogen levels which lead to vaginal dryness and soreness, a skin infection, or irritation or allergy to the medicine, can keep symptoms from clearing up.

For men whose lichen sclerosus won’t clear up with medication, circumcision almost always is successful. Once the foreskin is removed, the disease usually doesn’t recur. This is not the case for women, though, therefore operation in the genital region or around the anus generally isn’t recommended. But the majority of the time drugs will do the task of eliminating lichen sclerosus once and for all.