Description

Lichen sclerosus (LIE-kun skluh-ROW-sus) is a condition that causes irregular color, thin skin. It usually affects the genital and anal areas.

Anyone can get lichen sclerosus but postmenopausal women are at greater risk. It is not contagious and cannot be transmitted through sexual contact.

The treatment is usually a medicinal ointment. This treatment helps the skin to return to its usual color, and reduces the risk of scarring. Even if the symptoms disappear, they tend to come back. So it is likely that the need for long-term follow-up care.

Symptoms

It is possible that you have a bit of lichen sclerosus with no symptoms. When symptoms do occur, they typically affect the skin of the genital and anal areas. The back, shoulders, arms, and breasts may also be affected. Symptoms may include:

  • Soft coloration of the skin patches
  • Blemishes, wrinkles in the skin, patches of
  • Itching
  • Pain or a burning sensation
  • Easy bruising
  • Fragile skin
  • The changes in the pipe to the flow of urine (urethra)
  • Bleeding, formation of blisters, or open sores
  • Painful sex

When to see a doctor

Check with your health care provider if you have symptoms of lichen sclerosus.

If you've already been diagnosed with lichen sclerosis, consult your health care provider every 6 to 12 months. These visits are important to verify the changes in the skin or the side effects of treatment.

Causes

The exact cause of lichen sclerosus is not known. It is likely that a combination of factors, including an overactive immune system, their genetic composition, and prior skin damage or irritation.

Lichen sclerosus is not contagious and cannot be transmitted through sexual contact.

Risk factors

Anyone can get lichen sclerosus, but the risk is greater for:

  • Postmenopausal women
  • Children under 10 years of age
  • Women who suffer from other autoimmune disease, such as forms of low thyroid function (hypothyroidism)
  • Men with urinary incontinence or an uncircumcised penis
  • People with a family history of the disease

Complications

Complications of lichen sclerosus include pain during sex, and the scars, including one that covers the clitoris. Scars on the penis can cause painful erection, low urine flow and an inability to retract the foreskin.

People with vulvar lichen sclerosus are also at increased risk of squamous cell carcinoma.

In children, constipation is a common complication.

Diagnosis

Your health care provider can diagnose lichen sclerosus looking at the affected skin. You may need a biopsy to rule out cancer. You may need a biopsy if your skin does not respond to steroid creams. A biopsy involves removing a small piece of affected tissue for examination under a microscope.

You may be referred to the specialist in skin diseases (dermatologist), the female reproductive system (gynecologist), urology, and pain medicine.

Treatment

With treatment, the symptoms often improve or disappear. Treatment of lichen sclerosis depends on the severity of your symptoms are and where it is on your body. The treatment can help relieve the itching, improve the appearance of your skin and reduce the risk of scarring. Even with the success of the treatment, the symptoms often come back.

Ointments, medicated

Steroid ointment clobetasol is commonly prescribed for the lichen sclerosis. In first place you need to apply the ointment to the affected skin twice a day. After several weeks, your doctor will probably suggest that you only use twice a week to prevent the reoccurrence of the symptoms.

Your health care provider will do a follow-up of the side effects associated with long-term use of topical corticosteroids, such as thinning of the skin.

Also, your health care provider may recommend a calcineurin inhibitor, such as tacrolimus ointment (Protopic).

Ask your health care provider how often you'll need to return for follow-up examinations — probably once or twice a year. The long-term treatment is necessary to control the itching and irritation and prevent serious complications.

Circumcision

Your health care provider may recommend removing the penis foreskin (circumcision) if the opening for the flow of the urine has been reduced by lichen sclerosus.

Lifestyle and home remedies

These self-care tips can help relieve the irritation of the skin:

  • Apply petroleum jelly (Vaseline, Aquaphor, other) on the affected area.
  • Gently wash the affected area daily and dry. Use gentle, fragrance-free soap and avoid the bathrooms too.
  • Relieve the burning and pain with a bath in the morning and in the evening, with water that is comfortable to the touch. Do not add bubble bath or other products.
  • Take an oral antihistamine at bedtime to help control the itching as you try to sleep.
  • The use of soft perfume of toilet paper without dyes.
  • Avoid irritants, such as tight-fitting clothing and scented detergents.

Preparing for your appointment

If you have symptoms of lichen sclerosus, to make an appointment with your health care provider. You may be referred to a specialist in the diagnosis and treatment of skin conditions (dermatologist).

Here's some information to help you prepare for your appointment.

What you can do

Before your appointment, make a list of:

  • Your symptoms and how long you have had them.
  • Your key medical information, such as other conditions with which you have been diagnosed, and any prescription or over-the-counter medications you use, including vitamins and supplements.
  • Questions to ask your health care provider.

Some basic questions to ask your doctor about the potential lichen sclerosus include:

  • What is the most likely cause of my symptoms?
  • What treatment approach do you suggest, if any?
  • If the first treatment does not work, what would you suggest then?
  • How much do you expect my symptoms improve with treatment — and how soon?
  • I'm going to need treatment for this condition for the rest of my life?
  • What self-care measures, what can I do to relieve the symptoms?
  • What can I do to help prevent the symptoms from coming back?

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

  • How serious is the discomfort?
  • Have you noticed any bleeding?
  • Do your symptoms include pain during urination or bowel movements?
  • Do your symptoms include pain with intercourse?
  • Has had previous injuries to the affected area?
  • What measures have been adopted for the treatment of this condition yourself?
  • Have you had the prescription of treatments for this condition?
  • Have you been diagnosed with any other medical condition?
Symptoms and treatment of Lichen sclerosus