Table of ContentsView AllTable of ContentsMedicationsSelf-CareHolistic ApproachSurgeryTreatment and Prevention
Table of ContentsView All
View All
Table of Contents
Medications
Self-Care
Holistic Approach
Surgery
Treatment and Prevention
While there is no cure forlichensclerosus, treatment can often help control symptoms, prevent scarring, and reduce the risk ofskin cancer.
The genital itching and pain that this problem causes can often be reduced with prescribed steroid ointments. Certain lifestyle routines and self-care can also help reduce symptoms and control flares. Surgery may be needed in severe cases.
This article describes common lichen sclerosus treatments. It also discusses ways to avoid flares and prevent the problem from becoming severe.
DIGICOMPHOTO/SCIENCE PHOTO LIBRARY / Getty Images
Who Treats Lichen Sclerosus?A lichen sclerosus specialist can determine your condition’s most appropriate treatment plan. This may include one or more of the following specialists in a multidisciplinary team approach:Dermatologist:A specialist in the diagnosis and treatment of skin conditionsObstetrician-gynecologist (ob-gyn):A specialist in diseases and disorders of the female reproductive system, pregnancy, and childbirthPrimary care provider (PCP):A healthcare provider who is considered your main providerUrogynecologist: A specialist in treating the female urinary tract, includingfemale pelvic conditionsUrologist:A specialist in diseases and disorders of the urinary tract)
Who Treats Lichen Sclerosus?
A lichen sclerosus specialist can determine your condition’s most appropriate treatment plan. This may include one or more of the following specialists in a multidisciplinary team approach:Dermatologist:A specialist in the diagnosis and treatment of skin conditionsObstetrician-gynecologist (ob-gyn):A specialist in diseases and disorders of the female reproductive system, pregnancy, and childbirthPrimary care provider (PCP):A healthcare provider who is considered your main providerUrogynecologist: A specialist in treating the female urinary tract, includingfemale pelvic conditionsUrologist:A specialist in diseases and disorders of the urinary tract)
A lichen sclerosus specialist can determine your condition’s most appropriate treatment plan. This may include one or more of the following specialists in a multidisciplinary team approach:
Lichen Sclerosus Treatment: Medications
It is advised to treat all cases of genital lichen sclerosus—even those that are asymptomatic—to preserve your quality of life and prevent scarring. Therapy can also reduce the risk of anatomical, sexual, and urinary dysfunction.
When patches of lichen sclerosus occur in places other than the genital and anal areas, they may get better without treatment.
Medication options are outlined below.
Topical Steriods
A class of prescription drugs calledtopical steroidsis commonly used as the first-line treatment for lichen sclerosus. These medications are prescribed in powerful formulations, categorized as ultra-potent because of their strength. They work against inflammation in your skin.
Ointment vs. CreamLichen sclerosus medication can be administered as an ointment or cream, though ointments are advised. Ointments are stronger than creams and do not include the alcohol and preservatives commonly used in creams that can burn or sting irritated skin.
Ointment vs. Cream
Lichen sclerosus medication can be administered as an ointment or cream, though ointments are advised. Ointments are stronger than creams and do not include the alcohol and preservatives commonly used in creams that can burn or sting irritated skin.
The most common treatment regimen for lichen sclerosus involves topical clobetasol propionate (0.05%) applied over the affected area twice daily for 12 weeks. Research indicates that up to 75% of people using clobetasol for lichen sclerosus achieve relief of symptoms. It may be continued past 12 weeks, as directed, for flares, maintenance therapy, andremission.
Factors such as your age, severity of disease, and area of the body affected help determine which steroid is most appropriate. Other steroids of varying strengths, including the following, may also be used based on your needs:
Intralesional Steroid Therapy
In some cases of difficult-to-treat lichen sclerosus, one may benefit from an intra-lesional (delivered directly into a skin lesion)steroid injectionusing Kenalog (triamcinolone acetonide)2.5–5 milligrams per milliliter (mg/mL).
Topical Calcineurin Inhibitors
Topical calcineurin inhibitorsare sometimes used as an off-label treatment if your lichen sclerosus is intolerant or unresponsive to a topical steroid. These drugs, which are applied once or twice daily for one to two months, include the following:
Retinoids
Topical retinoids may provide a useful alternative to steroids in treating lichen sclerosus. Research shows thatretin-A cream (tretinoin)(0.025%) applied for six months may provide an alternative to steroids, though it is not as effective as first-level steroids.
Lichen Sclerosus and CircumcisionCircumcision(removal of the foreskin) is often curative in the early stages of uncomplicated lichen sclerosus in men. This can leave the penis susceptible tophimosis, a condition in uncircumcised males in which the foreskin is tight and unable to retract. Circumcision is reported to be effective in more than 75% of men with lichen sclerosus.
Lichen Sclerosus and Circumcision
Circumcision(removal of the foreskin) is often curative in the early stages of uncomplicated lichen sclerosus in men. This can leave the penis susceptible tophimosis, a condition in uncircumcised males in which the foreskin is tight and unable to retract. Circumcision is reported to be effective in more than 75% of men with lichen sclerosus.
Understanding How Topical Steroids Work
Lichen Sclerosus Treatment Through Self-Care
Lichen sclerosus self-care involves good hygiene and other strategies that reduce irritation and ease symptoms of skin irritation and pain, including:
Holistic Approach to Lichen Sclerosus Treatment
A holistic approach to lichen sclerosus treatment involves therapies that are not always considered part of traditional medicine. This approach addresses the whole person with treatment that helps you take responsibility for your own well-being so you can support traditional treatments.
This can include the following:
Dietary Modifications
Foods that are high in oxalates (an organic compound found in plants) can lead to the worsening of symptoms. Studies indicate the following foods with high oxalate levels may be linked to worsening symptoms of lichen sclerosus:
Patient Education
People who have lichen sclerosus may be counseled to take the following steps to improve their treatment results:
Psychosexual Counseling
Lichen sclerosus can cause impairment in the areas of intimate relationships, sexuality, and mental health. It can affect your overall quality of life and general happiness. Research indicates that psychosexual counseling can significantly improve the sexuality, quality of life, and well-being of women who receive this type of treatment.
Herbal Therapies
Herbal therapies and complementary medicines may provide some relief of symptoms of inflammatory diseases. The following agents have had variable results in improving symptoms:
When Does Lichen Sclerosus Require Surgical Treatment?
Surgery is regarded as a second-line therapy for lichen sclerosus in both women and men.
In women, surgical treatment for lichen sclerosus may be required for the following circumstances:
In men, surgical treatment is reserved for circumcision in uncircumcised men when very strong topical steroids and other first-line treatments are ineffective.
Second-Line TherapiesWhile not regarded as first-line treatments, research indicates that the following therapies have proven to relieve some symptoms of lichen sclerosus:Carbon dioxide laser therapyUltraviolet (UV) A1 phototherapyPhotodynamic therapy(use of topical 10% 5-ALA cream (5-aminolevulinic acid)Cryotherapy (use of extreme cold to manage inflammation)Platelet-rich plasma (PRP)(injection of platelet cells taken from your blood to help in healing)
Second-Line Therapies
While not regarded as first-line treatments, research indicates that the following therapies have proven to relieve some symptoms of lichen sclerosus:Carbon dioxide laser therapyUltraviolet (UV) A1 phototherapyPhotodynamic therapy(use of topical 10% 5-ALA cream (5-aminolevulinic acid)Cryotherapy (use of extreme cold to manage inflammation)Platelet-rich plasma (PRP)(injection of platelet cells taken from your blood to help in healing)
While not regarded as first-line treatments, research indicates that the following therapies have proven to relieve some symptoms of lichen sclerosus:
Ongoing Lichen Sclerosus Treatment and Preventive Measures
Lichen sclerosus is an incurable condition that requires lifelong maintenance. Without treatment or self-care, it can cause serious complications.
Treatment can reduce and potentially eliminate symptoms, though periodic flares are always possible. This disease requires following a treatment regimen that involves monitoring your body for signs of disease progression.
Maintenance therapy for lichen sclerosus can include the following regimen:
Summary
Lichen sclerosus is a chronic skin disease that can cause itching and pain. While it can affect any body part, the disease often involves your genitals and the area around them.
Without treatment, this disease can result in changes that affect the normal function of your urinary system and sexual performance. This can impact your quality of life.
The first-line treatment involves the use of a very potent steroid ointment. Lifelong follow-up and care are needed since flares can occur even after you control symptoms. When scarring occurs, surgery may be advised.
Early treatment of this disease can help prevent problems like scarring. Lifetime care and follow-up are needed to reduce your risk of flares.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kraus CN.Vulvar lichen sclerosus.JAMA Dermatol. 2022;158(9):1088-1088. doi:10.1001/jamadermatol.2022.0359
National Organization for Rare Disorders (NORD).Lichen sclerosus.
Singh N, Mishra N, Ghatage P.Treatment options in vulvar lichen sclerosus: a scoping review.Cureus. 13(2):e13527. doi:10.7759/cureus.13527
Kwok R, Shah TT, Minhas S.Recent advances in understanding and managing lichen sclerosus.F1000Res. 2020;9:F1000 Faculty Rev-369. doi:10.12688/f1000research.21529.1
Cedars-Sinai.Lichen sclerosus.
Vittrup G, Westmark S, Riis J, et al.The impact of psychosexual counseling in women with lichen sclerosus: a randomized controlled trial.J Low Genit Tract Dis. 2022;26(3):258-264. doi:10.1097/LGT.0000000000000669
Yale Medicine.Lichen sclerosus.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
