Table of ContentsView AllTable of ContentsWhy Do You Get Lichen Sclerosus?SymptomsTreatmentComplications
Table of ContentsView All
View All
Table of Contents
Why Do You Get Lichen Sclerosus?
Symptoms
Treatment
Complications
Lichen sclerosusis a skin condition affecting the genitals that causes white patches and itchiness. Skin changes in the genital region can be alarming, especially if you’re sexually active. It mainly affects women, especially aftermenopause, but people of any sex and even kids can develop it as well.
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The cause of lichen sclerosus is unknown, although an overactive immune system may play a role.
Researchers still need to gain an understanding of what can cause a flare-up of lichen sclerosis. However, it is correlated with:
It’s also possible that certain people have a genetic tendency toward the disease, and studies suggest that abnormal hormone levels may also play a role. Here’s what it’s helpful to know about this relatively uncommon skin disease that is important to treat to avoid complications.
Prevalence
Lichen Sclerosus Symptoms
Mild cases usually start as shiny white spots on the skin of the vulva in women or on the foreskin of uncircumcised men. It also sometimes affects the area around the anus.In women, it can appear on other body parts—particularly the upper torso, breasts, and arms—but this is rare.
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 can cause:
It’s a good idea to avoid having sex, wearing tight clothing or tampons, riding a bike, or any other activity that might cause pressure or friction on the affected areas while you are experiencing symptoms. Any trauma, including friction, can cause fragile skin to be damaged and lead to scarring.
Severe Symptoms
In severe cases in women, lichen sclerosus can lead to scarring that causes the inner lips of the vulva to shrink and disappear, the clitoris to become covered with scar tissue, and the opening of the vagina to narrow.People with lichen sclerosis can sometimes experience sexual dysfunction because of these symptoms.
In men with severe lichen sclerosus, the foreskin can scar, tighten, and shrink over the head of the penis, making it hard to pull back the foreskin and decreasing sensation in the tip of the penis. Occasionally, erections are painful, and the urethra (the tube through which urine flows) can become narrow or obstructed, leading to burning or pain during urination and even bleeding during intercourse.
When lichen sclerosus develops around the anus, the discomfort can lead to constipation, particularly in children.
What Causes a Genital Rash and How Is It Treated?
Lichen Sclerosus Treatment
There are a few different approaches to treating lichen sclerosis in the genitals. There are different types of medication, including systemic medication and topical medication, as well as procedures that can help clear up symptoms.
Corticosteroids
Topical corticosteroids are usually the first line of defense against lichen sclerosus to cure the disease and restore the skin’s normal texture and strength.
However, steroids won’t reverse any scarring that may have already occurred. And because they’re very strong, it’s important to contact a healthcare provider frequently to check the skin for side effects when the medication is used daily.
Once symptoms are gone and the skin has regained its strength, the medication can be used less frequently but may still be needed a few times a week to keep lichen sclerosus in remission.
Immune Modulating Medication
If the disease doesn’t clear up after a few months of using atopical steroid creamor ointment, a healthcare provider may move on to prescribing a medication that modulates the immune system, such as Protopic (tacrolimus) or Elidel (pimecrolimus).
For people who can’t tolerate other medications, retinoids may be helpful. Sometimes, too, other factors, such as low estrogen levels that causevaginal drynessand soreness, a skin infection, or irritation or allergy to the medication, can keep symptoms from clearing up.
Procedures
For men whose lichen sclerosus won’t clear up with medication,circumcisionis almost always effective.Once the foreskin is removed, the disease usually does not recur. For women, surgery in the genital area or around the anus generally isn’t recommended.
Does Lichen Sclerosus Ever Go Away?Complete remission of lichen sclerosus is more likely in men. For uncomplicated cases treated early, 90% or more of men can experience full resolution of symptoms.However, it is less likely to entirely go away in women, although there can be times when the condition improves.
Does Lichen Sclerosus Ever Go Away?
Complete remission of lichen sclerosus is more likely in men. For uncomplicated cases treated early, 90% or more of men can experience full resolution of symptoms.However, it is less likely to entirely go away in women, although there can be times when the condition improves.
Complications of Lichen Sclerosus
Lichen sclerosus can have some complications beyond the discomfort of the condition, including scarring and an increased risk of skin cancer.
Scarring
Lichen sclerosis of the genital skin can cause scarring that can interfere with urination, sexual intercourse, or both.
Cancer
Summary
Lichen sclerosus can be treated with medications and, in extreme cases for men, circumcision. If you are concerned about your skin health or have symptoms, see a healthcare professional.
7 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.
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Kraus CN.Vulvar lichen sclerosus.JAMA Dermatol. 2022;158(9):1088-1088. doi:10.1001/jamadermatol.2022.0359
Smith A, Muhammad N, Cigna S, Krapf J. (191).A systematic review of sexual health consequences among women with vulvar lichen sclerosus.The Journal of Sexual Medicine. 2023;20(Supplement_1):qdad060.183. doi:10.1093/jsxmed/qdad060.183
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