What is lichen sclerosus?

Lichen sclerosus is a skin condition. It creates patches of shiny white skin that’s thinner than normal. The condition can affect any part of your body, but it most commonly affects skin in the genital and anal regions. Lichen sclerosus is most common on the vulvas of women.

Mild cases of lichen sclerosus sometimes go unnoticed because they don’t cause any symptoms aside from the visible, physical symptoms of white, shiny skin. The areas of skin may also be slightly raised.

Because the affected areas are often around the vulva and genital, they may not be noticed unless other symptoms occur.

If you do experience symptoms from lichen sclerosus, you may notice:

  • itching, which can range from mild to severe
  • discomfort
  • pain
  • smooth white spots
  • painful sexual intercourse

Because the skin affected by lichen sclerosus is thinner than normal, it can bruise or blister more easily. In severe cases, it can result in ulcerated lesions, or open wounds.

Scientists aren’t yet sure what causes lichen sclerosus. They have determined that it isn’t contagious, and it can’t be spread through contact, including sexual intercourse.

However, there are several theories about what contributes to its development. These include:

Some people do have a higher risk for developing lichen sclerosus, including:

  • postmenopausal females
  • uncircumcised males, as the condition most often affects the foreskin
  • children who haven’t yet gone through puberty

If you suspect that you have lichen sclerosus, your doctor can diagnosis it for you. You can make an appointment with your primary care physician. Many women make an appointment with their gynecologists.

Your doctor will ask about your physical history. They’ll also do a physical exam and look at the affected areas. In many cases, they’ll be able to diagnose lichen sclerosus on appearance alone, though they may take a skin biopsy for a definite diagnosis.

If they conduct a skin biopsy, they’ll numb the affected area with a local anesthetic before they use a scalpel to shave off a small portion of skin. This piece of skin will be sent to a lab for testing.

Lichen sclerosus can lead to bruises, blisters, and even ulcerated lesions, which are open wounds. If these wounds aren’t kept clean, they can become infected. Because they’re often in the genital and anal regions, it can be hard to prevent infections.

There is also a small chance that lichen sclerosus can develop into a type of skin cancer called squamous cell carcinoma. If your lichen sclerosus turns into squamous cell carcinomas, they may resemble red lumps, ulcers, or crusted areas.

Except in cases involving children, which sometimes resolve on their own, lichen sclerosus can’t be cured. However, it can be treated.

Treatment options include:

  • topical corticosteroids, which are often applied daily
  • removal of the foreskin in severe cases involving men
  • ultraviolet light treatment for affected rashes not on the genitals
  • immune-modulating medications like pimecrolimus (Elidel)

For women experiencing painful sexual intercourse due to tightening of the vagina, your doctor can prescribe vaginal dilators, a water-based lubricant, or, if needed, a numbing cream like lidocaine ointment.

In the cases of childhood lichen sclerosus, the condition may disappear when the child goes through puberty.

Adult lichen sclerosus can’t be cured or even treated entirely, but there are treatment options to help reduce symptoms. Self-care measures can help prevent future complications. These include:

  • carefully cleaning and drying the area after urinating
  • avoiding harsh or chemical soaps on the affected area
  • monitoring the affected areas for signs of skin cancer