What is Lichen Sclerosis?

Lichen sclerosis (LIE-kun skluh-ROW-sis) is an uncommon condition that creates patchy, white skin that is thinner than normal. Lichen sclerosis may affect skin on any part of your body, but most often involves skin of the vulva, foreskin of the penis or skin around the anus.

Anyone can get lichen sclerosis, but postmenopausal women are at highest risk. Left untreated, lichen sclerosis may lead to other complications.

You may not need treatment because sometimes lichen sclerosis improves on its own. If you do need treatment, your doctor can suggest options to return a more normal appearance to your skin and decrease the tendency for scarring.

Symptoms

Lichen sclerosis can affect the skin on any part of your body. Sometimes, no symptoms are present. When they do occur, lichen sclerosus symptoms may include:

1)Itching (pruritus), which can be severe
2)Discomfort, which is generally greater if lichen sclerosus appears on or around your genital or anal areas
3)Smooth white spots on your skin that may grow into blotchy, wrinkled patches
4)Tenderness of the affected areas of your skin
5)Easy bruising or tearing
6)In severe cases, bleeding, blistering or ulcerated lesions
7)Painful intercourse

Causes

The exact cause of lichen sclerosis is not known. However, the condition may be related to a lack of sex hormones in the affected skin or to an overactive immune system. Previous skin damage at a particular site on your skin may increase the likelihood of lichen sclerosis at that location.

Although lichen sclerosis may involve skin around your genitals, it is not contagious and cannot spread through sexual intercourse.

Lichen sclerosis occurs most often in postmenopausal women, but it also occurs in men and children. In women, lichen sclerosis usually involves the vulva. In boys and men, uncircumcised males are most at risk, because the condition generally affects the foreskin. In children, the signs and symptoms may improve at puberty.

Western Medicine Treatment

If lichen sclerosis is not in your genital area, you may not need treatment for lichen sclerosis, especially if you are not having symptoms. In fact, many cases disappear without any treatment. If you have lichen sclerosis on or around your genitals or anus, or have a more advanced case on other parts of your body, your doctor will recommend treatment.

Corticosteroids

The most commonly prescribed treatment for lichen sclerosis is corticosteroid ointments or creams. These medications are usually quite effective and help stop the itching right away.

Doctors generally recommend putting cortisone creams or ointments on the affected patches of skin every day for several weeks. After that, you will likely need to continue applying corticosteroids a couple of times a week to prevent a recurrence of lichen sclerosis. Your doctor will monitor you for side effects associated with prolonged use of topical corticosteroids, such as thinning of the skin.

Other treatment options

If corticosteroid treatment does not work, other treatments your doctor may prescribe include:

1)Immune-modulating medications, such as tacrolimus (Protopic) and pimecrolimus (Elidel)
2)Prescription sex hormones
3)Ultraviolet light treatment, for nongenital areas


Treatments cause your skin to assume a more normal appearance and decrease its tendency for further scarring.

For men with lichen sclerosis on the foreskin, removal of the foreskin (circumcision) is a common treatment in cases resistant to other therapies or more advanced cases. Surgery generally is not recommended for women with lichen sclerosus because the condition may just come back after surgery.


Adopted From Mayo Clinic