Lichen sclerosus is an uncommon, long-term skin condition characterized by thin, itchy skin with white patches. It mainly occurs in the skin of the genitals and around the anus, but other parts of the body may also be affected. Lichen sclerosus is more common in women than in man and in postmenopausal women.
Patients with localized scleroderma are thought to be at a higher risk of developing this condition.
Lichen sclerosus is not an infectious disease, and it is not contagious. It cannot be transferred between sexual partners.
What causes lichen sclerosus?
The exact cause of lichen sclerosus is unknown, but it is thought to be linked to an overactive immune system.
The condition might also have a hereditary component, as 15 percent of patients have a family member with the lichen sclerosus.
Irritated and damaged skin increases the likelihood of lichen sclerosus developing at a particular site.
Diagnosis and symptoms of lichen sclerosus
Lichen sclerosus can be irritating and distressing, but it usually does not present a severe threat to health.
In mild cases, the symptoms are hardly noticeable. The most common are itching, white spots on the skin, wrinkled patches, and easy bruising.
In more severe cases, affected skin areas can bleed, and blisters and scars can form. Lichen sclerosus in the genital regions can cause pain during intercourse.
Although lichen sclerosus mainly affects the genital regions, it can also be found elsewhere, including on the breasts, shoulders, upper arms, and back. The condition is very rare in childhood.
In women, lichen sclerosus is mostly located at the vulva (the skin surrounding the entrance of the vagina) and around the anus. In men, it usually affects the foreskin and end of the penis. It is less common in circumcised men.
The condition is usually diagnosed by visual examination of the skin. In some cases, the doctor will take a small skin biopsy and analyze the skin by dermoscopy, which involves viewing the skin with surface microscopy.
Treatments
There is currently no cure for lichen sclerosus, but there are many ways symptoms can be controlled.
In mild cases, simple actions such as avoiding washing the affected area with soap, or scratching, as well as applying a barrier cream can relieve symptoms. Avoiding tight clothes and wearing those made of natural materials can also help.
In more severe cases corticosteroid creams and ointments may be prescribed.
In rare cases, problems that are caused by lichen sclerosus have to be corrected by surgery. In women, the condition can lead to a narrowing of the vaginal opening, which can be widened surgically. In men, removal of the foreskin might be necessary.
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