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28th Mar 2024

What is lichen sclerosus? Here’s what you need to know about this common condition

Anna Martin

Lichen sclerosus

For many of you reading this, it will be your first time hearing about lichen sclerosus (LS)

Though not often spoken about, it’s by no means a rare condition.

Estimates for LS, involving the female genitals, vary from one in 30 older adult women to one in 300 to 1000 patients seen in general gynaecology offices.

It usually occurs in postmenopausal women, although men, children, and premenopausal women may be affected.

What causes lichen sclerosus?

Lichen sclerosus
Credit: Canva

The cause of lichen sclerosus is not clear, though health care providers suspect that a number of factors may be involved. These include:

  • Genetics: LS seems to be more common in some families. People who are genetically predisposed to LS may develop symptoms after experiencing trauma, injury, or sexual abuse.
  • Immune system disorders: LS in females may be an autoimmune disorder, in which the body’s immune system mistakenly attacks and injures the skin. Women with LS are at greater risk of developing other autoimmune disorders, such as some types of thyroid disease, anaemia, diabetes, alopecia areata, and vitiligo.
  • Infection: Researchers have not been able to clearly demonstrate any relationship between infections and LS. LS is not contagious.
  • Hormones: LS is more common in prepubertal girls and postmenopausal women, suggesting that hormonal changes influence the disease. However, treatments such as hormone replacement therapy or the application of testosterone or progesterone have not been shown to be effective for females with LS.

What are the symptoms?

According to The Mayo Clinic, it’s possible to have mild lichen sclerosus with no symptoms.

When symptoms do occur, they usually affect the skin of the genital and anal areas. The back, shoulders, upper arms and breasts may also be affected. Symptoms may include:

  • Smooth discolored skin patches
  • Blotchy, wrinkled skin patches
  • Itching
  • Soreness or a burning feeling
  • Easy bruising
  • Fragile skin
  • Changes in the tube for urine flow (urethra)
  • Bleeding, blistering or open sores
  • Painful sex

What’s the treatment?

Lichen sclerosus
Credit: Canva

Lichen sclerosus cannot be cured, but prescription steroid cream can help to relieve the symptoms.

You may need to use the cream regularly for a few months to get your symptoms under control.

If your symptoms keep coming back, you may have to keep using it every now and again, just make sure to check in with your GP.

Other ways you can help relieve symptoms include:

  • Washing with an emollient soap substitute instead of regular soap – ask a doctor or pharmacist about suitable products
  • Regularly apply a barrier cream or ointment, such as petroleum jelly, to affected areas
  • Wear cotton or silk underwear
  • Use vaginal lubricant if sex is uncomfortable