Lichen sclerosus (LS)

What is lichen sclerosus (LS)?

Lichen (LY-kin) sclerosus (skle-rou-sis) is a long-term skin condition. It can be on any part of the body. It is most often on the vulva and anal area.

The skin can look:

• White, shiny, and fragile
• White, thickened, and callous-like
• Irritated and red

All 3 forms can happen at the same time. It may also be found in more than one family member, especially mother daughter pairs.

It is not contagious. You cannot get it from or give it to others.

It is not a type of cancer.

It happens most often in women who have gone through menopause. It can happen at any age though, even children.

What causes lichen sclerosus?

The cause is still unknown. Many studies have been done to try to find the cause.

It may be caused by an autoimmune response. Antibodies are made by the body to fight infections. With lichen sclerosus, the antibodies attack your skin and tissue causing damage.

What are the signs of lichen sclerosus?

• Mild to severe itching
• Skin tears or ulcers caused by scratching
• Bruised skin with small broken blood vessels
• Flattened or absent inner lips of the vulva (labia minor)
• Narrowed opening of the vagina
• Clitoris becomes buried (covered with skin)

Signs can be different from woman to woman. They may get better then worse at different times of your life. It may be worse during hot summer months when you are sweating more. More moisture can irritate skin.

How is lichen sclerosus diagnosed?

• Your provider will look for skin changes of the vulva.
• A biopsy or small skin sample might be needed to confirm.

What is the treatment for lichen sclerosus?

It may be treated with:

• Follow the Vulvar Skin Care Guidelines.
• Steroid ointments, creams, or vaginal inserts
  • Put them on affected areas, as ordered.
  • These will help the soreness, burning, redness, and discharge.
  • Caution: Use only as prescribed by your provider. Overuse may cause thinning of the skin. This will make the problem worse rather than helping it.
• Combination medicine:
  • Put them on the vulva and anus.
  • This will help the redness, itching, and irritation.
  • Caution: Use only as prescribed by your provider. Overuse may cause thinning of the skin. This will make the problem worse rather than helping it.
• Tacrolimus (Protopic) ointment 0.1% or 0.3%:
  • Put it on the vulva and anus.
  • It helps the redness, itching, and irritation by calming the immune response.
  • Caution: Use only as prescribed by your provider. It may cause a slight burning sensation.

Can it be cured?

It tends to be a long-term condition.  Symptoms can often be kept under good control when treated.

Women with lichen sclerosus may have a higher risk of getting vulvar skin cancer. Have regular follow-up with your provider. Call your provider if you have any skin changes.

Mild scarring is normal. Severe scarring is rare. This can cause the opening of the vagina to be narrowed. This can often be prevented by protecting and treating the skin.

A biopsy or small skin sample may be taken to rule out other skin conditions if your symptoms do not get better after being treated.