All Health Topics

Lichen simplex chronicus (LSC)

Published May 5, 2020
• Reviewed by a UI Health Care Provider
on Aug. 19, 2026

What is LSC?

  • It is a skin condition caused by long-term irritation of the vulva.
  • It may cause:
    • Burning
    • Itching
    • Thickened skin
  • Many providers call it an "itch-scratch cycle." This happens when the vulvar skin gets sensitive and irritated. You may have this for weeks, months, or years.
  • You cannot get it from others. You cannot give it to others.

What are the signs and symptoms of LSC?

Signs and symptoms may be:

  • Mild to severe vulvar itching or burning or both
  • Pink to dusky red or purple looking skin
  • Swelling or thickened skin or both
  • Leathery texture to the skin
  • Tears in the skin caused by scratching
  • Raw or damp feeling or both
    • People tend to think vaginal discharge is the cause of the dampness. The dampness may come from the outer vulvar skin though. Long-term irritation to the outer vulvar skin can cause it to weep. This leads to a sticky white discharge in the inner labial folds called "smegma".

Moisture, itching, scrubbing, and the use of medicines may cause the skin to look different for each person.

What causes LSC?

It may be caused by many factors, such as contact irritants. When you have an irritation long enough that an "itch-scratch cycle" starts, lichen simplex may happen.

  1. Something rubs or irritates the skin.
  2. You start to scratch the itchy skin.
  3. Scratching, often during sleep, causes the skin to thicken.

What are contact irritants?

They are products that irritate the skin. This is not always an allergic reaction. The difference between an "allergen" and an "irritant" is:

  • Allergens are materials that cause 1 or more of these:
    • A general skin reaction, such as a rash, hives, or blisters
    • Itching after touching it only 1 or 2 times.
    • Trouble breathing
  • Irritants are materials that cause:
    • Burning or itching at the site where it touches the skin

These items may irritate vulvar skin:

  • Laundry detergents with enzymes, whiteners, brighteners, or fragrances
  • Fabric softeners and dryer sheets
  • Bath soaps, gels, and lotions
  • Bubble bath, oils, bath salts, or skin softeners
  • Feminine hygiene sprays, perfumes, or powders
  • Adult and baby wipes or towelettes
  • Deodorant tampons and pads
  • Douches or washes
  • Contraceptive creams, jellies, foams, and sponges
  • Condoms, prepackaged with lubricant or spermicide
  • Toilet paper that is ultra strong, ultra soft, colored, perfumed, or has Aloe
  • Synthetics, such as nylon underwear or panty hose

How is LSC diagnosed?

  • A provider will look for common skin changes of the vulva.
  • Vaginal discharge is tested to see if you have an infection.
  • A biopsy (small piece of skin) might be needed to diagnose LSC.

How is LSC treated?

The goal of treatment is to lessen itching and break the "itch-scratch cycle".

  • Always follow the Skin Care Guidelines you are given.
    • Keep the vulvar site clean and dry.
    • Even if you take away the irritant, you may get LSC if the "itch-scratch cycle" has started and you do not get treatment.
  • Use topical steroids.
    • Ointments are often better than creams.
    • Use a thin layer where you have discomfort.
    • This will help:
      • Burning
      • Itching
      • Redness
      • Swelling
    • Use only as ordered by your provider. Overuse may make it worse.
  • Do baking soda soaks.
  • Gold Bond® (baby power with 0.15% menthol) or Zeasorb® (anti-fungal powder with 2% miconazole nitrate) may be used on the vulva and groin if chronic dampness or moisture is a problem.
  • Medicines may be taken by mouth to help lessen itching.
  • Think about losing weight if you are overweight.

Your symptoms should slowly get better with treatment. If they do not get better, a follow-up visit and other treatment may be needed.