Vaginal lichen planus

What is lichen planus?

Lichen planus is a skin condition which causes inflammation and ulcer-like changes of the skin. Lichen planus can occur on any part of the body including:

  • The vulva and vagina
  • The gums and lining of the mouth (oral lichen planus)
  • The skin–most often the skin of the arms, legs, and trunk of the body

Lichen planus of the vulva and vagina occurs more often in women of menopausal age but can be found in all age groups, including children.

What are the signs and symptoms of lichen planus of the vulva and vagina?

  • Increased vaginal discharge–usually sticky, heavy, and yellow
  • Redness, soreness, burning, and raw areas of the vulva and vagina
  • Bleeding and or pain with intercourse
  • Scarring which may cause shortening, narrowing, or closure of the vagina
  • Symptoms vary from woman to woman and may range from mild to severe

How is lichen planus diagnosed or identified?

Your doctor will look for skin changes commonly associated with lichen planus. Vaginal discharge is also examined. On occasion a biopsy or small sample of skin might be needed to help establish the diagnosis when the above findings are not clear.

What is the cause of lichen planus?

The exact cause of lichen planus is still unknown, but an autoimmune theory has been suggested. In this theory, antibodies are normally made by the body to fight infections. With lichen planus the antibodies attack normal skin and tissue causing damage.

It is believed that lichen planus cannot be passed from one person to another. For example, it cannot be passed during childbirth, through sexual intercourse, or by touching the skin of someone with lichen planus. A few studies suggest that it may be found in more than one family member.

What is the treatment for lichen planus?

Treatment may include any of the following:

Steroid ointments or creams

A thin layer of cream is applied to the vulva or inserted into the vagina to decrease soreness, burning, and redness.

Caution: Use only as prescribed by your doctor. Overuse may result in thinning of the skin which will make your problem worse rather than helping it.

Following the guidelines for vulvar skin care to avoid anything that may irritate your skin.

Calcineurin inhibitors

A thin layer of cream is applied to the vulva or inserted into the vagina to decrease soreness, burning, and redness.

Other immune modulators

These are used in consultation with dermatology and internal medicine providers.

Intercourse as desired or use of vaginal dilators

Your doctor or nurse will instruct you on the correct use of dilators, if you choose to use this method. It prevents a decrease in length or depth of the vagina due to scarring by gently stretching the skin.

Lichen planus tends to be a long term condition, but symptoms can usually be kept under control with treatment and regular follow up.

Oral lichen planus

About half of the women with vulvar/vaginal lichen planus may also have oral lichen planus.

Signs of oral lichen planus include sores and small scars in the mouth or on the gums.

Treatment includes the use of steroid medication in the form of lozenges.

Last reviewed: 
June 2018

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