Lichen planus is a skin infection that can appear both on the skin and inside the mouth. Lichen planus can also develop inside the vagina causing an itching, burning, red rash that interferes with intercourse because of pain or scarring. It is thought that lichen planus is caused by an autoimmune inflammatory response, meaning that the body is reacting against itself for some unknown reason. While there is no specific cure for lichen planus, symptoms can be controlled with treatment.
Lichen planus occurs in women between the ages of 30 to 60 years old. It affects one percent of all women, typically inside their mouth. Between 25 to 50 percent of those with oral lichen planus develop it vaginally. Lichen planus is not a contagious disease so cannot be passed person to person. It has been found that people with hepatitis C have an increased incidence of lichen planus so a doctor should check to see if a person tests positive for this disease.
Symptoms of vaginal lichen planus:
Vaginally, lichen planus can cause an increased discharge that is thick and yellow. Whitish patches and sensitive reddened skin that is itchy, burning and painful appear either inside the inner labia or around the vulvar area. Sometimes the vaginal tissue may adhere to other tissue and scarring can occur along with narrowing of the opening or depth of the vagina.
Lichen planus may be mistaken for lichen sclerosus, another type of vaginal rash. See my article at www.empowher.com/skin-rash/content/lichen-sclerosus-genital- skin-rash because it is important to be evaluated by a dermatologist or gynecologist with experience in vulvo-vaginal diseases if uncertain. Additionally, lichenoid appearing skin reactions may occur from the use of certain medications such as beta-blockers, certain antibiotics and NSAIDs, which can look like lichen planus but are not.
How it is treated:
Lichen planus is first treated with intravaginal steroid ointment, cream or suppositories. Steroid medication should only be used as directed by the doctor to avoid the risk of thinning the vaginal tissue from over use. A vaginal dilator may be recommended if symptoms of scarring and narrowing appear in order to maintain the elasticity of the vaginal tissue. Another topical cream that has been used with some success is an eczema medication called Tacrolimus but its use should be closely monitored. If topical medications do not improve lichen planus, then oral steroids may be tried.
Lichen planus can be a chronic problem where symptoms improve then reoccur. A lifestyle adjustment to having pain that interferes with one’s sexuality can be difficult. Women with lichen planus and lichen sclerosus may find support from online groups such as http://lichensclerosus.net who also have a yahoo group. The National Vulvodynia Association at www.nva.org may also be a helpful resource.
sources:
www.uihealthcare.com/depts/med/obgyn/patedu/vulvarvaginaldisease/lichenplanus.html
www.aad.org/skin-conditions/dermatology-a-to-z/lichen-planus
Vulvar Lichen Planus by Andrew T. Goldstein, MD and Arielle Metz, MD at
http://o.b5z.net/i/u/10023334/i/vulvar_lichen_planus_-_Goldstein__Metz.pdf
Michele is an R.N. freelance writer with a special interest in woman’s health care and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles