Lichen sclerosus is an uncommon condition that creates patchy, white skin which is thinner than normal. It usually affects the genital and anal areas, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD). Sometimes, lichen sclerosus also appears on the upper body, breasts and upper arms.
Lichen sclerosus occurs most often in postmenopausal women, but it also occurs in men and children. In women, lichen sclerosus usually involves the vulva. In boys and men, uncircumcised males are most at risk.
The American Academy of Family Physicians (AAFP) wrote that doctors don’t know the exact cause of lichen sclerosus. It could be due to an overactive immune system, hormone problems, injury or a family history of lichen sclerosus.
Lichen sclerosus is not an infection. Reassurance was offered by DrexelMedicine.org that the condition is not contagious and cannot be passed on to a sexual partner.
Sometimes lichen sclerosus doesn’t have any symptoms. However, said NIAMSD, early in the disease, symptoms may include small white, shiny and smooth spots appearing on the skin. Later, the spots grow into bigger patches.
The patches become thin and crinkled and the fragile skin tears easily. Bright red or purple bruises are also common and the skin can become scarred.
AAFP listed other symptoms including itching, pain or discomfort in the affected area, painful urination, and pain during sex. If lichen sclerosus occurs in the anal area, painful bowel movements and constipation can result.
Women with severe genital lichen sclerosus may not be able to have sex, wrote NIAMSD. The disease can cause scars that narrow the vagina. Also, sex can hurt and cause the patches to bleed. Women with severe vaginal scarring may need surgery, but only after the condition is controlled with medication.
Patients with non-genital lichen sclerosus often don’t need treatment because it usually goes away over time.
Topical steroids are the most effective treatment for lichen sclerosus and help restore normal texture to genital tissue and prevent further inflammation and changes in the vulva.
As tissue returns to a more normal texture, steroid use may be decreased. However, it’s important to continue treatment as lichen sclerosus can recur. Treatment can prevent further changes in genital tissue, but any previous scarring isn’t reversible without surgery.
Persistent lichen sclerosus in one location may slightly increase the risk of skin cancer, although this has not yet been definitively proved, said Mayo Clinic.
Sources:
"About Vulvar Lichen Sclerosus | Drexel Vaginitis Center | Drexel Medicine, Philadelphia, PA." Drexel Medicine, Philadelphia, PA | Drexel Medicine, Philadelphia, PA. N.p., n.d. Web. 30 June 2013.
http://www.drexelmedicine.org/patient-services/obstetrics-and-gynecology/vaginitis-center/about-vulvar-lichen-sclerosus
Cornforth, Tracee. "Lichen Sclerosus FAQs - Lichen Sclerosis." Women's Health Issues - Women's Health Questions and Answers - Women's Sexual Health. N.p., n.d. Web. 30 June 2013.
http://womenshealth.about.com/cs/linchensclerosis/a/lichensclerosus.htm
"Fast Facts About Lichen Sclerosus." Arthritis, Musculoskeletal and Skin Diseases Home Page. N.p., n.d. Web. 30 June 2013.
http://www.niams.nih.gov/Health_Info/Lichen_Sclerosus
"Lichen Sclerosus | Overview." FamilyDoctor.org. American Academy of Family Physicians, n.d. Web. 30 June 2013.
http://familydoctor.org/familydoctor/en/diseases-conditions/lichen-sclerosus.html
"Lichen sclerosus - MayoClinic.com." Mayo Clinic. N.p., n.d. Web. 30 June 2013.
http://www.mayoclinic.com/health/lichen-sclerosus/DS00725
Reviewed July 11, 2013
by Michele Blacksberg RN
Edited by Jody Smith