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.