Lichen simplex is a severe form of eczema that affects the vulva. It can also affect other areas of the body such as the anus, the legs and the nape of the neck. The condition is intensely itchy.
Unlike general eczema, where the rash is present at onset, the rash with lichen simplex only develops because the person has been scratching excessively and has damaged the skin.
What Causes the Itch?
Doctors don’t know what causes it but think that the central and peripheral nerves and inflammatory cells are altered so they perceive an abnormal sensation of itch in otherwise healthy tissue.
The mind-body connection also comes into it as emotional tension can induce the itchy sensation in some people.
Environmental causes are also to blame for some cases of lichen simplex and are thought to be a contact dermatitis type of reaction. For instance, there was a small study looking at a chemical called P-phenylenediamine (an ingredient of hair dye) found that patients lichen simplex symptoms improved after they discontinued use of the hair dye.
The condition isn’t dangerous but it should be treated because it can be emotionally distressing and interrupt sleep and therefore affects mental functioning and motor skills.
If the lichen simplex is in the vulvar area, it can also make sexual intercourse painful and difficult and lead to diminished quality of life.
• Emollient creams (to sooth sore skin and cleanse the area -- they can be used instead of soap).
• Topical steroid cream (to suppress the lichen simplex). It should only be used in tiny amounts as it can make the skin thinner, which could in the long term make the situation worse. A 30 g tube should last three months.
• Anti-itch creams
• Antihistamine medicine (to ease the itch).
• Lidocaine anaesthetic cream can also dim the itch.
If you suffer from any kind of genital eczema you should avoid using soaps, shampoo or bubble bath near the area. You should also use a non-biological washing powder for people with sensitive skin so that your clothes don’t end up irritating your skin.