Rashes that appear on most places of the body can be discussed openly with friends and family. Rashes that are present on the genital and anal area are more difficult to talk about. Lichen sclerosus is a rare condition where thin, white-porcelain patches appear on genital skin that can be severely itchy, cause tenderness or pain and may bruise or tear easily.
Lichen sclerosus most commonly occurs to post-menopausal women over the age of 50 but it can also appear in men and children. Typically, the white patches are in the genital area and can cause restriction of the skin. In women, there may be reduction of the size of the opening of the vagina. Tightening of clitoral hood skin may lead to pain with intercourse or intolerance to pressure of any kind on the sensitive areas.
Males who are uncircumcised are the most at risk of developing lichen sclerosus since it appears principally on the foreskin. In men, the tightening and thinning of the foreskin during an erection may interfere with intercourse or prevent urination.
No one knows the cause of lichen sclerosus. It is thought it could be some type of immune response or possibly come from exposure to a spirochete. While it most frequently appears on genital skin areas, lichen sclerosus patches may arise on skin in other parts of the body.
How lichen sclerosus is treated:
A dermatologist will evaluate the skin area and determine if a biopsy is needed. Gynecologists usually treat lichen sclerorus when it appears in a woman’s genital area. In males, a urologist should be consulted. If the lichen sclerosus is not on the genital area, the patch may just be monitored to see if it goes away on its own.
Otherwise, potent corticosteroid creams are the most common first treatment. The creams will need to be rubbed over the area daily for several weeks and continued even after the lichen sclerosus improves to keep it controlled.
In men, circumcision surgery may relieve the pain from tightened foreskin during an erection or while urinating. Women do not usually undergo vaginal surgery unless a malignancy is found or severe scarring occurs.