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Skin Disorders and Treatment
Acrochordons
Acanthosis Nigricans
Actinic keratosis
Allergic Contact Dermatitis
Alopecia Areata
Anal Warts
Angioma
Amoebiasis
Aphthous Ulcer
Athlete's Foot
Atopic Dermatitis
Baldness
Blackheads
Blue Nevi
Browen's Disease
Bullous Pemphigoid
Candidiasis
Cavernous Hemangioma
Cellulite
Chilblains
Chapped Lips
Cracked Heels
Cysts
Dandruff
Dark Circles
Dermatitis Herpetiformis
Dermatitis
Dermatofibroma
Dry Lips
Dyshidrotic Eczema
Eczema
Enlarged Pores
Epidermolysis Bullosa
Erythroderma
Eye Stye
Facial Rashes
Fibroadenoma
Flexural Psoriasis
Fordyce's Condition
Folliculitis
Freckles
Furunculosis
Genital Herpes
Granuloma Annulare
Grovers Disease
Hand Dermatitis
Heat Rash
Herpes Simplex
Herpes Zooster
Hidradenitis Suppurativa
Hirsutism
Hot Tub Folliculitis
Ichthyosis
Impetigo
Ingrown Toe Nail
Intertrigo
Keloid
Keratoacanthoma
Keratosis Pilaris
Leucoderma
Lichen Planus
Lichen Sclerosus
Lichen Simplex Chronicus
Lichen Straitus
Liver Spots
Lupus Erythematosus
Lymes Disease
Lymphomatoid Papulosis
Mastocytosis
Melasma
Morton's Neuroma
Mucocutaneous Candidiasis
Necrobiosis Lipoidica Diabeticorum
Paget's Disease
Pemphigus Vulgaris
Pityriasis Versicolor
Pityriasis Rosea
Pruritis Ani
Shingles
Tinea Versicolor
Tinea Cruris
Venous Angioma
Vulvodynia
Xerosis
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Lichen Sclerosus
Lichen sclerosus (LIKE-in skler-O-sus) is a chronic inflammatory skin disorder that can affect men, women, or children, but is most common in women. It usually affects the vulva (the outer genitalia or sex organ) and the anal area. Lichen sclerosus (aka lichen sclerosis or lichen sclerosis et atrophicus) is a painful skin condition that typically affects the vulva (or penis) and anus. Lichen sclerosus is a condition in which the skin around the vulva has look like a crinkled or parchment. It occurs less commonly in extra-genital areas. It most often affects adult women in their age of 50 and 60. Any area of the skin can be affected but most commonly the anogenital area. LS are not contagious and cannot be transmitted by sexual intercourse. There is some speculation, as yet unproved, that LS may be genetic. In males, lichen sclerosus affects the foreskin and end of the penis. It is uncommon but can occur at any age, including young boys. Lichen sclerosus does not affect other mucous membranes and only 1 in 10 people have other areas of their skin develop lichen sclerosus. They can come up anywhere, but cause most trouble in the genital areas.
Symptoms of Lichen Sclerosus
- chronic itching and soreness of the vulval area and pain
- splitting of the vulval skin, causing stinging and pain
- inflammation and sometimes swelling
- splitting and bleeding of the skin around the anal opening when passing bowel motions, causing pain and discomfort
- the skin becomes fragile and pale and white in appearance and there is an increased susceptibility to infection and thrush
- "shrinking" (atrophy) of the vulva area, change in shape and size of the area, sometimes causing urination difficulties and sexual problems
- loss of vulval features, labia, clitoris
- pain and difficulties with sexual intercourse possibly leading to total sexual abstinence (enforced celibacy) for long periods of time
- narrowing of the vaginal opening
- fusion of the labia, clitoral hood and urethra
- blisters and ulceration (considered to be uncommon)
- LS does not extend into the vagina
- in men the foreskin becomes "fused" or tight making retraction of the foreskin painful and urination may become difficult
- there is a small risk, estimated at between 3% and 5%, of cancer of the vulva in adult women
- for men there may also be a small risk of penile cancer
Lichen Sclerosus Causes
There are a lot of theories about its cause, but none are proved. The most popular is that it is an 'autoimmune' condition, in which the body's own immune system mistakenly damages its own skin. They are more common in older women, and in women who have auto-immune illnesses such as thyroid problems or pernicious anemia. There also appears to be a link with other auto-immune conditions, for example thyroid disease. However, none of this is carved in stone.
Lichen Sclerosus Treatment
- Bland moisturisers help to soften and protect the skin.
- In men, tightening of the foreskin will often respond to steroid ointments. If not, a circumcision may be worth considering.
- The fragile skin of lichen sclerosus may be more susceptible than normal skin to infection with candida yeasts (thrush) or bacteria; and may split or even bleed. Your doctor will treat all of these problems on their merits.
- Wear loose fitting clothes and consider wearing thigh high hose instead of panty hose. Wear cotton underwear that "breathes."
- Do not use any soap on your vulva and wash no more than once a day with clear water only using your fingers instead of a wash cloth. Pat the area gently to dry
- Do not use any douches, perfumes, feminine hygiene sprays, commercial lubricants, or other substances on the vulva other than those prescribed or suggested.
- Use lubrication if needed with intercourse, most women with chronic vulvar symptoms do not find intercourse pleasurable and therefore do not lubricate naturally. Vegetable oil is a good lubricant to use because it has no alcohol or preservatives in it.
- The goals of treatment of LS are to relieve bothersome symptoms and to prevent the condition from worsening. A clinician may recommend medication for the physical symptoms, and may refer the patient for support and therapy for other issues associated with the condition, such as problems with sexual functioning.
- If you experience any long term burning sensations after using your treatment then do consult your healthcare professional as some people do experience reactions. In fact, if you have any queries at all or you are uncertain about the amount of cream to use or have any anxieties at all, do ask your consultant to see you again. Surgery is not a treatment for LS but is sometimes necessary to alleviate the effects of scarring, fusion and where the vaginal opening has narrowed. Read about steroids and emollients and other useful advice from NLSSG.
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Skin Treatments