What is lichen sclerosus?

Lichen sclerosus (LS) is a long-term chronic skin condition that causes the outer layer of the skin to become thin, white, and wrinkly. This layer is known as the epidermis, and the skin layer beneath it is called the dermis, which contains blood vessels, hair roots, nerve endings, and sweat glands. LS can cause the epidermis to become thin which may allow inflammatory cells to invade the dermis, causing pain, swelling, and broken blood vessels.

Lichen sclerosus can affect any part of the body, such as the neck, shoulders, breast, or thighs. However, this condition far more commonly affects the outer parts of the genital and anal areas of both men and women. Although LS is often found in women over the age of 50, it can also happen in younger women, as well as in men and children.

Experts are still unsure what actually causes the condition, but research has shown that possible factors include immune system problems, and hormonal imbalances – particularly lower estrogen levels.

Some common symptoms of lichen sclerosus

One of the main symptoms is the appearance of skin changes in affected areas. You may notice small white places which grow into larger, thin and wrinkled patches. These patches will go from the outer part of the vagina, all the way to the anus. For men, this will include the penis and general genital area, spreading to the anus.

Symptoms might include:

  • Vulva itching is very common among women
  • Anal itching, or bleeding
  • Pain during sex
  • Blisters in the genital area
  • Pain or trouble urinating
  • Men may suffer painful erections

LS does not affect the inner organs such as the vagina or uterus, and cannot be transmitted via sexual intercourse.

Treatment options

A medical practitioner, or a dermatologist, would be the best to help with medical intervention. Treatment may begin with a steroid ointment and move on to steroid injections if it doesn’t help. Patches on the body will be treated first, which may also include using ultraviolet light treatment. Fortunately, body patches may even disappear on their own.

Treatment in the genital and anal areas is more difficult, but without treatment, it very seldom gets better. Steroid ointments are also used, but if used for a long period, can lead to an unpleasant yeast infection in those areas.

Ways that you can help yourself reduce some of the symptoms of lichen sclerosus:

  • Do not scratch or irritate the area.
  • Wear cotton underwear instead of synthetic items.
  • Avoid wearing tight pants or skirts, as well as tight-fitting underwear.
  • Try not to use scented soaps or bubble baths. These products sometimes have allergens that can cause irritation.
  • Never use feminine sprays or douches.

Remember that the key to success is to practice good hygiene, and opt for natural products when purchasing personal items.

Possible complications of LS

  • Men who have LS on the penis may suffer scarring and shrinkage of the foreskin. This results in difficulty pulling back the foreskin and can cause pain during sex for both men and women. If it becomes chronic, the only way to get relief is to undergo circumcision.
  • Women who have LS on the vulva have a raised risk of developing squamous cell skin cancer, which is cancer in the cells which make up the middle and outer layers of the skin. Men who have LS on the penis, are also at risk.

Fortunately, this type of cancer is not usually life-threatening, but if not treated can spread to other parts of the body and cause major problems. This means that lichen sclerosus sufferers must constantly check the genital areas for suspicious sores or blisters which will not heal.

Most people will need long-term treatment and care to manage and reduce LS symptoms.

Studies have shown that the skin patches on the other parts of the body do not have any skin cancer risks.

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