Tell Me More About Lichen Sclerosus

Question:

My doctor diagnosed me with lichen sclerosus based on my symptoms, as I chose not to have a biopsy. She is treating me with steroid cream. What should I know about this condition and its treatment?

Answer:

Lichen sclerosis (LS) is a skin condition that causes patchy, discolored, thin skin in different body areas [1]. While LS commonly targets the genitals and anus, the arms and upper body may also be affected [1].

While anyone can get LS, postmenopausal women are at a higher risk [1]. As LS develops, spots on the body morph into larger patches where the skin becomes thin, crinkled, and extremely sensitive. In addition, the patches of skin may become prone to tearing and scarring from the thinning of the skin.

Symptoms can include [1]:

  • Smooth, light-colored patches of skin
  • Itching
  • Soreness or a burning feeling
  • Easy bruising
  • Fragile skin
  • Bleeding, blistering, or open sores
  • Painful sex

The gold standard treatment for LS is a topical steroid cream to apply to the affected skin [2]. The typical dosage is to apply the cream once a day for the first month, alternate days the second month, and then twice weekly in the third month for women [2]. UV light treatments (phototherapy) can treat LS, but only after steroid creams have failed to help, especially since phototherapy is known to increase the risk of skin cancer [2]. LS may increase the risk of cancer in the genital areas as well, so phototherapy is not always the best treatment option. If you have widespread LS or are not responding to topical creams, your doctor may recommend oral steroids or other medications, but only if all other options have failed [2]. If LS has led to scarring that restricts areas in the genitals, like the urethra, surgery may be indicated to remove the affected skin and improve quality of life [2].

In addition to steroid creams, there are other remedies you can try at home [1]:

  • Use petroleum jelly, like Aquaphor, on the areas bothering you
  • Use mild, unscented soaps
  • Don't soak in the bath for long periods
  • Take an oral antihistamine before bed, like Benedryl, to control itch at night
  • Keep your clothing loose so it does not rub the area
  • Try using an unscented detergent, especially clothes that will touch the area, like underwear

While treatment with steroid creams may help reduce itching and prevent scarring, symptoms usually come back, and there is a risk of developing cancer, so you should follow up with your doctor one to two times a year [1].

Sources

[2] De Luca, D. A., Papara, C., Vorobyev, A., Staiger, H., Bieber, K., Thaçi, D., & Ludwig, R. J. (2023). Lichen sclerosus: The 2023 update. Frontiers in medicine10, 1106318. https://doi.org/10.3389/fmed.2023.1106318

[1] Mayo Clinic (2022, September 29).  Lichen sclerosus. Retrieved from https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/symptoms-causes/syc-20374448


The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only.


The continued availability of external resources is outside of the NWHN’s control. If the link you are looking for is broken, contact us at [email protected] to request more current citation information.