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 sclerosus is a skin condition that forms thin white patches of skin in varying areas of the body. While lichen sclerosus commonly targets the genitals and anus, the arms and upper body may also be affected. Postmenopausal women are often diagnosed with this condition. As lichen sclerosus develops, spots on the body morph into larger patches where the skin becomes thin, crinkled and extremely sensitive. Purple and red bruises in the affected areas are common. In addition, the patches of skin may become prone to tearing and scarring. Other symptoms include itching, discomfort, pain, blisters and bleeding. If you have lichen sclerosus of the genital skin, your health care provider may prescribe a cream or ointment for treatment to prevent itching. This treatment will decrease from daily use to 2-3 times a week to help prevent the condition from returning. These methods of treatment may come with negative side effects.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), long-term use can cause “thinning and redness of the skin, stretch marks where the cortisone cream is applied and genital yeast infections.” If you find that cortisone creams aren’t helping, have your health care provider check for low estrogen levels, infections or allergy to the medication. These conditions may prevent your symptoms from improving. Other methods of treatment include retinoids, tacrolimus ointment and ultraviolet light treatments (on areas other than the genitals). Since the areas affected by lichen sclerosus have higher skin cancer risks, it is important to follow-up with your health care provider every 6 to 12 months. Click here to learn more about lichen sclerosus.

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