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Weekly Column -What kind of disorder is lichen sclerosus? Is it rare and can it become cancerous?

Lichen sclerosus is a chronic skin disorder that mainly affects postmenopausal women, although premenopausal women and men can still experience the condition. It causes irritated skin around external genitalia such as the vulva, usually in the form of white patches where the skin becomes thin, wrinkled, and extremely sensitive. Women experiencing lichen sclerosus often experience flare-ups or attacks that consist of intense itching. Although lichen sclerosus is not contagious and cannot be transmitted sexually, minor abrasions and chaffing may lead to bleeding, tearing, and blistering of affected areas.

The condition is often confused with fibromyalgia, which is characterized by widespread musculoskeletal pain, and scleroderma, which is a chronic connective tissue disease. There are some common symptoms between these conditions, such as muscle pain, fatigue, and mild flu-like symptoms. While some research suggests it could be tied to genetics, most researchers believe lichen sclerosus is a disorder of the immunological system. Currently, understanding of the causes of this disorder is still in development and is is considered rare.

Treatment for lichen sclerosus usually involves ointments or creams that can alleviate itching. The most commonly prescribed creams for lichen sclerosus are corticosteroids, which are used to provide relief for inflamed areas of the body. Other treatments include immune-modulating medications and ultraviolet light therapy, although the latter is only recommended for non-genital areas. The NIH recommends seeing a doctor every 6 to 12 months for lichen sclerosus, in order to evaluate the condition and determine the best treatment.

In some cases, lichen sclerosus can lead to cancer, but only 4% of women with the condition have been reported to develop vulvar cancer. This can take many years, so it is believed that with proper treatment and frequent visits to a doctor, cancer can be avoided. Some cases of lichen sclerosus improve on their own, but in more severe cases, doctors may recommend surgical removal of the affected skin layers. This is more common for patients with penises, as patients with vulvas can redevelop the condition after surgery. Many of these treatments, such as ultraviolet light therapy and corticosteroid ointments, are sometimes used in combination with one another.

Research regarding lichen sclerosus is still incomplete, so in order to get proper treatment, you should seek doctors or specialists who can recommend the best option for you. Check out the Association for Lichen Sclerosus and Vulval Health’s website for more information on how to find a doctor specializing in the condition.


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