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Definition

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.  Patients who have untreated disease have a slightly increased risk of a skin cancer of the involved areas.

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.

Symptoms

The symptoms are the same in children and adults. Early in the disease, small, subtle white spots appear. These areas are usually slightly shiny and smooth. When lichen sclerosus occurs on parts of the body other than the genital area, most often there are no symptoms, other than itching. If the disease is severe, bleeding, tearing, and blistering caused by rubbing or bumping the skin can cause pain. When lichen sclerosus develops around the anus, the discomfort can lead to constipation. This is particularly common in children.

Treatment

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.

Use an emollient (moisturizer) cream such as aqueous cream or similar instead of soap to clean the genital area. This is also soothing.

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