Lichen sclerosus specialist

Lichen sclerosus is a chronic skin condition that can affect both men and women, though it is more commonly seen in women, particularly in the vulvar region.

Lichen sclerosus is characterised by patches of thin, white skin that may feel fragile or appear wrinkled. In women, these changes often occur around the vulva, although other areas like the upper body and arms can be affected.

The condition is believed to be autoimmune, meaning the body's immune system mistakenly targets its own skin. However, hormonal changes, particularly reduced oestrogen levels during menopause, may also be a contributing factor.

If you’ve noticed any of these signs, a visit to our clinic to see one of our Consultant Gynaecologists can make a significant difference in getting the best treatment for your symptoms.

The severity of lichen sclerosus symptoms can vary widely. Some women experience mild symptoms, while others find the condition significantly disruptive to their everyday lives. 

Common signs that you could have the condition include:

• White, patchy skin: These areas may become more visible over time and feel different from surrounding skin.
• Itching and soreness: Persistent itching is a common symptom that can lead to daily discomfort and disturbed sleep.
• A burning sensation: It’s common to experience a burning feeling around the vulva, which is unpleasant, and sometimes constant.
• Skin changes: The affected areas may become thinner, more fragile, and more prone to tearing or bleeding.
• Red or inflamed skin: Shiny, red patches are often tender to the touch, and if they go untreated, can become more painful.
• Pain during sex: Due to your skin’s sensitivity, you might find sex painful, which can impact sensation, comfort and pleasure.

Even though these symptoms may suggest you have lichen sclerosus, only a doctor will be able to provide a proper diagnosis. 

If you notice any of the above symptoms, it is really important to visit a doctor with expertise in vulval conditions. Our Consultant Gynaecologists or women’s health GPs can assess your symptoms to ensure you get the treatment you need, as untreated lichen sclerosus can affect your wellbeing, and lead to scarring.

The exact cause of lichen sclerosus is not entirely known, but some research suggests that an overactive immune system may contribute to the condition, possibly reacting to the skin as if it’s a threat. Although this can sound worrying, it’s important to know that this response is not linked to hygiene, infection, or anything you’ve done wrong. Many skin conditions arise without a clear reason, and lichen sclerosus is one of these. The most important thing is that you get the help you need to manage the symptoms.

Yes, lichen sclerosus is most prevalent in women going through menopause. While it’s not fully understood why this is, many people believe hormonal changes play a role. 

During menopause, a decline in your oestrogen levels can lead to dryness and thinning of the skin, particularly around your vulva, making you more susceptible to issues like lichen sclerosus. Taking care of your overall wellbeing – including your vaginal and vulval health –  and monitoring any changes can prompt you to seek help if necessary, and can have a positive impact on how you feel. However, lichen sclerosus is not exclusive to menopause. It can affect women, men, and even children, though less commonly.

Monitoring your vulval health, especially during menopause, is essential. Any changes in skin texture, appearance, or sensation should be looked at by a doctor as soon as possible. 

It’s best to visit a GP or Consultant Gynaecologist with a good understanding of vulval conditions. Diagnosis typically involves:

• Medical history review: You’ll be asked about your symptoms, how long you’ve had them, and any previous skin conditions you might have had.
• Physical examination: Your doctor will then take a look at the affected areas, to confirm any diagnosis.  
• Biopsy (if needed): In rare cases, your doctor may need to take a small skin sample to later be examined under a microscope, if they are uncertain about what the condition is.

First and foremost, a gentle vulval care routine is essential, especially when you’re experiencing discomfort or inflammation. Treatment for lichen sclerosus focuses on relieving symptoms, improving skin health, and preventing progression. This may include:

• Emollients: Gentle moisturisers or soap substitutes can soothe irritated skin and prevent dryness.
• Topical steroids: These are the first-line treatment and help reduce inflammation, itching, and skin damage.
• Non-surgical treatments: For more severe cases, MonaLisa Touch therapy (a non-invasive laser therapy) may improve tissue elasticity, hydration, and collagen production.
• Sensitive hygiene: If you have lichen sclerosus, it’s important to avoid using harsh or scented soaps. If your vulval skin is inflamed or sore, you might want to wear loose clothing made of natural fabrics, to avoid making any discomfort worse. 

While topical treatments can relieve symptoms like dryness and itching, they may not address deeper skin changes associated with lichen sclerosus, particularly if you’re experiencing certain skin changes related to reduced oestrogen in the menopause.

Treatments such as the MonaLisa Touch laser can sometimes improve women’s symptoms, by aiming to boost hydration, elasticity, and blood flow in and around the vulva. We offer this non-invasive treatment at our London clinic, which, among other benefits, can help to stimulate collagen production and improve tissue health.

Many women have found that vaginal laser treatment reduces symptoms of itchiness, discomfort, and soreness, and can even make sex feel more comfortable and pleasurable. In essence, MonaLisa Touch may help you feel more like yourself by improving skin health and reducing uncomfortable symptoms.

No, not everyone with lichen sclerosus experiences significant discomfort. Some women may only notice mild skin changes, while others endure persistent itching, burning, or pain. Even if your symptoms seem minor, it’s important to seek medical advice, as untreated lichen sclerosus can lead to complications over time.

No, lichen sclerosus is not contagious and cannot be transmitted through sexual contact or physical touch. Plus, it’s not caused by your personal hygiene habits. While certain skin conditions can be caused by external factors, lichen sclerosus is believed to originate within the body, and is possibly linked to immune or hormonal changes. If you have any skin symptoms in and around your vulva that are causing you concern, visiting our specialists can help to identify the exact issue, and guide you towards the appropriate treatment.

If you’re aware of any unusual changes in the appearance, texture, or sensation of the skin on and around your vulva, it’s crucial to visit your doctor. There are many treatments that can help prevent the progression of lichen sclerosus, and improve any unpleasant symptoms.

Good vulval care includes:

• Avoiding perfumed products and soaps to avoid further irritation
• Using un-fragranced or mild moisturisers on your skin to keep it hydrated
• Having regular check-ups if you’ve been diagnosed with the condition