Lichen Sclerosus

Lichen sclerosus is a chronic skin condition that predominantly affects the genital and anal areas, though it can appear elsewhere on the body. While it can affect anyone, it is most common in women, particularly post-menopausal women. The condition is not contagious or harmful to general health but can significantly impact quality of life due to its symptoms. Early diagnosis and management can help alleviate discomfort and prevent complications.

What is Lichen Sclerosus?

Lichen sclerosus is characterized 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.

What Are Common Symptoms of Lichen Sclerosus?

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 disturb sleep.
• A burning sensation: Many women experience pain, particularly during sex, or while going to the bathroom.
• 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.

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

What Causes Lichen Sclerosus?

The exact cause of lichen sclerosus remains unknown, but researchers believe an overactive immune system and hormonal shifts may play a role. While the immune system normally protects the body from infections and harmful substances, in lichen sclerosus, it could be mistakenly targeting healthy skin cells instead.

The condition is not linked to hygiene or infections, and cannot be spread through sexual contact or physical touch.

Is Lichen Sclerosus Most Common in Menopause?

Yes, lichen sclerosus is most frequently diagnosed in post-menopausal women. This is most likely linked to hormonal changes, and the decline in oestrogen levels, which can make skin more fragile and prone to irritation. 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 sensations should be looked at by a doctor as soon as possible. 

How Can Lichen Sclerosus Be Diagnosed?

It’s best to visit a GP or consultant gynaecoloigst 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, the 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. 

What Are the Best Ways to Treat Lichen Sclerosus?

Treatment for lichen sclerosus focuses on relieving symptoms, improving skin health, and preventing progression. This may include:

• Emollients: Gentle moisturizers 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, non-invasive laser therapies like MonaLisa Touch therapy and Platelet Rich Plasma therapy may improve tissue elasticity, hydration, and collagen production.

If you have lichen scleroeus, 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. 

Does Lichen Sclerosus Always Cause Discomfort?

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.

What Should You Do If You Notice Changes in Your Vulval Skin?

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 unfragranced or mild moisturisers on your skin to keep it hydrated.  
• Having regular check-ups if you’ve been diagnosed with the condition.

Make an Appointment at The Medical Chambers Kensington

Our women’s health GPs and consultant gynaecologists understand the symptoms of lichen sclerosus, and can offer you tailored advice and care to suit your needs. If you’d like to find out more, please call 020 7244 4200, or make an appointment online.