Lichen Sclerosus - Symptoms and Treatment

Lichen sclerosus is a skin disorder that can affect men, women, or children, but is most common in women. It usually occurs on the vulva (the outer genitalia or sex organ) in women, but sometimes develops on the head of the penis in men. Occasionally, lichen sclerosus is seen on other parts of the body, especially the upper body, breasts, and upper arms.

Causes of Lichen Sclerosus

The causes for the Lichen sclerosus are not definitely known. Sometimes it has been discovered that an overactive immune system triggers antigens that result in Lichen sclerosus. Some may have a genetic tendency towards this disease. Hormone levels which are abnormally high may also cause this. Skins which have already been scarred or damaged are susceptible to this disease. Lichen sclerosus however, is not contagious.

Symptoms of Lichen Sclerosus

The most common symptoms of lichen sclerosus includes :

• Thry mild to severe itching in the vulvar area
• The skin that appears fragile, pale, and/or white
• Bruised skin with broken blood vessels or "blood blisters"
• The small tears or fissures in the skin
• scar tissue covering the labia or clitoris
• Bleeding or tearing of skin when having bowel movements

Diagnosis of Lichen Sclerosus

Doctors can diagnose an advanced case by looking at the skin. However, early or mild disease often requires a biopsy (removal and examination of a small sample of affected skin). Because other diseases of the genitalia can look like lichen sclerosus, a biopsy is advised whenever the appearance of the skin is not typical of lichen sclerosus.

Treatment of Lichen Sclerosus

The most effective treatments for lichen sclerosus includes :

1. Do not use any soap on your vulva and wash no more than once a day with clear water only using your fingers instead of a wash cloth.  Pat the area gently to dry.
2. Do not use any douches, perfumes, feminine hygiene sprays, commercial lubricants, or other substances on the vulva other than those prescribed or suggested.
3. Wear loose fitting clothes and consider wearing thigh high hose instead of panty hose.
4. Wear cotton underwear that "breathes."
5. The circumcision is the most widely used therapy for lichen sclerosus. This procedure removes the affected skin, and the disease usually does not recur.
6. Xylocaine jelly will often help to numb the area before intercourse and make sexual activity more comfortable.  This should be applied liberally 15-20 minutes before intercourse.  This medication can also be used at other times when irritation or pain is at its worst.

Another treatment consists of testosterone ointment (3-4 times daily) for four weeks. Some women find that warm sitz baths can help lessen the itching.