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What Is Lichen Sclerosus? 

Lichen sclerosus is a chronic inflammatory skin condition that typically presents as itchy white patches. While it can affect any part of the body — the torso and upper arms, for instance — the genitals are the most frequently stuck part in women, concretely the vulva and the skin immediately surrounding the anus.

Symptoms of lichen sclerosus include:

  • Initially, you can expect small, white, shiny, and smooth, patches of skin
  • These patches will gradually increase in size and perhaps join together, after which the skin also becomes thin and wrinkly. The patches may become raised in appearance. At this point, blood bruises and small skin tears become frequent, and you may also notice scarring. Blisters can occur too.
  • Itching is another very frequently seen symptom of lichen sclerosus in the genital region.

Note that, although lichen sclerosus may look frightening to anyone who hasn't seen it before, it's not a sexually transmitted disease nor contagious in any way. Women with lichen sclerosus may experience discomfort during sex because of the condition, but there is no other reason to avoid sex — you cannot pass the condition onto your partner.

Lichen Sclerosus: Causes And Risk Factors

It is not yet clear what causes this inflammatory skin condition.

Though some people who have relatives with lichen sclerosus will develop the condition themselves, the hereditary component of the condition has not been well-established. Lichen sclerosus is thought to be an autoimmune disease, and hormonal factors are also believed to play a role in its development — postmenopausal women are the most commonly affected. People with other autoimmune conditions may be at a higher risk of developing lichen sclerosus, and injuries can trigger the condition as well. 

My Symptoms Look Like Those You've Described: Do I Have Lichen Sclerosus?

Anyone with significant and unexplained skin changes, whether in the genital region or anyone else, should see a doctor for proper diagnosis. A dermatologist, OBGYN, or primary care provider will all serve you well. If you do have lichen sclerosus, your doctor will usually be able to tell right away, just by looking. A biopsy will, however, usually be taken to confirm the diagnosis. 

How Can Lichen Sclerosus Be Managed?

Since lichen sclerosus is a chronic condition, it cannot be cured. It can, however, be managed in several ways. While not all manifestations of lichen sclerosus need treatment, those affected by lichen sclerosus of the genital area do require care. The management of lichen sclerosus can be divided into two broad categories, namely self-care and medical care. 

Your doctor may prescribe or recommend:

  • Steroid creams. These reduce your symptoms.
  • Surgery. In some cases, lichen sclerosus creates uncomfortable adhesions that require surgical excision. 
  • Women with genital lichen sclerosus may be more prone to developing genital yeast infections, which will also need to be treated.
  • Your doctor may suggest the use of dehydrating creams that will soften the skin. 

Lichen sclerosus does, very occasionally, develop into skin cancer. More frequent medical checkups are in order. 

In terms of self-care, you can keep a close eye on any changes that may occur to your skin and moisturize the affected areas with the cream your doctor recommends. Try to minimize your genital skin's contact with urine and feces, which can aggravate symptoms, and avoid using harsh soaps on the area. Most of all, be an active patient — ask any questions you have and report all new symptoms and concerns to your healthcare provider. 

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