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Lichen Planus and Lichen Schlerosus: two similar-sounding medical conditions that are actually quite different. Here, we look at these two intimate conditions, and find out what makes them similar, what sets them apart, and what can be done.

Lichen Planus and Lichen Schlerosus are both skin conditions that affect the vulval area. The vulva is a woman's external genital organs (including her mons pubis, labia majora, labia minora, clitoris and vaginal opening). Lichen Planus and Lichen Schlerosus can also affect men and the penis, although this seems to be less common.

Is it cancer?

Lichen Planus and Lichen Schlerosus are not cancer. However both may develop into a type of skin cancer called squamous cell cancer over a period of many years.

This is not certain to occur.

However, if it does happen, note that squamous cell cancer is the second most common cancer and can often be treated. It is most-often slow-growing and rarely spreads.

However, it is still cancer.

If you have Lichen Planus or Lichen Schlerosus, you should be checked every six months by a doctor for signs of change.

Is it an STI?

No. There is absolutely no connection between sex and Lichen Planus or Lichen Schlerosus.

Nuns can get Lichen Planus and Lichen Schlerosus. Virgins can get it.

Furthermore, it's not contagious, so merely being diagnosed with Lichen Planus or Lichen Schlerosus ought not prevent you enjoying a full and active sex life. However, the itchy, fragile skin around the vulva can make sex uncomfortable. The conditions can also cause vulval pain, which may make you disinclined to have sex.

One study found that women with Lichen Schlerosus were unlikely to be sexually active.

Do what feels right for you.

 So, what does cause Lichen Schlerosus and Lichen Planus?

It's thought that an autoimmune response may be partly to blame. Women who have a thyroid disorder, diabetes, or pernicious anaemia are more likely to experience Lichen Schlerosus or Lichen Planus.

It can also run in families (with mothers-and-daughters, and groups of sisters, reportedly affected), so it's thought that there may be an inherited factor involved.

Symptoms: Lichen Planus

Lichen Planus affects the skin of the vulva, but may affect the mouth, anus and (rarely) the oesophagus (a.k.a. the gullet; the tube that passes food from your mouth to your stomach).

Lichen Planus is hardly ever found in children or adolescents. It is most common in women of middle-age and older.

In Lichen Planus:

  • There is a red rash with patches of grey
  • Open ulcers may occur in all these areas (including inside the vagina and mouth)
  • There may be rawness inside the vagina
  • Sex will usually be extremely painful
  • The mouth will usually be affected, making eating extremely painful

If Lichen Planus is not diagnosed promptly, scarring can occur. This means your vaginal lips will shrink, your vagina will fuse together, and your clitoris will vanish.

Symptoms: Lichen Schlerosus

Lichen Schlerosus only affects your vagina. However, unlike Lichen Planus, which mainly affects women of middle-age and older, Lichen Schlerosus affects all ages, including young children.

It looks completely different to Lichen Planus:

  • In Lichen Schlerosus, the skin is patched with white
  • It may look like a "figure of eight" encircling your vulva and anus, but can occur anywhere on your genitals
  • Over time, scar tissue can collect around the vagina, making sex painful.
  • If unmanaged for a long time, the labia minora will shrink, the vaginal opening will reduce and the clitoris will become smaller.
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