Learn more about the causes, symptoms, complications, treatment and self-care tips for this blotchy skin condition that affects the genital and anal areas.
Lichen sclerosus (LIE-kun skluh-ROW-sus) is a condition that causes patchy, discolored, thin skin. It usually affects the genital and anal areas.
Anyone can get lichen sclerosus but postmenopausal women are at higher risk. It isn't contagious and can't be spread through sexual contact.
Treatment is usually a medicated ointment. This treatment helps return the skin to its usual color and reduces the risk of scarring. Even if your symptoms clear up, they tend to come back. So you'll likely need long-term follow-up care.
It's possible to have mild lichen sclerosus with no symptoms. When symptoms do occur, they usually affect the skin of the genital and anal areas. The back, shoulders, upper arms and breasts may also be affected. Symptoms may include:
See your health care provider if you have symptoms of lichen sclerosus.
If you've already been diagnosed with lichen sclerosus, see your health care provider every 6 to 12 months. These visits are important to check for any skin changes or side effects of treatment.
Lichen sclerosus is a skin condition characterized by discolored, blotchy patches of skin.
The exact cause of lichen sclerosus isn't known. It's likely a combination of factors, including an overactive immune system, your genetic makeup, and previous skin damage or irritation.
Lichen sclerosus isn't contagious and can't be spread through sexual contact.
Anyone can get lichen sclerosus, but the risk is higher for:
Complications of lichen sclerosus include painful sex and scarring, including covering of the clitoris. Scarring of the penis can cause painful erection, poor urine flow and an inability to retract the foreskin.
People with vulvar lichen sclerosus are also at an increased risk of squamous cell carcinoma.
In children, constipation is a common complication.
Your health care provider may diagnose lichen sclerosus by looking at the affected skin. You may need a biopsy to rule out cancer. You may need a biopsy if your skin doesn't respond to steroid creams. A biopsy involves removing a small piece of affected tissue for examination under a microscope.
You may be referred to specialists in skin conditions (dermatologist), the female reproductive system (gynecologist), urology and pain medicine.
With treatment, symptoms often improve or go away. Treatment for lichen sclerosus depends on how severe your symptoms are and where it is on your body. Treatment can help ease itching, improve how your skin looks and decrease the risk of scarring. Even with successful treatment, the symptoms often come back.
Steroid ointment clobetasol is commonly prescribed for lichen sclerosus. At first you'll need to apply the ointment to the affected skin twice a day. After several weeks, your health care provider will likely suggest that you use it only twice a week to prevent symptoms from returning.
Your health care provider will monitor you for side effects associated with prolonged use of topical corticosteroids, such as further thinning of the skin.
In addition, your health care provider may recommend a calcineurin inhibitor, such as tacrolimus ointment (Protopic).
Ask your health care provider how often you'll need to return for follow-up exams — likely once or twice a year. Long-term treatment is needed to control itching and irritation and prevent serious complications.
Your health care provider might recommend removing the penis foreskin (circumcision) if the opening for urine flow has been narrowed by lichen sclerosus.
These self-care tips may help ease skin irritation:
If you have symptoms of lichen sclerosus, make an appointment with your health care provider. You may be referred to a specialist in the diagnosis and treatment of skin conditions (dermatologist).
Here's some information to help you get ready for your appointment.
Before your appointment make a list of:
Some basic questions to ask your health care provider about possible lichen sclerosus include:
Your health care provider is likely to ask you questions, such as: