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Lichen Sclerosus
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Lichen Sclerosus

Gynecologic Health * Obstetrics and Gynecology * Pelvic Organ Prolapse * Vaginal Relaxation * Vulvar Cancer

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What Is Lichen Sclerosus?

A woman may not experience anymore excruciating pain, suffering and embarrassment than that caused by a disease called "Lichen Sclerosus."

Lichen Sclerosus (LIKE-in skler-O-sus) or "LS," is a chronic inflammatory skin disorder that is most common in women, but can affect men as well.

Lichen Sclerosus usually affects the vulva, including the labia majora, labia minora, clitoris (clitoral glans), clitoral hood, vagina/vaginal introitus, the vestibule (also referred to as the vulval vestibule, vulvar vestibule, vaginal vestibule and vestibule of the vagina, which is the area in between the labia minora where the urethral opening and vaginal opening are located) and the anal area.

When LS affects the vagina (within the vulva) or vaginal mucosa, which is the lining of the vagina, it is no longer known as Lichen Sclerosus, but Lichen Planus "LP."

Lichen Sclerosus appears predominantly in postmenopausal women. Occasionally, Lichen Sclerosus is seen on other parts of the body, especially the upper body, breasts, and upper arms.

The symptoms are the same in children and adults. Early in the disease, small, subtle white spots appear. These areas are usually slightly shiny and smooth. As time goes on, the spots develop into bigger patches, and the skin surface becomes thinned and crinkled. As a result, the skin tears easily, and bright red or purple discoloration from bleeding inside the skin is common.

More severe cases of Lichen Sclerosus produce scarring in the vulvovaginal area which may cause the inner lips of the vulva to shrink and disappear and the clitoris could become covered with scar tissue. In addition, the opening to the vagina (vaginal introitus) may narrow significantly making intercourse painful, if not impossible. Urination is also very painful.

Lichen Sclerosus is not only a painful disease and serious health concern,
left untreated, it could lead to Vulvar Cancer.

While research is being done at present, the cause of Lichen Sclerosus is still not understood. Some medical researchers and physicians believe that an overactive immune system may play a significant role while others believe some women may have a genetic trait. Other areas of medical research concerning Lichen Sclerosus include abnormal hormone levels as well as an infectious bacterium called a "spirochete" may trigger the changes in the immune system that causes Lichen Sclerosus.

Unfortunately, at the present time, Lichen Sclerosus is not curable, but can be managed to significantly reduce the pain and most of the symptoms.

Although definitive data are not available, Lichen Sclerosus is considered a rare disorder that can develop in people of all ages. It usually appears in postmenopausal women and primarily affects the vulva. It is uncommon for women who have Lichen Sclerosus of the vulva or have the disease on other skin surfaces. The disease is much less common in childhood.

Lichen Sclerosus is very rare in men.

What Are the Symptoms of Lichen Sclerosus?

Symptoms vary depending on the area affected. Patients experience different degrees of discomfort. When Lichen Sclerosus occurs on parts of the body other than the genital area, most often there are no symptoms, other than itching. If the disease is severe, bleeding, tearing, and blistering caused by rubbing or bumping the skin can cause pain.

Very mild Lichen Sclerosus of the vulvovaginal area often causes no symptoms at all. If the disease worsens, itching is the most common symptom. Rarely, Lichen Sclerosus of the vulva may cause extreme itching that interferes with sleep and daily activities. Rubbing or scratching to relieve the itching can create painful sores and bruising, so that many women must avoid sexual intercourse, tight clothing, tampons, riding bicycles, and other common activities that involve pressure or friction. Urination can be accompanied by burning or pain, and bleeding can occur, especially during intercourse. When Lichen Sclerosus develops around the anus, the discomfort can lead to constipation that is difficult to relieve.

This is particularly common in children. It is important to note that the signs of Lichen Sclerosus in children may sometimes be confused with those of sexual abuse.

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