Lichen sclerosus et atrophicus, also known as just lichen sclerosus, is a
chronic inflammatory skin disorder that affects the genital and perianal skin. Lichen sclerosus is most often diagnosed in women over the age of 50, but pre-pubertal children can also be affected. Lichen sclerosus is 10 times more common in women than in men, and there is a higher likelihood of developing the disorder if there is a family history of lichen sclerosus, autoimmune disease, pernicious anemia, or alopecia areata.
Vulval lichen sclerosus Lichen sclerosus is primarily on the non-hair bearing, inner areas of the vulva and is either localized to a small area or extensively involves to surrounding skin. Lichen sclerosus can be very itchy and sore and cause adhesions and scarring.
Penile lichen sclerosis In males, lichen sclerosis generally presents on the tip of the penis, which becomes white, firm, and scarred.
Extragential lichen sclerosis Extragential lichen sclerosis is when the condition affects other sites and presents as one or more white, dry plaques.
What causes lichen sclerosus?
The cause of this condition is not fully understood but includes genetic, hormonal, irritant, traumatic, and infectious components. Lichen sclerosus is considered an autoimmune disease. Autoimmune diseases are often associated with antibodies to a specific protein.
What are the complications?
- Infections: Commonly herpes simplex, fungal infections, or “staph” infections.
- Squamous cell carcinoma: Patients with lichen sclerosus in anogenital sites have an increased risk of vulvas, penile, or anal squamous cell carcinoma.
What is the treatment?
- Topical medications: Steroid ointments are the first line of treatment and can be prescribed to control symptoms related to lichen sclerosus. Intravaginal oestrogen creams or topical calcineurin inhibitor ointments and creams can also be prescribed treat lichen sclerosus.
- Oral medications: In severe cases, oral steroids or retinoids can be prescribed as treatment.
- Gentle skin care:
- Wash the area gently once or twice a day
- Use a non-soap cleanser
- Avoid tight clothing, rubbing, and scratching
If you are noticing symptoms of lichen sclerosus et atrophicus, our dermatologists can work with you to develop a customized treatment plan to improve your quality of life.
