Overview

Lichen sclerosus (LIE-kun skluh-ROW-sus) is an uncommon condition that creates patchy, white skin that's thinner than normal. Lichen sclerosus can affect skin anywhere on your body. But it most often involves skin of the vulva, foreskin of the penis or skin around the anus.

Anyone can get lichen sclerosus but postmenopausal women have a high risk.

Sometimes lichen sclerosus improves on its own, and you won't need any treatment. If you do need treatment, your doctor can suggest options to return a more normal appearance to your skin and decrease the tendency for scarring.

Symptoms

Sometimes, mild cases of lichen sclerosus cause no noticeable signs or symptoms.

When they do occur, lichen sclerosus symptoms may include:

  • Itching (pruritus), which can be severe
  • Discomfort or pain
  • Smooth white spots on your skin
  • Blotchy, wrinkled patches
  • Easy bruising or tearing
  • In severe cases, bleeding, blistering or ulcerated lesions
  • Painful intercourse

When to see a doctor

See your doctor if you have signs and symptoms common to lichen sclerosus.

If you've already been diagnosed with lichen sclerosus, see your doctor every six to 12 months to be checked for any skin changes or treatment side effects.

Causes

The exact cause of lichen sclerosus isn't known. An overactive immune system or an imbalance of hormones may play a role. Previous skin damage at a particular site on your skin may increase the likelihood of lichen sclerosus at that location.

Lichen sclerosus isn't contagious and cannot be spread through sexual intercourse.

Lichen sclerosus often occurs in postmenopausal women, but also in men and children. In women, lichen sclerosus usually involves the vulva. In boys and men, uncircumcised males are most at risk, because the condition generally affects the foreskin.

In children, the signs and symptoms may improve at puberty.

Complications

Skin cancer may rarely develop in areas affected by lichen sclerosus, though lichen sclerosus doesn't cause skin cancer. Women with lichen sclerosus on the vulva are more likely to develop vulvar cancer. But consistent treatment with topical corticosteroids may reduce this slightly higher risk.

Severe lichen sclerosus can make sex extremely painful for women because itching and scarring may narrow the vaginal opening and affect the ability or desire to have sexual intercourse. In addition, blistering may create extremely sensitive skin to the point that any pressure on the area is unbearable.

Lichen sclerosus may rarely cause tightening and thinning of the foreskin in uncircumcised men. This can cause problems during an erection or when urinating.

Sept. 03, 2015
References
  1. Ferri FF. Lichen sclerosus. In: Ferri's Clinical Advisor 2016. Philadelphia, Pa.: Mosby Elsevier; 2016. https://www.clinicalkey.com. Accessed Aug. 12, 2015.
  2. Fistarol SK, et al. Diagnosis and treatment of lichen sclerosus. American Journal of Clinical Dermatology. 2013;14:27.
  3. What is lichen sclerosus? National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/health_info/Lichen_Sclerosus/default.asp. Accessed Aug. 12, 2015.
  4. Schlosser BJ, et al. Lichen sclerosus and lichen planus in women and girls. Clinical Obstetrics and Gynecology. 2015;58:125.
  5. Ofori AO, et al. What's new in dermatology? http://www.uptodate.com/home. Accessed Aug. 6, 2015.
  6. Murphy R. Lichen sclerosus. Dermatology Clinics. 2010;28:707.
  7. Chi CC, et al. Topical interventions for genital lichen sclerosus. Cochrane Database Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008240.pub2/abstract. Accessed Aug. 7, 2015.
  8. Funaro D, et al. A double-blind, randomized prospective study evaluating topical clobetasol propionate 0.05% versus topical tacrolimus 0.1% in patients with vulvar lichen sclerosus. Journal of the American Academy of Dermatology. 2014;71:84.