Overview

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.

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Symptoms

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:

Smooth discolored skin patches
Blotchy, wrinkled skin patches
Itching
Soreness or a burning feeling
Easy bruising
Fragile skin
Changes in the tube for urine flow (urethra)
Bleeding, blistering or open sores
Painful sex

When to see a doctor

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.

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Causes

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.

Risk factors

Anyone can get lichen sclerosus, but the risk is higher for:

Postmenopausal women
Children younger than 10 years old
Women who have another autoimmune disease, such as forms of low thyroid function (hypothyroidism)
Men with urinary incontinence or an uncircumcised penis
People with a family history of the disease

Complications

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.

By Mayo Clinic Staff

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Diagnosis & treatment

Sept. 29, 2022

AskMayoExpert. Lichen sclerosus (balanitis xerotica obliterans). Mayo Clinic; 2021.
Lichen sclerosus. Merck Manual Professional Version. https://www.merckmanuals.com/professional/dermatologic-disorders/psoriasis-and-scaling-diseases/lichen-sclerosus. Accessed July 25, 2022.
Goldsmith LA, et al., eds. Morphea and lichen sclerosus. In: Fitzpatrick's Dermatology in General Medicine. 9th ed. McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. Accessed July 25, 2022.
Lewis FM, et al. British Association of Dermatologists guidelines for the management of lichen sclerosus, 2018. British Journal of Dermatology; doi:10.1111/bjd.16241.
Kelly AP, et al., eds. Genital lesions in women. In: Taylor and Kelly's Dermatology for Skin of Color. 2nd ed. McGraw Hill; 2016. https://accessmedicine.mhmedical.com. Accessed July 25, 2022.
Cooper SM, et al. Vulvar lichen sclerosus. https://www.uptodate.com/contents/search. Accessed March 4, 2021.
Sominidi Damodaran S (expert opinion). Mayo Clinic. Aug. 12, 2022.

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