Lichen sclerosus

Overview

Lichen sclerosus (LIE-kun skluh-ROW-sus) is an uncommon condition that creates patchy, white skin that appears thinner than normal. It usually affects the genital and anal areas.

Anyone can get lichen sclerosus but postmenopausal women are at higher risk.

Your doctor can suggest treatment with creams or ointments that help return a more normal appearance to your skin and decrease the tendency for scarring. The condition does tend to recur, so long-term follow-up care may be needed. Rarely, lichen sclerosus improves without treatment.

Symptoms

People with mild lichen sclerosus may have no signs or symptoms.

Signs and symptoms usually affect the skin of the genital and anal areas, but may also affect the skin of the upper body, upper arms and breasts. They may include:

• Redness
• Itching (pruritus), which can be severe
• Discomfort or pain
• Smooth white patches on your skin
• Blotchy, wrinkled patches
• Tearing or bleeding
• In severe cases, bleeding, blistering or ulcerated sores
• Painful sex

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 cause of lichen sclerosus is unknown. 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, but they will still need monitoring for disease activity.

Risk factors

The risk of lichen sclerosus is higher for postmenopausal women, although it can occur in men and children. Men who are uncircumcised have a higher risk because the condition often affects the foreskin.

Complications

Complications of lichen sclerosus include painful sex, urinary retention, constipation and an inability to retract the foreskin. People with lichen sclerosus are also at an increased risk of squamous cell carcinoma of the affected area.