Lichen Sclerosis
Lichen sclerosis (LS) is an inflammatory skin disorder that most often affects the skin of the vulva and around the anus.
It can occur at any age but is most common after the menopause. We do not understand why some people get the condition. It is not an infection and you cannot pass the condition on to other people. It is thought that LS may be autoimmune in nature (where the body’s own immune system attacks itself).
- Itching of the skin around the opening of the vagina and the anus
- Soreness of the skin, especially when passing urine
- Skin colour changes - can be white or red
- Change in the appearance of the vulva. Some women may notice that the labia minora (vulval lips) or the clitoral hood have shrunk and appear flattened. The opening of the vagina may narrow.
- Difficulty with intercourse
Diagnosis
This is usually made by a specialist in the clinic by taking your history and examining the vulva.
Rarely, a biopsy (small piece of skin) is taken to confirm the diagnosis.
Treatment
There is no cure for LS; it is a chronic condition. Treatment aims to control symptoms and preserve normal structure as far as possible.
Steroid ointment is very effective at stopping or reducing itching. Moisturising the skin is important and it is essential to avoid soapy / perfumed products on the vulva. It is rare that surgery forms part of the treatment of LS. The main indication for surgery is to widen the opening of the vagina as this can help to improve discomfort with intercourse or prevent difficulty passing urine.
Follow up
If you are told you have LS, your specialist will want to see you regularly until symptoms are under control.
If you have a diagnosis of LS you should be on long term follow up. This is because having LS is associated with a small risk (3-5%) of developing a skin cancer. You should be seen once a year as a minimum.
