Vulvar Lichen Sclerosus: What You Need to Know

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Vulvar lichen sclerosus (LS) is a chronic inflammatory condition that affects the skin of the vulva, the external female genitalia. It can cause itching, pain, irritation, and changes in the appearance of the vulvar skin. It is not contagious, sexually transmitted, or caused by poor hygiene. It is most common in postmenopausal women, but it can also affect children and men.

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What Causes Vulvar Lichen Sclerosus?

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The exact cause of vulvar lichen sclerosus is unknown, but it is likely related to an overactive immune system that mistakenly attacks the vulvar skin. Some factors that may increase the risk of developing vulvar lichen sclerosus include:

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• Genetic predisposition
• Previous skin damage or infection
• Hormonal changes
• Autoimmune diseases, such as thyroid disorders

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What are the Symptoms of Vulvar Lichen Sclerosus?

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The symptoms of vulvar lichen sclerosus may vary from person to person, and they may come and go over time. Some common symptoms include:

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• Itching and burning of the vulva
• White, shiny, or wrinkled patches of skin on the vulva
• Thinning and fragility of the vulvar skin
• Bruising, bleeding, or blisters on the vulva
• Painful urination or sexual intercourse
• Scarring or narrowing of the vaginal opening or the urethra (the tube that carries urine out of the body)
• Increased risk of vulvar squamous cell carcinoma, a type of skin cancer

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How is Vulvar Lichen Sclerosus Diagnosed?

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To diagnose vulvar lichen sclerosus, your healthcare provider will ask you about your medical history, symptoms, and medications. They will also examine your vulva and may take a small sample of skin (a biopsy) to confirm the diagnosis and rule out other conditions.

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How is Vulvar Lichen Sclerosus Treated?

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There is no cure for vulvar lichen sclerosus, but treatment can help manage the symptoms and prevent complications. The main treatment for vulvar lichen sclerosus is a topical steroid cream or ointment that reduces inflammation and itching. You will need to apply it regularly as prescribed by your healthcare provider. Other treatments that may be used include:

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• Topical calcineurin inhibitors, such as tacrolimus or pimecrolimus, that suppress the immune system and reduce inflammation
• Emollients or moisturisers that hydrate and protect the vulvar skin
• oestrogen creams that may help improve the elasticity and thickness of the vulvar skin in postmenopausal women
• Surgery that may be needed to remove scar tissue or cancerous lesions

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How Can I Prevent or Reduce Flare-ups of Vulvar Lichen Sclerosus?

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Some lifestyle measures that may help prevent or reduce flare-ups of vulvar lichen sclerosus include:

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• Avoiding irritants, such as perfumed soaps, detergents, wipes, or pads
• Wearing loose-fitting cotton underwear and clothing
• Gently washing and drying the vulva daily with water or mild soap
• Applying a barrier cream or petroleum jelly before urinating or swimming
• Avoiding scratching or rubbing the vulva
• Using lubricants during sexual intercourse
• Following up with your healthcare provider regularly for monitoring and treatment adjustments

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Sources

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[1] Debbo Africa: https://debbo.africa

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[2] Lichen sclerosus - Symptoms and causes - Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/symptoms-causes/syc-20374448

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[3] Lichen Sclerosus: Causes, Symptoms, Diagnosis & Treatment. https://my.clevelandclinic.org/health/diseases/16564-lichen-sclerosus

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[4] Common Benign Chronic Vulvar Disorders | AAFP. https://www.aafp.org/pubs/afp/issues/2020/1101/p550.html

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[5] What is Vulval Lichen Sclerosus? - Newson Health Menopause Society. https://www.nhmenopausesociety.org/resources/what-is-vulval-lichen-sclerosus/