A chronic (long-term) inflammatory disorder that negatively affects the skin on the genitals is called lichen sclerosus. Experts do not fully understand what exactly causes this condition, but they think it is an autoimmune disorder. Doctors usually recommend topical medicines, light therapy, immunosuppressants, and circumcision to treat this disorder.
Most of the time, lichen sclerosus affects the skin on the vulva (the outside part of the vagina), penis, foreskin, urethra, and anus. It also looks like a thin, discolored, itchy, and scaly patch. Sometimes, people may also develop blisters and sores on their genitals, and the symptoms of lichen sclerosus may spread to other parts of the body. It is very important to get treatment for this disease. Otherwise, it may lead to scarring, dyspareunia (painful sexual intercourse), and difficulties with bowel movement or urinating. This condition is also known as balanitis xerotica obliterans (BXO).
In general, lichen sclerosus occurs quite rarely, and it affects about 200,000 people in the U.S. It happens rarely even if you have several risk factors.
What Are The Symptoms of Lichen Sclerosus?
While this disorder mostly affects the genitals, in rare cases, it may also cause symptoms on your neck, chest, torso, upper back, wrists, and mouth. The main symptoms often include white, raised spots on the vulva, anus, foreskin, or the tip of the penile (glans). However, lichen sclerosus may also cause other symptoms. Check some of them below:
- Cracking
- Scarring
- Inflammation
- Ulcers and sores
- Dyspareunia
- Dysuria (painful urination)
- Weak urine stream
- Phimosis (inability to pull the foreskin back)
- Penile discharge (unusual discharge that comes out from the penile)
Do not hesitate to visit a doctor if any of the previous symptoms occur. Otherwise, it may lead to serious complications.
Causes and Risk Factors
Healthcare professionals do not understand what exactly causes this condition, but they have found some factors that could increase your risk. Examples include:
- Postmenopause – Women between the ages of 40 and 60 are at increased risk of lichen sclerosus. Furthermore, girls who have not gone through puberty are also at increased risk.
- Autoimmune disorders
- Allergies
- Diabetes
- Obesity (excessive body weight)
- Family history – if you have a parent or sibling with this condition, your risk of developing it significantly increases.
- Skin trauma or irritation
- Hormonal changes – According to some studies, reduced levels of Estrogen are associated with lichen sclerosus.
In addition, this disorder is not contagious, which means it cannot spread from one person to another.
Complications
People who leave this condition untreated may also experience some complications. Check some of them below:
- Genital scarring and fusing
- Urinary and sexual dysfunction
- Chronic (long-term) skin damage
- Increased risk of skin cancer
The previous list does not contain a complete list of complications, but you can consult with your healthcare professional about ways to reduce the risk of developing them.
Is There a Way to Prevent Lichen Sclerosus?
Unfortunately, it is not possible to prevent this disorder, but doctors may recommend some tips to reduce the symptoms. These include:
- Skincare routine – You should regularly wash with soap and warm water to prevent infections.
- Wear loose-fitting underwear
- Do not wear clothing that irritates your skin (such as wool and silk)
- Take showers or baths with lukewarm water
- Use unscented laundry detergent
- Avoid long rides on a bicycle, motorcycle, or horseback
- Change out of wet swimsuit and clothing as soon as possible
Diagnosis
First, doctors will perform a physical examination to check for irregularities linked to the disease. Thereafter, they may ask some questions about your symptoms and medical history to get more clues about your disorder. Furthermore, they may also perform a skin biopsy. During this test, physicians will remove a small sample of the affected skin for testing.
Treatment
Usually, healthcare professionals prescribe different treatments for people with lichen sclerosus. Moreover, it can be treated without circumcision. Check below some common treatments often recommended by doctors for people with this disease:
- Topical corticosteroid creams – These medicines are applied directly to the affected skin. Most of the time, physicians prescribe Clobetasol.
- Phototherapy (also known as light therapy) – This option uses ultraviolet light (commonly, ultraviolet B or UVB) to reduce inflammation and itching.
- Immunosuppressants – Sometimes, these medicines may help ease the symptoms. Physicians usually prescribe an ointment that contains Tacrolimus.
- Surgery – This option is often recommended by doctors for people with moderate to severe lichen sclerosus, and it may include urethroplasty, circumcision, and others.
How Soon After Treatment Will I Feel Better?
Typically, the recovery time varies among people with this disease because it depends on several factors. Examples include the severity of the condition, overall health, age, sex, and your response to treatment.
Frequently Asked Questions
Is lichen sclerosus an autoimmune disease?
The exact cause of lichen sclerosus is unknown, but many experts believe it has an autoimmune component. This means the immune system may mistakenly attack healthy skin. Genetics, hormonal changes, and skin injury may also contribute to its development.
Is lichen sclerosus contagious?
No. Lichen sclerosus is not contagious and cannot spread through sexual contact, skin-to-skin contact, or by sharing personal items such as towels or clothing.
Can lichen sclerosus go away on its own?
In most adults, lichen sclerosus is a chronic condition that usually requires long-term treatment and regular follow-up. While symptoms may improve with treatment, the disease can flare up again if treatment is stopped. In some children, the condition may improve after puberty.
Does lichen sclerosus increase the risk of cancer?
Yes. Untreated or poorly controlled genital lichen sclerosus slightly increases the risk of developing squamous cell carcinoma of the affected area, particularly vulvar or penile cancer. Regular medical checkups and proper treatment can significantly reduce this risk.
Can people with lichen sclerosus have a normal sex life?
Yes. Many people with lichen sclerosus can maintain a healthy sex life, especially when the condition is diagnosed early and treated appropriately. If pain during intercourse occurs, your healthcare provider may recommend medications, lubricants, or other therapies to improve comfort.
Can children develop lichen sclerosus?
Yes. Although it is more common in postmenopausal women, lichen sclerosus can also occur in children, particularly girls before puberty. Early diagnosis and treatment can help prevent scarring and long-term complications.
How often should I see my doctor if I have lichen sclerosus?
Most healthcare providers recommend regular follow-up appointments, even if your symptoms are well controlled. Depending on your condition, visits may be scheduled every 6 to 12 months to monitor treatment effectiveness, detect complications, and screen for signs of skin cancer.
Can diet help improve lichen sclerosus?
There is no specific diet proven to treat or cure lichen sclerosus. However, eating a balanced diet, maintaining a healthy weight, and managing conditions such as diabetes may support overall health. If you notice certain foods worsen your symptoms, discuss them with your healthcare provider.
What should I avoid if I have lichen sclerosus?
To reduce irritation, avoid scratching the affected skin, using scented soaps or hygiene products, wearing tight-fitting clothing, and exposing the area to prolonged friction. Gentle skin care and following your doctor’s treatment plan can help minimize flare-ups.
Can lichen sclerosus come back after treatment?
Yes. Although treatment is often very effective at controlling symptoms, lichen sclerosus frequently recurs. Many people require long-term maintenance therapy with topical medications and regular follow-up appointments to keep the condition under control and reduce the risk of complications. If you have any other questions, ask your physician.
