Lichen sclerosus is a rare skin condition that usually occurs in the genital or anal area. It creates white, patchy areas of skin that may be thinner and tighter than other areas of skin. Skin affected by lichen sclerosus is often more susceptible to bruising and tearing, which can lead to painful sex when it is located on the genitals.
Who can get lichen sclerosus?
While men, women, and children of all ages can get lichen sclerosus, it is most common in postmenopausal women. Obese men or those with uncircumcised penises may be more likely to experience this condition because lichen sclerosus can develop on the foreskin or shaft skin with penile retraction. Finally, individuals may be at higher risk of getting lichen sclerosus if they have an autoimmune disease or a history of lichen sclerosus in their family.
What causes lichen sclerosus?
The cause of lichen sclerosus is unknown, but an overactive immune system, hormonal imbalance, chemical irritation from urine, recurrent fungal infections, and previous damage to the skin are thought to contribute to its development. Lichen sclerosus is not contagious and cannot be passed from one person to another during sexual intercourse.
What are the symptoms?
Although lichen sclerosus usually affects the genital or anal area, it can also affect the breasts, torso, and upper arms. Some people with mild lichen sclerosus may never notice symptoms, but for moderate to severe cases, the most common symptoms include:
- Smooth white patches of tight skin that may grow in size over time
- Itchiness
- Skin that tears and/or bruises easily
- Redness
- Discomfort or pain
- Blisters
- Painful sex
How is lichen sclerosus diagnosed?
A health care provider can usually diagnose lichen sclerosus through obtaining a patient health history and conducting a physical exam of the area of skin that is impacted. Sometimes, a biopsy of the affected area may be required. This means that they will take a small sample of the skin and send it to a lab to be examined more closely under a microscope.
How is it treated?
Though it is uncommon, lichen sclerosus can occasionally improve on its own. Most of the time, a health care professional will recommend creams or ointments to reduce itchiness and scarring and improve the look of the skin. The most common first-line treatment for lichen sclerosus is a steroid ointment or cream that an individual can apply to the affected area. Removing the foreskin may be an option for people with uncircumcised penises if that is where they are experiencing lichen sclerosus. However, surgery in the genital or anal area is usually not recommended as a treatment because lichen sclerosus can reoccur. It is a good idea to schedule regular follow-up visits with a health care provider so that they can monitor any changes in the area.
Resources:
Cedars-Sinai. Medically reviewed by Michael Lehrer, MD; Rita Sather, RN; Raymond Kent Turley BSN, MSN, RN. (2021). Lichen Sclerosus. https://www.cedars-sinai.org/health-library/diseases-and-conditions/l/lichen-sclerosus.html.
Mayo Clinic. (2020, October 10). Lichen Sclerosus. https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/symptoms-causes/syc-20374448.
WebMD. Medically reviewed by Debra Jaliman, MD. (2020, September 10). What is Lichen Sclerosus? https://www.webmd.com/skin-problems-and-treatments/lichen-sclerosis.
