Lichen Sclerosus

 

Lichen Sclerosus is a chronic, inflammatory skin condition that affects the genital area (most often around the vulva or anus), resulting in white patches and scarring. It can sometimes extend to involve the groin. It does not affect the vagina but as it can be at the entrance it is often mistaken for thrush. Symptoms of itch, burning and soreness are common, but often there are NO symptoms.  

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Lichen Sclerosus affects around one in 80 women (it is far less common in men). It can happen at any age, but is most common in middle-aged and elderly women. For most women it is a lifelong condition. It can be itchy, painful and cause permanent scarring. 4% of women with this condition go on to develop vulva cancer. 

You cannot “catch” or “give” this condition to anyone. It is thought that Lichen Sclerosus may be an auto-immune disorder, where your immune system becomes confused and attacks your skin instead of protecting it. Lichen Sclerosus appears to be more common in women with other auto-immune illnesses such as thyroid problems, diabetes, celiac disease, pernicious anaemia or ulcerative colitis. 

 

What are the Signs & Symptoms? 

Lichen Sclerosus symptoms can range from very mild to quite severe.  

There may be skin dryness through loss of oil producing skin glands. The skin surface can be thickened and white in active disease, or pale, thinned and fragile in long standing disease.  

If  the case causes the patient to itch and scratch this can result in very thickened white skin, blood blisters and wearing of the skin. Skin fragility can result in splitting. Damaged skin is susceptible to secondary infection by yeasts or bacteria which may result in skin soreness.  

 
Chronic inflammation can result in scarring and loss of normal skin architecture.  These changes may include: 

  • covering over of the clitoris by skin (hooding) 

  • loss of the inner lips (labia minora) 

  • bands of joined skin above and below the vaginal opening, that can make the vaginal entrance small, and result in painful intercourse.  

In men, Lichen Sclerosus usually affects the tip of the penis and foreskin (this is also called Balanitis Xerotica Obliterans). Occasionally the urethral opening may narrow resulting in difficulty passing urine.