Dermatology (Skin conditions)

Lichen Sclerosus

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This is a condition which affects only the skin. It affects men and women and may develop at any age, from childhood into adult life. The peak incidence in women is around the age of 50. It usually affects the skin of the genital area but occasionally affects skin elsewhere on the body causing white patches of skin.
Lichen sclerosus is not infectious and you cannot give it to anyone else. There is a genetic predisposition to getting it and it is associated with a particular genetic type (HLA DQ7) and may be associated with auto- immune disorders, such as thyroid disease or pernicious anaemia. Occasionally people have a relative with lichen sclerosus but this is rare. You may get a blood test to see if you are predisposed to developing autoimmune disorders. A skin biopsy may be necessary to confirm the diagnosis. This is performed using an injection of local anaesthetic to numb the skin and then a small piece of skin about 6 mms in diameter is removed and sent to the laboratory for examination. Lichen sclerosus produces scarring of the skin which may make it tight and cause soreness, irritation and may make sexual intercourse uncomfortable. Splitting of the skin may occur, especially at the lower part of the vaginal opening during intercourse. Lichen sclerosus does not extend into the vagina. Lichen sclerosus usually responds well to treatment with a steroid cream which makes the symptoms a lot better and may prevent further scarring. Using steroid cream may, therefore, not only help you now but may reduce problems in the future. Lichen sclerosus usually persists for many years but may, especially in children, clear completely or be less troublesome. Some people with lichen sclerosus, probably less than 4%, get abnormal cells in the affected skin, which may lead to a skin cancer, so this is why we will see you regularly. If you notice a lump, or get a raw area that does not heal within 3 weeks, bring your appointment forward so we can check this has not occurred.

We advise the following:

  • Avoid tight clothing and nylon or Lycra shorts.
  • Avoid using soap, bubble bath or shampoo in the bath of deodorants in this area.
  • Apply your steroid cream as directed. If you have no symptoms then use it less often. You may need to use it only once a week or even less often. If your symptoms recur then increase the frequency again.
  • Routine follow-up by GP or hospital

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