What is Lichen Sclerosus?
Lichen sclerosus is a chronic skin condition that causes thin, white, patchy skin—most often affecting the genital and anal areas, though it can appear elsewhere. It is not contagious and not sexually transmitted.
The condition is more common in postmenopausal women, but it can affect people of any age or gender.
What are the symptoms?
Symptoms can vary from mild to more troublesome, and may include:
- White, shiny patches on the vulva, anus, or skin
- Itching, often intense
- Soreness or pain, especially when passing urine or during sex
- Tearing or cracking of the skin
- Bleeding, blistering, or ulcers
- Painful intercourse
- Narrowing of the vaginal opening in advanced cases
In some people, the condition may cause no noticeable symptoms at all.
What causes Lichen Sclerosus?
The exact cause is unknown, but possible contributing factors include:
- Autoimmune conditions – the immune system attacks healthy skin
- Hormonal changes, especially low oestrogen
- Genetic predisposition
- Previous skin trauma or irritation
It’s not caused by poor hygiene or infections.
Is it serious?
Lichen sclerosus is not life-threatening, but it can cause significant discomfort and affect quality of life.
In rare cases, long-standing untreated lichen sclerosus in the vulval area may increase the risk of developing vulval cancer, which is why regular monitoring and treatment are important.
How is it diagnosed?
Your GP or specialist (such as a gynaecologist or dermatologist) may:
- Examine the affected area
- Ask about symptoms and medical history
- Take a biopsy (a small sample of skin) if the diagnosis is uncertain or if there are concerning changes
How is it treated?
Lichen sclerosus can’t be cured, but it can be effectively managed.
First-line treatment:
- Strong steroid creams or ointments (e.g. clobetasol propionate)
- Used daily at first, then reduced to maintenance
- Helps reduce symptoms and prevent skin damage
- Safe when used as directed
Other supportive treatments:
- Emollients or moisturisers – to soothe and protect the skin
- Avoiding irritants – e.g. scented soaps, bubble baths, tight clothing
- Topical oestrogen (if needed, especially postmenopause)
Self-care tips:
- Use gentle, non-perfumed products for washing
- Pat dry, don’t rub the area
- Avoid tight underwear or trousers
- Use barrier creams (like petroleum jelly) if the area is prone to friction
- Keep the area clean and dry, but don’t over-wash
Will I need ongoing care?
Yes — regular follow-up is important to:
- Monitor for skin changes
- Adjust treatment if needed
- Check for signs of complications (e.g. precancerous changes)
Your doctor may recommend yearly check-ups, or more frequent if symptoms are severe.
What if it affects my sex life or mental wellbeing?
Many people feel embarrassed or anxious, and it can affect intimacy and self-esteem. You are not alone, and support is available:
- Speak with your GP or a specialist
- Consider counselling or sex therapy if it’s impacting relationships
- Patient support groups can be helpful too
Summary
- Lichen sclerosus is a long-term but manageable skin condition
- It is not contagious or caused by poor hygiene
- Early treatment with steroid creams helps prevent complications
- Regular follow-up is key to staying healthy