What is it?
Lichen sclerosus is a condition in which the skin around the vulva
has a crinkled or parchment-like appearance. This can sometimes
present as patchy, random, white lesions on labial skin (the area
outside of the vaginal opening). The cause is unknown.
Lichen sclerosis has been found in all age groups, but most
affected individuals are postmenopausal. Girls in their first decade
of life are afflicted with patchy, random, white lesions on labial skin.
Most of these girls' conditions improve when menarche arrives
(first menstruation). However, the lesions may remain throughout
the menstrual years, usually as small, white areas. White or red
color changes may be evident in chronic conditions. The skin in
this area is dry, rough, and may be affected with fissures. As the
condition progresses, the thickness of the skin mass in the vaginal
area increases. This condition may also cause vulvar pain and
severe itching of the vaginal area.
In initial phases, lichen sclerosis has no major symptoms and does
not require treatment. However, postmenopausally, this condition
is more significant and should be evaluated more carefully.
Treatment may involve relieving the symptoms with hydrocortisone.
Topical hydrocortisone should not be used over a long period of
time. Another treatment consists of testosterone ointment (2-3
times daily) for four weeks. Some women find that warm sitz baths
can help lessen the itching.
This condition may be involved with the exposure of the vaginal
skin to heat and moisture. As always, keep this area clean and dry,
avoiding tight clothing.