Lichen Sclerosus

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.

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