Lichen sclerosus is a chronic skin condition involving foreskin of penis in men, vulva in women or skin around the anus. At times this condition also afflicts other areas of the body such as upper arm, breast and skin around the trunk. The condition is characterized with areas of white patches, thinner than the normal adjacent skin area.
Lichen sclerosus can cause permanent scarring as one of its complication. It is more common in women than in men and children, especially in women over the age of 50. Sometimes girls in their pubertal age are also affected.
The exact cause of lichen is not known. Itching is the prominent symptom of lichen slcerosus. There is no absolute cure though sometime the disease improves on its own. In other cases patient needs rigorous treatment and follow up.
What Causes Lichen Sclerosus?
At least 1 in 300 people around the world are known to suffer from lichen sclerosus. Majority of them are women above the age of 50 or postmenopausal age. In ratio, men are less affected than women. Scientists are not able to pin point the exact reason for development of this disease.
However, they suspect it is related to lack of sex hormones in affected part of the skin. Over activity of the immune system is also believed to be a reason for its development. It is also linked with autoimmune diseases such as thyroid disease etc. But there is no certainty about it.
Though lichen sclerosus is a disease more restricted to genital area, it is not a STD. It is also not a contagious disease. It is not caused due to poor hygiene. Men with their genital foreskin intact are at more risk than men who have undergone circumcision.
History of previous injury to the skin increases the chances of development of lichen sclerosus.
Signs And Symptoms Of Lichen Sclerosus
Many times patient suffering from lichen sclerosus may not have any symptoms at all. But when they do, they occur as;
- Small white spots which are smooth and shiny. Later on they spread and form white patches. The skin in affected area becomes wrinkled.
- The skin at the site becomes thin. It gets torn easily.
- Intolerable itching is the most prominent symptom.
- In women the vulva becomes white and thick. It becomes extremely itchy. Blisters and ulcerations develop. Patient bleeds many times from the vagina as a result of bruises.
- Sexual intercourse is extremely painful and difficult for women suffering from lichen sclerosus. It may form scars in the vulva.
- Similarly, the skin around the anus becomes extremely sore and itchy. Bowel movement becomes uncomfortable.
- In men the foreskin may become narrow giving rise to difficulty in passing urine.
Lichen Sclerosus Treatment
If the white patches are on the arms and upper region of the body, they usually do not require any treatment. These white patches heal without any specific medication.
- However, lichen sclerosus in genital has to be treated as the condition is extremely itchy and painful. There is possibility of scaring. The patient may have difficulty in urination as well as sexual performance.
- Physician will recommend corticosteroid cream for local application. It has to be applied in thin layer in the area for few weeks or months. Overuse of steroid may result in reverse effect and that is thinning of skin which is already thin. Therefore patient has to regularly consult their doctor.
- Sometime topical sex hormones are prescribed to be applied locally. They have been found effective in some cases.
- For non genital areas, use of ultraviolet light is found to be effective.
- Circumcision is valuable for men having lichen slcerosus on foreskin. However, in women surgery is not recommended as there is chance of recurrence after surgery.
- Applying immune modulating creams is now days recommended treatment for lichen sclerosus in genital area.