Lichen Sclerosus is a non-cancerous, inflammatory disease the results in scarring and atrophy or hyperplasia in the tissues usually the genital area. Women are more susceptible with an onset usually postmenopausal. The etiology is unknown but factors that may contribute are autoimmune disorders, diabetes, or thyroid disorders.
Patients may have no complaints or may have an intense itch (puritus) and pain/soreness in areas where Lichen Sclerosus is present. Other symptoms may be present such as bleeding, dyspareunia, or dysuria. Often there are white, atrophic patches and papules on the labia minora and/or labia majoria. Scratching the affected area may lead to excoriations and lichenification (thickening of the normal skin). Lichen Sclerosus is not a sexual transmitted infection and cannot be passed to your partners. The excoriations can however increase the risk of acquiring sexually transmitted infections. Advance disease may lead to scarring. Lesions may also be present on thighs, breasts, shoulders, wrists, and neck.
There is no cure for lichen sclerosus, it is chronic condition that causes flares. The goal is to decrease symptoms and prevent anatomical distortion. It can be managed with topical steroids. Topical steroids such as clobetasol propionate 0.05% or halobetasol propionate 0.05% are effective. It may take up to 8-12 weeks of tapered high potency steroid cream for symptoms to improve. Good vaginal hygiene is important. Avoid itching to prevent a secondary infection. Oral antihistamines can be used to help decrease itchiness. Keeping nails short and wearing cotton gloves to sleep can help prevent scratching while sleeping. Do not use any type of soap in vaginal area since it may cause chemical and mechanical irritation. Wash with just plain water and pat dry with a clean towel. Referral to gynecologist for evaluation. Malignant transformation can develop so persistent symptomatic or changing lesions in the vaginal area should be biopsy if no improvement is noted.
Once cleared, your doctor may request routine follow-ups once or twice a year.
Dr. Bhatia is board-certified gynecologists trained in women’s health, gynecological diseases, gynecology surgery, metabolic treatment, and hormone replacement therapy. If you believe that you may be experiencing symptoms of Lichen Sclerosus or would like to schedule a well-woman exam, contact our office today at (210) 222-2694.14