Lichen sclerosus
Lichen sclerosus is a skin problem that causes thin, wrinkled patches that are itchy and painful. The patches often look white in lighter skin. In darker skin, the patches may be lighter or darker than the skin around them. If the skin tears, bright red or purple spots may appear.
Doctors don't know the exact cause of this problem. But genetics, autoimmune diseases, and changes in hormone levels may be part of the reason. It is not caused by an infection and is not contagious.
Anyone can get lichen sclerosus, but people who have gone through menopause are more likely to get it.
This skin problem can affect any part of the body. But in most cases, it occurs on the skin of the anus (the opening where stool leaves the body), the vulva (the area around the vagina), and the tip of an uncircumcised penis.
If the skin patches are on the anus, vulva, or penis, treatment is important to prevent problems. If these areas aren't treated, the skin can thin, tear, and bleed. This can be painful. Untreated lichen sclerosus can also cause severe itching and scarring. The openings to the vagina and anus can narrow, and the foreskin over the penis may tighten and shrink. This scarring is permanent and can make going to the bathroom and having sex painful.
Lichen sclerosis on the genitals can also increase the risk of skin cancer. Regular skin exams are recommended.
Lichen sclerosus can be treated with strong, medicated creams or with a prescription medicine. In most cases, surgery to remove the foreskin is the recommended treatment for lichen sclerosus on the tip of the penis.
How can you care for yourself when you have lichen sclerosus?
- Be safe with medicines. If your doctor prescribed a cream, apply it exactly as directed. Call your doctor if you think you are having a problem with your medicine.
- Put cold, wet cloths on the area to reduce itching.
- Wear loose-fitting clothes. Avoid nylon and other fabric that holds moisture close to the skin. This may allow an infection to start.
- If your doctor told you to use nonprescription moisturizing cream on your skin, read and follow the directions on the label.
Care tips
- Do not douche, unless your doctor tells you to.
- Avoid hot baths. Don't use soaps or bath products to wash the area around your vulva. Rinse with water only, and gently pat the area dry.
- Keep your penis clean. If you haven't been circumcised, gently pull the foreskin back to wash your penis with warm water. Make sure your penis is dry before you get dressed.
Lichen sclerosus: When to call
Call your doctor now or seek immediate medical care if:
- You have symptoms of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
Watch closely for changes in your health, and be sure to contact your doctor if:
- The affected area grows or changes.
- You have new or worse symptoms.
- You do not get better as expected.
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