What Is Lichen Sclerosus?

Lichen Sclerosus is a chronic inflammatory skin disorder that can affect men, women, or children, but is most common in women. It usually affects the vulva (the outer genitalia or sex organ) and the anal area.

The symptoms are the same in children and adults. Early in the disease, small, subtle white spots appear. These areas are usually slightly shiny and smooth. As time goes on, the spots develop into bigger patches, and the skin surface becomes thinned and crinkled. As a result, the skin tears easily. A bright red or purple discoloration from bleeding inside the skin is common. More severe cases of lichen sclerosus produce scarring that may cause the inner lips of the vulva to shrink and disappear, the clitoris to become covered with scar tissue, and the opening of the vagina to narrow.

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How common is Lichen Sclerosus?

Although definitive data are not available, Lichen Sclerosus is considered a rare disorder that can develop in people of all ages. It usually appears in postmenopausal women and primarily affects the vulva. It is uncommon for women who have vulvar Lichen Sclerosus to have the disease on other skin surfaces.

What Are the Symptoms of Lichen Sclerosus?

Symptoms vary depending on the area affected. Patients experience different degrees of discomfort. When Lichen Sclerosus occurs on parts of the body other than the genital area, most often there are no symptoms, other than itching. If the disease is severe, bleeding, tearing, and blistering caused by rubbing or bumping the skin can cause pain.

Very mild Lichen Sclerosus of the genital area often causes no symptoms at all. If the disease worsens, itching is the most common symptom. Rarely, Lichen Sclerosus of the vulva may cause extreme itching that interferes with sleep and daily activities. Rubbing or scratching to relieve the itching can create painful sores and bruising, so that many women must avoid sexual intercourse, tight clothing, tampons, riding bicycles, and other common activities that involve pressure or friction

Urination can be accompanied by burning or pain, and bleeding can occur, especially during intercourse. When Lichen Sclerosus develops around the anus, the discomfort can lead to constipation that is difficult to relieve

What Causes Lichen Sclerosus?

The cause is unknown, although an overactive immune system may play a role. Some people may have a genetic tendency toward the disease, studies suggest that abnormal hormone levels may also play a role. Lichen Sclerosus has also been shown to appear at sites of previous injury or trauma where the skin has already experienced scarring or damage.

How Is Lichen Sclerosus Treated?

Lichen Sclerosus of the genital skin should be treated, even when it is not causing itching or pain, because it can lead to scarring that may narrow openings in the genital area and interfere with either urination or sexual intercourse or both. There is also a very small chance that skin cancer may develop within the affected areas.

The treatment of choice is an ultrapotent topical corticosteroid (a very strong cortisone cream or ointment). These creams or ointments may be applied daily for several weeks, which will be sufficient to stop the itching. However, long-term but less frequent applications (sometimes as infrequently as twice a week) will be needed to keep the lesions from reactivating.

What Is LichenMona Lisa Touch Treatment Sclerosus?

Recently, microablative fractional CO 2 laser treatment (FxCO 2 ) (SmartXide 2 V 2 LR laser system, for MonaLisa Touch, DEKA, Florence, Italy) has been proposed for the management of LS. Specifically, two small studies demonstrated that FxCO 2 therapy appears to be a promising treatment modality to treat Lichen Sclerosus. These studies demonstrated that FxCO 2 treatment may stimulate tissue healing in Lichen Sclerosus. Furthermore, by reducing inflammation, the clinical symptoms of Lichen Sclerosus, such as intense itching and burning, were improved.