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What is Lichen Sclerosus?

Everyone loves a good mystery, but lichen sclerosus is not a mystery to love.

Lichen sclerosus is a chronic skin condition that typically affects the vulva. It is not known what causes it, nor why it mostly affects women over-50. It’s a mysterious condition, but it’s easy to identify.

What does it look like and what do we know about it?

Lichen Sclerosus looks like white patches on the skin or vulva, that are itchy and easily damaged (as in they might bleed or hurt if scratched). Because of this, it can be painful to have sex, or urinate, and scars may form where the patches are if they are irritated.

While the exact cause is not currently known, we know that it is not contagious (so you can’t spread it by having sex, for example), it is not an STI, it’s not believed to be hereditary, and it is not caused by poor hygiene. The medical community believes it may be due to the immune system mistakenly attacking and damaging the skin, but as previously noted, it most commonly affects post-menopausal women (and therefore, might be similarly linked to a decrease in elasticity and moisture in the vagina).

It is considered to be a rare condition, affecting about 1 in 80 women (1.25% of women – in other words, 98.75% of women will not be affected). That being said, the prevalence of the condition may be underestimated, given that it is often misdiagnosed.

How can it be treated?

This is a chronic condition, meaning it can’t be cured. Fortunately, you can treat the symptoms by applying prescription steroid cream, which may need to be used for a few months to keep the symptoms under control. As with most chronic conditions, the symptoms may return.

Besides prescription steroid cream, there are a few other ways to care for yourself if you have lichen sclerosus. Replace regular or perfumed soaps (which can strip moisture from the skin) with emollient soap (which adds a layer of moisture and protects skin – have a pharmacist direct you), wear cotton or silk underwear (also known as “breathable” underwear), be gentle with the affected area (for example, gently dabbing after urinating), and use lubricant during sex if you feel irritated. Likewise, it is also recommended not to scratch or rub the affected area, wear tight/restrictive clothing, or wash your underwear with detergent (just use water).

Are there complications associated with lichen sclerosus?

 Unfortunately, yes – but at a low risk. Having lichen sclerosus increases your chance of developing vulvar cancer, which affects about 4% of women with the condition. It is always best to get the affected area seen by your doctor and take note of any changes to the area, including looking for a lump or ulcer that doesn’t go away.

All in all, lichen sclerosus is most likely not something you have to be concerned about, as it’s not a common condition. That said, as it mostly affects post-menopausal women, it’s important to be aware of. If you ever notice something unusual about your vagina area, get it checked out by a doctor, even if you don’t think it’s any cause for concern. It’s always better to be safe than sorry!