What is Lichen Sclerosus
A chronic inflammatory skin condition that can affect men, women and children, lichen sclerosus is a disease for which there are no known definite causes. It is an itchy, painful skin problem occurring in the genital area, though it has also been seen on the upper body, breasts, and upper arms. Thankfully, it is not a contagious disease and cannot be sexually transmitted. Most people who have the disease may not even know what is lichen sclerosus and may not seek treatment until the uncomfortable symptoms of lichen sclerosus like itching start to manifest themselves. It is mostly seen in post-menopausal women, though men and young girls are no strangers to the condition.
In young girls, puberty acts as a cure for lichen sclerosus, leading to the argument from some scientists that the imbalance of hormones in the body may be the cause of lichen sclerosus. It affects the vulva in women, and in men, it is seen on the foreskin of the penis. In men, the condition is also called balanitis xerotica obliterans. Initially, small white spots that appear shiny show up on the skin around the vulva and often around the anus too. Intense itching, irritation, and soreness are the usual symptoms. Itching is said to be particularly severe at night. With time, the spots grow larger, and the skin on them becomes wrinkled and fragile, and red blisters may appear. With scratching or rubbing, the skin may crack as also become raw. Scarring of the skin is also common. Scarring and changes in the color of the skin remain even after the condition is treated and cured. Left untreated over months, the skin in the vulva might shrink, and eventually the entry point into the vagina may become narrower. Risks of other skin infections also increase when the skin of the vulva is raw. Having sex and passing stools may become painful for women and men may have difficulty in passing urine.
While causes of lichen sclerosus may be unknown, instances of lichen sclerous in the upper body have been recorded. Luckily, itching is limited to the lichen sclerosus that occurs in the genital area. It has been found that incidence of lichen sclerosus is more common among those who have an autoimmune disease like an underactive thyroid. Diagnosis of lichen sclerosus can be made by the doctor examining the skin, based on the appearance and texture of the skin and the blisters. The dermatologist or the gynecologist, using local anesthesia, may take a small sample of the skin for biopsy. Cancers developing on the skin patches with lichen sclerosus are a possibility that doctors like to rule out by examining the skin under the microscope. This also help rule out other skin diseases.
Skin that is damaged or scarred by a previous injury is also prone to blisters of lichen sclerosus. In men, lichen sclerosus treatment options include circumcision to remove the foreskin on the penis. This ensures that there is no relapse of the condition in men. However, similar treatments to remove the patches from the skin of women are not as effective as it cannot stop the condition from coming back.
A lichen sclerosus treatment cream or ointment can be used to control the itching and heal the skin. Unpleasant side effects of using cortisone creams over a long time include redness of the skin, stretch marks, and yeast infections in the genital area. With low estrogen levels and secondary infection at the site, the effectiveness of the treatment may be reduced. Vitamin A supplements have been found to be helpful to some people. Other ointments are prescribed for those who cannot tolerate corticosteriods. Ultraviolet treatment may be used if the skin affected is not in the genital area.
