Patient Information: Vulvar - Vaginal Disease

Anal Lichen Sclerosis

Vulvar/Anal Lichen Sclerosis

What is Lichen Sclerosis?
Lichen Sclerosis is a skin condition which can occur on any part of the body including the vulva and anal area. Lichen sclerosis may appear in three forms:

• Thinned, white areas of skin ( the most common )
• Thickened white skin
• Irritated red skin

All three forms may occur at the same time.

Lichen Sclerosis occurs more often in women who have gone through menopause, but can occur in all age groups including children.

What are the signs and symptoms of Lichen Sclerosis?

• Skin tears or ulcers - caused by scratching.
• Mild to severe itching.
• Bruised skin with small broken blood vessels.
• Flattened or absent inner lips of the vulva (labia minora).
• Narrow opening of the vagina.

Symptoms differ from woman to woman and may improve or become worse for varying periods of time. Symptoms may be worse during hot summer months with increased sweating and moisture causing skin irritations.

How is Lichen Sclerosis diagnosed (identified)?
Your doctor or health care provider will examine the vulva and anal area to look for the common skin changes seen with lichen sclerosis. On occasion a biopsy of the area may be needed.

What is the cause of Lichen Sclerosis?
Many studies have been done to try and determine the cause of Lichen Sclerosis. The exact cause is still unknown, but an autoimmune theory has been suggested

Autoimmune theory: Antibodies are normally made by the body to fight infection. With lichen sclerosis, antibodies attack skin and tissue causing damage.

Since this problem is not due to an infection, it is believed that lichen sclerosis cannot be passed from one person to another (for example: during childbirth, through sexual intercourse, or by touching the skin of someone with lichen sclerosis). Lichen sclerosis may be found in more than one family member, especially mothers and daughters.

What is the treatment for Lichen Sclerosis?
Treatment may include any of the following:

• Steroid Ointments or creams
  How it is used: The cream is applied to the vulva and anal areas.
  How it Works: Decreases redness, itching, and irritation.
  Caution: Use only as prescribed by your doctor. Overuse may result in thinning of the skin which will make your problem worse rather than helping it.
• Combined ointment medications
  How it is used: The cream is applied to the vulva and anal areas.
  How it Works: Decreases redness, itching, and irritation.
  Caution: Use only as prescribed by your doctor. Overuse may result in thinning of the skin which will make your problem worse rather than helping it.
• Following the Guidelines for Vulvar Skin Care to avoid anything that may irritate your skin.

Is Lichen Sclerosis cured with treatment?
Lichen sclerosis tends to be a long term condition. Symptoms can usually be kept under control with treatment and regular follow up. Mild scarring of the skin is common but severe scarring which causes the opening of the vagina to be narrowed can usually be prevented with treatment.

If symptoms do not improve with treatment, a biopsy or small skin sample may be taken to rule out other skin conditions. Lichen sclerosis does not cause skin cancer, although there have been reported cases of skin cancer occurring in the same area as lichen sclerosis.

Peer Review Status: Internally
Peer Review Date: 2004