Lichen Sclerosus Treatment in Women and Men (FAQs)

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What is lichen sclorosus? What are current treatments for this disease, and when you should call /see a doctor? It is a kind of uncommon long-term problem of skin. The areas of skin that affected by this disease are more likely to be patchy, and thinner & more white than normal. It can occur on the skin of any part of the body, but in many cases it usually affects skin around the anus (anal areas) and around genital area (foreskin of the penis or skin of vulva).

You might also be interested to read about early symptoms of Lyme disease and lupus skin rash, before continuing!

Anyone has a chance of getting this skin problem, but it is relatively more common in women (particularly for those who have postmenopuase phase (the phase after menopause))! But it also can occur in men (uncommon) and even in kids (rare). Uncircumcised boys or men may have higher risk than others who are circumcised.

What are complications of lichen sclerosus

If left untreated, this skin problem can generate some health problems, which may include:

1. This skin problem (especially if it affects the vulva) may increase the risk of patient of having vulvar cancer.
2. It may also increase the risk of skin cancer -- though there is still no adequate scientifically evidence to confirm this issue.
3. It may also affect the sex activity either in women and men (especially when this skin problem affects genital area)! 

What are the causes of lichen sclerosus?

Unfortunately, the exact causes of this skin problem are still unknown! But some experts believe that there may be a link between changes in hormone and lichen sclerosus. Another possible cause may be an overactive immune system -- more studies are required to find the clearly answer!

Sometimes, this skin problem appears on the site of skin that has been scarred /damaged from previous injury due to other skin problems.

Is it contagious?

Fortunately, it is not contagious -- though it can affect the genital area! In other words, a woman or a man who has lichen sclerosus does not spread the disease to her/his partner through a sexual intercourse.

How to diagnose this skin problem?

To make a diagnosis, there are usually 2 common steps:

1. Observing the area of the skin that may be affected by lichen slerosus (physical examination).
2. Taking a small piece of biopsy (affected tissue /skin patch)! This sample piece of biopsy is required by doctor to be analyzed to make sure that the skin problem is lichen sclerosus or others.

And what are the current treatments for lichen sclerosus?

In general, some goals of lichen sclerosus treatment are purposed to get back a more normal appearance of the patient’s skin and to reduce the tendency for scarring /further scarring. 

When you should see a doctor?

Sometimes, this skin problem may improve and go away on its own (especially for lichen sclerosus that only affects the upper body or arms). But if you in doubt with the condition of your skin, it’s much better to see a doctor to keep safe and get a clearly diagnosis.

Any skin problem (including lichen sclerosus) that affects the genital area should be more concerned and completely treated -- even though it is not itchy or not painful, there is a chance for the patches to scar and may be potential to cause problems associated with sex or urination or even may cause cancer!

What are kind of health professionals to treat lichen sclerosus?

1. A specific doctor to treat your skin or often familiar called as ‘dermatologists’.
2. A specific doctor to analyze & treat the reproductive system of women -- or familiar called as ‘gynecologists’.
3. A specific doctor to treat urogenital tract or often called as ‘urologists’.
4. Your primary healthcare provider.

Cortisone creams or ointments

These medications are the most commonly prescribed. They can be effective to treat/reduce/stop the itching sensation of the affected skin.

How to use these cortisone creams or ointments? Doctor usually will ask you to put these creams /day (for several weeks) on the affected patches of the skin. But these medications usually don’t fix the scarring. 

Since these cortisone creams or ointments are usually prescribed to be used for a long time, there may also some side effects that occur (such as genital yeast infections, stretch mark, redness or/and thinning of the skin). Therefore, don’t forget to have a regular follow-up by your doctor.

But sometimes, these medications may fail to work to treat lichen sclerosus, which may be caused by certain conditions -- such as; allergy to the medicine, infection, or low levels of estrogen.

Surgery

Surgery is one of common effective options for lichen sclerosus in men, which is usually purposed to remove the foreskin on the penis. But this option is not good or not recommended for lichen sclerosus in women.

Other treatments

If cortisone creams or ointments don’t work, other treatments /medications that are prescribed by doctor may include: (a) elidel and protopic (immune-modulating medications), (b) retinoids, (c) prescription sex hormones, or (d) ultraviolet light treatment (for affected skin of non-genital areas)!

***Ask a doctor for more in-depth information about these medications!

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Reference: MayoClinic and www.niams.nih.gov