Highlights from this article

  • ​​Lichen sclerosus is a long-term skin condition that causes white, dry, wrinkly patches around the skin of the vulva and anus. 
  • Symptoms of lichen sclerosus include itching, burning, and pain during sex. But it’s not an STI, nor is it contagious! 
  • The cause of lichen sclerosus is unknown, and there’s no cure.
  • If left untreated, LS can increase your risk of skin cancer and genital scarring.
  • Treatment includes steroid creams, topical calcineurin inhibitors, over-the-counter moisturizers, as well as lifestyle changes.

Itching and dryness are symptoms of many common vaginal conditions, but while you may be used to vaginal itching as a result of a yeast infection, it can also be a symptom of a little-known disease called lichen sclerosus (LS). 

Lichen sclerosus can affect anyone regardless of age or sex, but people with vaginas are more likely to have it — especially after going through menopause. Below is everything you need to know about vulvar lichen sclerosus, including symptoms, potential causes, and treatment.  

What is lichen sclerosus?

Lichen sclerosus is a long-term inflammatory skin condition that causes white, wrinkly, dry patches on the vulva and anus. These patches can look shiny and sometimes thickened or raised. In some cases, LS can also appear on the upper body, like the arms and breasts.

Although it’s uncommon and not contagious (it can’t be passed on during sex) lichen sclerosus can seriously impact a person’s quality of life, including their sex life

Lichen sclerosus symptoms

The symptoms of LS will vary from person to person, and some people might not even experience any symptoms. If they do, the most common telltale signs of vulvar lichen sclerosus are: 

  • Dry, white patches on the vulva 
  • Itching and soreness of the vulva (which can get worse at night)
  • Tearing and bruising of the skin
  • Discomfort and pain around the vulva and vagina
  • Pain during intercourse 
  • Bleeding, blistering, or ulcers (in severe cases).

If left untreated, lichen sclerosus can lead to serious complications. Women with LS have a slightly higher risk of developing a type of skin cancer called squamous cell carcinoma, and in rare cases, untreated lichen sclerosus can cause scarring on the clitoris and vagina, which makes sex and bowel movements painful and difficult. . 

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Causes of lichen sclerosus 

Frustratingly, the cause of lichen sclerosus is unknown. The main theory is that lichen sclerosus is caused by an autoimmune disorder, which is when the body’s immune system is “overactive” and attacks healthy cells for unknown reasons. 

Studies have shown that women with lichen sclerosus are more likely to have an autoimmune disorder like diabetes, alopecia, anemia, thyroid disease, and vitiligo. While lichen sclerosus has been linked to the formation of certain antibodies, there’s still no conclusive evidence suggesting that lichen sclerosus is itself an autoimmune disorder. 

Since lichen sclerosus more often affects girls before puberty and post-menopausal women, some researchers believe low levels of reproductive hormones like estrogen may play a role

Some researchers believe that other potential causes for lichen sclerosus include: 

However, there’s still no consensus on whether these factors directly cause LS. 

How is lichen sclerosus diagnosed and treated? 

Lichen sclerosus is often diagnosed based on clinical examination, which often involves taking a very small punch biopsy to confirm the diagnosis.

Since doctors don’t know what causes lichen sclerosus, unfortunately, there’s no known cure. But there are several treatment options to help manage symptoms and prevent the condition from getting worse. 

You’ll likely have to keep treating lichen sclerosus because it doesn’t go away on its own, and can get worse over time if left untreated. 

The most common treatment for lichen sclerosus is a highly potent topical corticosteroid cream that you apply to the affected area to reduce inflammation and soften the skin. In the case that corticosteroids don’t work — or aren’t suited for you — you may be prescribed topical calcineurin inhibitors (tacrolimus and pimecrolimus), which stop your immune system from attacking healthy skin. These creams reduce itching and inflammation and are also commonly used to treat eczema. 

Lifestyle and home remedies

It’s really important that you refer to your doctor or OBGYN if you spot symptoms of lichen sclerosus so they can recommend the best course of treatment. That being said, there are a few lifestyle and self-care remedies you can implement to manage LS. 

Some things you can do to help treat lichen sclerosus are

  • Apply a moisturizer or emollient to the affected skin. 
  • Use lube to reduce discomfort during sex. In the case of scarring, vaginal dilators can help.
  • Avoid using fragranced or harsh soaps. 
  • Ease burning with cool compresses or ice packs. 
  • Try to avoid tight clothing.
  • Take an antihistamine to control any itching. 

Some believe that changing your diet can help with lichen sclerosus, but sadly there’s no evidence to support this