Lichen sclerosus

By Joseph Conrad

Lichen sclerosus is an unusual disease that forms patchy white skin appearing thinner than usual to a human individual. Specifically, it usually affects the anal and genital areas [1]. The disease can affect anyone, but women who have passed the stage of menopause have a high potential of being attacked by this disease.

The doctor can diagnose lichen sclerosus disease by using ointments or creams that assist in returning the normal appearance of the skin. The probability of this disease occurring is highly to recur; therefore long-term follow-ups are needed. Lichen sclerosus cannot end without proper treatment.

The Historicity of Lichen sclerosus Disease

The historicity of this illness can be derived from a narrowed epidermis with hyperkeratosis, an expansive band of regulated collagen under the der-moepidermal connection and a lymphocytic penetrating below the homogenized part [2].

A few numbers of women may have a thickened epidermis, which makes this disease to be complicated when it is being diagnosed. This can contribute tremendously in the long term to develop an associated female disease disorder called squamous cell carcinoma.  The duration of the time that lichen sclerosus has been present cannot be determined correctly using historical parameters.

Complications of Lichen sclerosus

Squamous cell carcinoma is the identified disease associated with lichen sclerosus disease. It is quite surprising that many doctors confuse lichen sclerosus with squamous cell carcinoma disease. Both of these diseases affect and attack mostly the genital areas.

Two kinds of research that have been done show that two hundred women with lichen sclerosus under a consecutive check-up have shown small cases but surely increased the occurrence of invasive squamous cell carcinoma [3]. The intensity of this risk is around 5 % or below lifelong in diagnosed patients with lichen sclerosus disease.

Symptoms of Lichen sclerosus

Symptoms and signs generally affect the skin of the anal and genital areas but also can affect the breasts, upper body, and upper arms. The symptoms include:

  • Redness.
  • Itching yourself at the affected areas.
  • Having pain or discomfort.
  • Having smooth spots on the skin.
  • Wrinkled, blotchy patches on the skin.
  • Bleeding or tearing.
  • In severe cases, having ulcerated sores, or blistering.
  • Having  painful sex.

When to See a Doctor

You need to seek medications from a professional doctor if you have symptoms and signs of lichen sclerosus disease.  If you have been diagnosed with this illness, you need to see a doctor for 6 to 12 months to be tested for any skin changes or watch out for side effects during treatment [4].

Causes of Lichen sclerosus Disease

The etiology of this illness is yet to be known.  A hormonal imbalance or an overactive immune system may play a bigger role for the outbreak of this disease. Previous skin damage at a specific place on your skin may boost the occurrence of lichen sclerosus. Mostly lichen sclerosus usually occurs in postmenopausal women, but also in children and men.

In women, lichen sclerosus disease usually attacks the vulva while to the uncircumcised males; they are at high risk because this condition usually affects the foreskin. In children, the symptoms and signs may improve at puberty, but more monitoring is needed for the disease activity [5].

Treatment of Lichen sclerosus Disease

There are a variety of treatments used to diagnose lichen sclerosus illness. This includes:

  • Pseudocyst of the clitoris:  clitoral covering adhesions surround over the clitoris and keratinous remains stick up below, which creates a painful pseudocyst. This calls for a total or subtotal circumcision.
  • Phimosis: the most common type of complication in men is secondary phimosis which necessitates circumcision if medical diagnosis fails.  If the disease persists even after surgery, it is crucial to carry out tropical corticosteroids to stop scarring and Koebnerization, specifically at the coronal sulcus area [6].
  • Treating with strong steroids ointments which usually fights inflammation and also softens the affected skin.
  • Moistures assist to protect and soften the skin.
  • In rare cases, a minor operation may be done to separate the adhesions if the skin folds together.

Management of Lichen sclerosus Disease

According to the research done according to the guidelines for the management of lichen sclerosus disease, it states that if the clinical diagnosis is not effective, then a biopsy should be done. A general medical practitioner should direct a patient to a gynecology, dermatology, or genitourinary departments for further check-ups [7].  

After treatment, the patient is supposed to apply steroid propionate clobetasol ointment. Once the symptoms of lichen sclerosus disease are done, then the steroid lotion should be used according to the doctor’s prescription.

Some patients can get an accomplished remission, while others need ongoing treatment.  In boys and men, circumcision may be done for phimosis. In children, if the treatment is not certain then a referral to an expert is recommended.

Self-Prevention of Lichen sclerosus Disease

  • Avoid, as much as possible, bathing with soap and instead be using an emollient soap.
  • Keenly wipe yourself after passing urine to lessen the contact of your skin with urine.
  • If sexual intercourse is irritating because of the tightening of the vagina at the entrance, it is recommended to apply lubricants to reduce the friction.
  • It is also very helpful to keep an eye on your skin. There is a higher risk of getting vulva cancer if lichen sclerosus becomes worse therefore; it is very advantageous to seek medical treatment at earlier stages.  
  • If you are smoker cease from smoking completely to reduce the exposure to cancer.

Lichen sclerosus is a chronic skin disease that can lead to worsening symptoms if left untreated or subsequently undiagnosed. The cause of this disease is yet to be discovered but it is thought that autoimmune and genetic factors may expose individuals to lichen sclerosus.  The illness is treated according to clinical presentation, and mostly biopsy is approved by researchers to verify the treatment.

Women are not only affected by this disease physically, but they are also affected emotionally and mentally. It is recommended that the medical community should collaborate with organizations like The EPIC Foundation to increase awareness of this illness and help in preventative and responsive measures.


  1. Barbagli G, Palminteri E, Baló S, et al.: Lichen sclerosus of the male genitalia and urethral stricture diseases. Urolint 2014;
  2. Garcia-Bravo B, Sánchez-Pedreno P, Rodríguez-Pichardo, et al: Lichen sclerosusetatrophicus. J Am AcadDermatol 2013;
  3. Nasca MR, Innocenzi D, Micali G: Penile cancer among patients with genital lichen sclerosus. J Am AcadDermatol 2015
  4. Powell J, Wojnarowska F: Childhood vuvlvar lichen sclerosus: an increasingly common problem. J Am AcadDermatol 2013; 
  5. Prowse DM, Ktori EN, Chandrasekaran D, et al.: Human papillomavirus-associated increase in p16-INK4A expression in penile lichen sclerosus and squamous cell carcinoma. Br J Dermatol 2016;
  6. Pugliese JM, Morey AF, Peterson AC: Lichen sclerosus: Review of the literature and current recommendations or management. J Urol 2017;
  7. Steigleder GK,Schlüter M: Lichen sclerosus andatrophicus. In: Andrade R, Gumport SL, Popkin GL, Rees TD (eds.): Cancer of the skin. Philadelphia, London, Toronto: Saunders. 2014