By Emily Reynolds, FNP-BC, DCNP
Dermatology Nurse Practitioner
Do you have chronic itching of your anal or genital areas? Have you noticed a discoloration, whiteness, or thinning of the skin there?
This is an embarrassing topic for most women and men to talk about. However, for any kind of rash or unusual skin issue like this, you may want to consider being evaluated for lichen sclerosus (LIE-kun skluh-ROW-sus) and possible treatment.
What Is Lichen Sclerosus?
Lichen sclerosus is a skin disease that affects the vulva or outer “lips” area of the female genitals as well as the surrounding genital tissue; it may also affect the rectum in men and women, or the penis in men. It is most common in postmenopausal women. However, it can occur in anyone, including prepubescent children.
Symptoms in women include itching, burning, or discomfort around the vulva and the vaginal opening, but some women have no symptoms at all. The skin of the vulva will appear white, thin, wrinkled, and shiny. If left untreated for a long time, the skin can shrink. In men, the same type of lesions can happen on the shaft and tip of the penis.
What Causes Lichen Sclerosus?
The cause is not fully understood, but it is believed to be an autoimmune reaction in which the immune system attacks the skin of the genital area. It is NOT infectious or contagious.
If It Doesn’t Bother Me, Why Does It Matter?
It is important to note that lichen sclerosus can increase the risk of skin cancer in the vulva or vagina by about 5%, and it is highly associated with penile cancers. Therefore, yearly exams of the genitals are recommended in patients with lichen sclerosus. Any new lumps, nonhealing sores, or changes in your symptoms should be reported to your healthcare provider.
How Is Lichen Sclerosus Diagnosed?
Oftentimes, with an experienced healthcare practitioner, the condition can be diagnosed with a simple examination of the skin. Other times, the condition may require a biopsy – in which case a small piece of the skin is sampled from the affected area and tested.
What Is the Treatment for Lichen Sclerosus?
There is no cure for lichen sclerosus, but there are options to make the symptoms improve dramatically.
The most common treatment is a strong cortisone ointment, which is initially prescribed to be applied to the area once to twice daily for a few months. The frequency is then reduced over time as symptoms improve. Typically, the topical steroid is continued on an infrequent basis indefinitely for maintenance and prevention, and this approach can improve the symptoms and force them into remission in 90% of patients.
Using gentle cleansing products on the affected areas, such as Dove for sensitive skin or just plain water, is important to avoid irritation when bathing. Scrubbing, loofah sponges, harsh soaps, beaded cleansers, and cleansing wipes are not recommended.
If the lichen sclerosus is severe, sometimes the dermatology provider will discuss oral medications that help to suppress the immune system and the skin condition.
If you are concerned about the symptoms described above or any other skin issues, please fill out our online form here or call (719) 355-1585 to schedule a consultation.
Emily Reynolds is a dermatology certified nurse practitioner. Emily specializes in women’s health dermatology issues. She is part of Vanguard’s Colorado Springs dermatology practice in Broadmoor and Woodland Park.
Vanguard Skin Specialists began as a Colorado Springs dermatology practice and now has additional offices in Canon City and Pueblo. Vanguard specializes in the diagnosis and treatment of skin cancer, and we also offer general dermatology, plastic surgery, and aesthetic treatments.
Other blogs by or about Emily Reynolds:
That Recurrent Boil No One Talks About
Do you get recurrent painful “boils” or “abscesses” in the armpits, groin, buttocks, or other skin folds? Read more.
From Administrator to Nurse Practitioner
I really love how everyone at Vanguard Skin Specialists does their best for patients. Read more.