Lichen sclerosus

Lichen sclerosus affects people of all ages, including children. But it's much more common in women over 50.

People with white, brown or black skin can get lichen sclerosus.

It causes patches on the skin that are usually:

The patches can appear anywhere, but most often are on the:

Having sex can be painful because the vulva may shrink or tighten. In men, the foreskin may tighten making erections painful.

If you have lichen sclerosus, there are some things you can do to help stop your skin becoming irritated or damaged.

wash with an emollient soap substitute instead of regular soap – ask a doctor or pharmacist about suitable products
gently dab your genitals dry after peeing
regularly apply a barrier cream or ointment, such as petroleum jelly, to affected areas
wear cotton or silk underwear
use lubricant if sex is uncomfortable

do not smoke
do not scratch or rub the affected skin
do not use scented soaps, bubble bath or shower gel
do not wear tight or restrictive clothes, such as tight-fitting underwear
do not wash your underwear with detergent – just use water
do not wear panty liners or use fragrance-free ones if you need to use them
do not do activities like cycling or horse riding until your symptoms have improved
do not smoke or go near naked flames if you use an emollient – emollients are not flammable on the skin, but when they get on fabrics such as dressings, clothing and bedding they can catch fire more easily

See a GP if you have:

an itchy white patch on your genitals or skin
been diagnosed with lichen sclerosus and treatment is not helping
been diagnosed with lichen sclerosus and have pain when going to the toilet or having sex

A GP may refer you to a specialist for tests and treatment.

Lichen sclerosus cannot be cured, but using a strong prescription steroid cream usually helps relieve the symptoms.

Unless your doctor tells you otherwise, follow the directions on the patient information leaflet that comes with the medicine.

You may need to use the cream regularly for a few months to get your symptoms under control.

If your symptoms keep coming back, you may have to keep using it every now and again.

You can get more cream from a GP if you need it.

Although treatment for lichen sclerosus can help, the affected skin can sometimes become scarred and tight over time.

The vulva may shrink, with the clitoris and small inner lips (labia minora) around the opening of the vagina often affected.

The scarring and tightness can cause discomfort when peeing, pooing and during sex. Having an erection can be painful.

If lichen sclerosus is severe, you might need a small operation, such as surgery to widen your vagina or remove your foreskin (circumcision).

Lichen sclerosus increases your risk of getting cancer on your vulva, penis or anus.

The risk is low, but it's a good idea to check yourself regularly and see a GP if you're worried.

Symptoms to look for include a lump, a change in skin texture, such as thickening, or an ulcer that does not go away.

The cause of lichen sclerosus is unknown.

It might be caused by your immune system, the body's defence against infection, mistakenly attacking and damaging your skin.

Lichen sclerosus is:

not caused by an infection
not contagious – you cannot spread it to other people through close contact, including sex
not caused by poor personal hygiene

Rubbing or damage to the skin can trigger lichen sclerosus or make it worse.