Lichen sclerosis is a skin disorder that is more common in women but that can also affect men and children. Lichen sclerosis usually occurs on the genitals but in some cases it can instead affect other parts of the body. When it affects females, lichen sclerosis generally involves the vulva and the parts around anus. Lichen sclerosis affects men who are not circumcised. This condition involves only the skin and never spreads to the inside of the vagina or anus to cause more complications.
The most common symptoms of this condition are tiny white spots on the genitals. The spots can be very itchy, especially at night, and they grow bigger in time. In some cases they may attach to each other to form larger affected areas. The surface of the skin affected by lichen sclerosis can become very thin and it can be easily torn (leading to bleeding), damaged, or get infected. Sometimes the affected skin can be painful to touch. It is recommended not to have sex (although lichen sclerosis is not contagious), wear tight clothes or ride a bike while having the white spots. In some cases a patient can experience pain while urinating and passing stool. Men can have painful erections. Women can have a narrowed vaginal opening. Lichen sclerosis can be undetected for months or even years because symptoms do not occur or the patient does not go to a doctor.
The main cause of lichen sclerosis is still unknown at the moment. One probable explanation is that lichen sclerosis is an autoimmune disorder, a condition in which the patient's immune system begins to attacks the body. In this case it is probably connected with the other autoimmune disease such as thyroid gland disorder. Some scientists believe that this condition can be hereditary. Sometimes, lichen sclerosis can be a consequence of bacterial inflammation or abnormal hormone levels.
In order to diagnose the condition, the doctor can just examine the skin or take a tissue sample (a biopsy), which will be examined in the lab. In very rare cases, lichen sclerosis will develop into cancerous lesions. The doctor will also perform a blood test in order to check if the thyroid gland functions properly and to examine hormone levels.
Lichen sclerosis is treated with topical creams and balms, which patients apply to the affected areas. The most common treatment is a topical steroid ointment which is useful for relieving the inflammation, and which will also reduce the itching the patient experiences. This ointment is usually applied for several months on a daily basis. The white spots will disappear in a couple of weeks but treatment should be continued because it takes more time for the skin to heal. It is advised to use liquid balms for cleaning the genitals instead of regular soap. If you are sexually active, it is good to use lubricants to reduce friction that could further damage the skin. If the vaginal opening is narrowed, the doctor may suggest a vaginal dilator which is put inside the vagina in order to stretch it.
Of course, diagnosis is the first step toward sucessful management of lichen sclerosis, and that is why any patient who notices white lesions or rashes around the skin of their genitals should seek medical attention as soon as they can.
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