Lichen sclerosus is a long-term skin condition that most often affects the vulva and the skin around the anus. It causes itching, soreness and white, thin or wrinkled patches of skin.
It can affect women and girls of any age, but is most common after the menopause. It is not an infection and cannot be passed on through sex or close contact.
Lichen sclerosus cannot be cured, but treatment controls the symptoms very well for most people, and regular follow-up is important.
Vulval appointments
Several of our consultants specialise in vulval skin conditions. Dr Inge Kreuser-Genis and Dr Sabrina Khan see vulval patients in extended 40-minute appointments, so there is time to talk through your symptoms in private.
Symptoms of Lichen Sclerosus
Some people have few symptoms, while others find them very troublesome.
Common signs include:
- itching, which is often worse at night
- soreness, splitting or bruising of the skin
- white, shiny or wrinkled patches
- pain or discomfort during sex
- changes in the shape of the vulva over time, if it is not treated
Causes of Lichen Sclerosus
The exact cause is not known. It is thought to be an autoimmune condition, where the immune system attacks the skin by mistake.
It is more common in people who have other autoimmune conditions, such as thyroid disease, and it sometimes runs in families. It is not caused by poor hygiene, and it is not a sexually transmitted infection.
Diagnosis of Lichen Sclerosus
Lichen sclerosus is usually diagnosed from its appearance during a careful examination.
A small skin biopsy may be taken under local anaesthetic if the diagnosis is uncertain, or if an area does not respond to treatment.
Treatment at Derma for Lichen Sclerosus
The main treatment is a strong steroid ointment, used daily at first and then less often to keep the condition under control. Used as directed, it is safe and very effective.
Treatment also includes:
- soap substitutes and moisturisers to protect the skin
- advice on avoiding irritants
- regular follow-up to check the skin and adjust treatment
Lichen sclerosus carries a small increased risk of skin cancer of the vulva. Keeping it well controlled reduces this risk, so any new lump, ulcer or sore patch that does not heal should be checked promptly.
Further reading: Patient leaflet from the British Association of Dermatologists
Frequently Asked Questions
Is lichen sclerosus infectious?
No. It cannot be passed to a partner and it is not a sexually transmitted infection.
Can it be cured?
There is no cure, but treatment usually controls the symptoms very well.
Is the steroid ointment safe to use long term?
Yes, when used as your dermatologist advises. Vulval skin tolerates it well, and the amount needed usually reduces once the condition is controlled.
Do I need to keep having check-ups?
Yes. Long-term follow-up keeps the condition controlled and picks up any changes early.
Related Specialists at Derma
Vulval dermatology specialists
Dr Kreuser-Genis and Dr Khan see vulval patients in extended 40-minute appointments (£400).
Dr Inge Kreuser-Genis
Consultant Dermatologist
General dermatologyPaediatric dermatologySkin surgery
Specialist interests in paediatric and vulval dermatology.
Dr Sabrina Khan
Consultant Dermatologist
General dermatologySkin surgery
Leads the vulval service in Oxford.
Dr Rachel Fisher
Consultant Dermatologist
General dermatologySkin surgery
Leads the vulval service at the Royal Berkshire Hospital, sits on the BSSVD Council and is the British Association of Dermatologists’ vulval representative.
Professor Rubeta Matin
Consultant Dermatologist
General dermatology
Specialist interests in skin cancer and moles, skin disease in transplant and immunosuppressed patients, and cutaneous lymphoma.
Also seen by
Any of our consultant dermatologists can assess vulval lichen sclerosus.
Dr Charles Archer
Consultant Dermatologist
Dr Sanju Arianayagam
Consultant Dermatologist
Dr Rima Clayton
Consultant Dermatologist
Dr Antonia Lloyd-Lavery
Consultant Dermatologist
Dr John Reed
Consultant Dermatologist
Dr Isabelle Vandormael
Consultant Dermatologist