Home > Health Guides by Topic > Gynecology & Reproductive Health > Gynecological Issues > Lichen SclerosisLichen Sclerosis:
A Guide for Teens
Lichen sclerosis is a skin condition that usually affects the vulva area (the outside parts of the female genitalia) and the anal area in young girls, adolescents, and adults. Similar to other skin conditions, there are treatments available to help the symptoms.
What is lichen sclerosis and what does it look like?
Lichen sclerosis (LS) is a skin condition that makes the vulva look white, slightly shiny, and smooth. The skin's surface becomes thin and delicate so that it tears easily. This can cause bleeding under the skin. In severe cases of lichen sclerosis of the genital area, scarring can occur. This causes the inner lips of the vulva to get smaller. The clitoris can become covered in scar tissue.
What causes lichen sclerosis?
We do not know the exact cause of lichen sclerosis. Scientists have different theories to try to explain the cause. Some scientists think that an overactive immune system may play a role in causing the disease. Some people may also develop lichen sclerosis due to their genes or to changes in hormones. Since lichen sclerosis is not caused by an infection, it cannot be spread and is not contagious.
What are the symptoms of lichen sclerosis?
Symptoms of lichen sclerosis may be different from one person to another and can be mild to severe. Girls and young women who have this disease may experience some or all of the following symptoms in the vulvar area:
How is lichen sclerosis diagnosed?
Lichen sclerosis can be a difficult diagnosis to make. It is not unusual for someone to see more than one doctor before the disease is finally diagnosed. This can be very frustrating for you if the treatment you are receiving isn't working. Most of the time, doctors who see a lot of patients with lichen sclerosis can often make the diagnosis just by looking at the skin, but still may need to do a biopsy. If you are in the early stages of lichen sclerosis, the doctor may have to do a biopsy (removal and examination of a small sample of affected skin) to identify the cause of your symptoms.
Will I need treatment?
Even if you do not have symptoms such as itching or pain, it is important for you to receive medical treatment for lichen sclerosis. Treatment to genital skin is necessary to try to prevent scarring of the vulva. Without treatment, there can be scarring that causes parts of the vulva to narrow and cause problems with passing urine or pain with sexual activity. Severe scarring can cause the opening to the vagina to narrow. Intercourse may be painful if the vagina narrows too much.
Are there medicines to treat lichen sclerosis?
Yes. Medications are available to help with the symptoms of lichen sclerosis. They are only available by a prescription from your doctor. If you have lichen sclerosis, your doctor will most likely prescribe a strong topical corticosteriod, which is a type of ointment that reduces swelling and itching on your skin. This medicine also decreases the body's immune response. Your doctor will probably tell you to apply this drug every day so that your skin can return to its normal surface and strength. The amount of time it takes for this to happen is different from patient to patient. It is important to realize that the treatment may not undo the scarring that may have already occurred.
If you need treatment for lichen sclerosis, be sure to ask your doctor how long you need to use it, and what side effects it might have. It is also important to go to all your appointments, especially if you are using strong medicine. |
Will I need surgery?
Most of the time, the prescription medicine works to control symptoms and return your skin to normal. In severe cases, surgery may be necessary if the lichen sclerosis did not respond to the medications and/or scarring has already formed.
Can people with lichen sclerosis have sex?
Lichen sclerosis is not contagious since it is a skin disorder and not a STD (sexually transmitted disease). Therefore, sexual intercourse can take place without having to worry about spreading lichen sclerosis. Adolescents and women suffering from severe cases of lichen sclerosis may not be able to have sex because of scarring that has caused the opening to the vagina to narrow. If you have this condition, trying to have sex may cause a lot of pain. However, with proper early treatment the skin will return to its natural condition before severe scarring occurs and sexual intercourse can take place. However, if severe scarring has already occurred and the opening to the vagina has already narrowed, vaginal dilators may be needed to correct the problem.
Does lichen sclerosis cause cancer?
Lichen sclerosis is not skin cancer. However, scientists have found that skin that has been scarred from lichen sclerosis is more likely to develop skin cancer. This is why it is so important for people who have this skin disorder to receive proper treatment right away. By doing this, your doctor can watch skin changes, treat your symptoms, and be alert to early signs of skin cancer.
Updated 3/12/06
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