Lichen sclerosus is a chronic inflammatory skin disorder that can affect men, women, or children, but is most common in women. It usually affects the vulva and the anal area. While lichen sclerosus appears predominantly in postmenopausal women, this skin condition is also known to develop on the head of the penis, almost exclusively in uncircumcised men. Occasionally, lichen sclerosus is seen on other parts of the body, especially the upper body, breasts, and upper arms.
Initially small, subtle white spots appear. These spots develop into bigger patches, and the skin surface becomes thinned and crinkled, resulting in skin that tears easily, and bright red or purple discoloration from bleeding inside the skin. Severe cases can produce scarring causing the inner lips of the vulva to shrink and disappear, the clitoris to become covered with scar tissue, and the opening of the vagina to narrow.
For more information on symptoms of lichen sclerosus, visit the NIAMS lichen sclerosus information page.
Although definitive data are not available, lichen sclerosus is considered a rare disorder that can develop in people of all ages. It usually appears in postmenopausal women and primarily affects the vulva. It is uncommon for women who have vulvar lichen sclerosus to have the disease on other skin surfaces. The disease is much less common in childhood. In boys, it is a major cause of tightening of the foreskin, which requires circumcision. Otherwise, it is very uncommon in men.
The cause is unknown, although an overactive immune system may play a role. Some people may have a genetic tendency toward the disease, and studies suggest that abnormal hormone levels may also play a role. Lichen sclerosus has also been shown to appear at sites of previous injury or trauma where the skin has already experienced scarring or damage.
Lichen sclerosus is not contagious.
Patients with lichen sclerosus of nongenital skin often do not need treatment because the symptoms are very mild and usually go away over time. The amount of time involved varies from patient to patient.
For more information on treatment options visit the NIAMS lichen sclerosus information page.
Women with severe lichen sclerosus may not be able to have sexual intercourse because of pain or scarring that narrows the entrance to the vagina. However, proper treatment with an ultrapotent topical corticosteroid can help restore normal sexual functioning, unless severe scarring has already narrowed the vaginal opening. In this case, surgery may be needed to correct the problem, but only after the disease has been controlled.
Lichen Sclerosus and cancer?
Lichen sclerosus does not cause skin cancer. However, skin that is scarred by lichen sclerosus is more likely to develop skin cancer. The frequency of skin cancer in men with lichen sclerosus is not known. It is important for people who have the disease to receive proper treatment and to see the doctor every 6 to 12 months, so that the doctor can monitor and treat any changes that might signal skin cancer.More information on lichen sclerosus?
The information on this page was reprinted from the National Institute of Arthritis and Musculoskeletal and Skin Diseases website. You can find more information about lichen sclerosus from these organizations:
- NIAMS/National Institutes of Health
Tel: 877-22-NIAMS (226-4267)(free of charge)
TTY: 301-565-2966 - American Academy of Dermatology
Tel: 847-330-0230 or 888-462-DERM (3376)(free of charge) - American College of Obstetricians and Gynecologists
Tel: 202-638-5577 - American Urological Association
Tel: 866-RING-AUA (746-4282) (free of charge) or 410-689-3700 - National Vulvodynia Association (NVA)
Tel: 301-299-0775
Acknowledgments
The NIAMS gratefully acknowledges the assistance of Libby Edwards, M.D., Wake Forest University School of Medicine, Winston-Salem, NC; Alan Moshell, M.D., National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH; and Maria Turner, M.D., National Cancer Institute, NIH, in the preparation and review of this booklet.
Published March 26, 2006.
