Lichen Sclerosus: Care Instructions

Overview

Lichen sclerosus is a long-term (chronic) skin problem. It can cause thin, wrinkled white patches in lighter skin. In darker skin, the patches may look lighter or darker than the skin around them. The patches are itchy and painful. If the skin tears, bright red or purple spots may appear. In most cases, it occurs on the skin of the anus (the opening where stool leaves the body), the vulva (the area around the vagina), and the tip of an uncircumcised penis.

Doctors aren't sure what causes lichen sclerosus. It isn't caused by an infection, and it's not contagious. You can't spread it to others.

If the skin patches are on the anus, vulva, or penis, treatment is important to prevent problems. If these areas aren't treated, the skin can thin, tear, and bleed. This can be painful. Untreated lichen sclerosus can also cause severe itching and scarring. The openings to the vagina and anus can narrow, and the foreskin over the penis may tighten and shrink. This scarring is permanent and can make going to the bathroom and having sex painful.

Lichen sclerosis on the genitals can also increase your risk of skin cancer. Regular skin exams are recommended.

Lichen sclerosus is usually treated with strong prescription cream or ointment. The medicine stops the inflammation, but the scarring of the skin doesn't go away. Those with scarring from advanced cases on the tip of the penis may have surgery to remove the foreskin.

Skin patches on any other part of the body usually go away on their own without treatment.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Be safe with medicines. If your doctor prescribed a cream, apply it exactly as directed. Call your doctor if you think you are having a problem with your medicine.
  • Put cold, wet cloths on the area to reduce itching.
  • Wear loose-fitting clothes. Avoid nylon and other fabric that holds moisture close to the skin. This may allow an infection to start.
  • If your doctor told you to use nonprescription moisturizing cream on your skin, read and follow the directions on the label.

Care tips

  • Do not douche, unless your doctor tells you to.
  • Avoid hot baths. Don't use soaps or bath products to wash the area around your vulva. Rinse with water only, and gently pat the area dry.
  • Keep your penis clean. If you haven't been circumcised, gently pull the foreskin back to wash your penis with warm water. Make sure your penis is dry before you get dressed.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • You have symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the area.
    • Pus draining from the area.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • The affected area grows or changes.
  • You have new or worse symptoms.
  • You do not get better as expected.