*Lichen sclerosus facts
*Lichen sclerosus facts author: John P. Cunha, DO, FACOEP
- Lichen sclerosus is a long-term problem of the skin that mostly affects the genital and perianal areas.
- Lichen sclerosus is most commonly seen in post-menopausal women. It is uncommon in men and children.
- Symptoms of lichen sclerosus include small white, shiny, smooth spots on the skin that grow into bigger plaques that become thin and crinkled. The skin may tear easily, and bright red or purple bruises are common. There may also be itching, bleeding, and blisters.
- The cause of lichen sclerosus is unknown but may be the result of an overactive immune system and hormone problems.
- Lichen sclerosus is not contagious.
- Lesions from lichen sclerosus on the arms or upper body usually go away without treatment. If lesions appear on the genitals, treatment for women involves topical prescription-strength steroid cream or ointment.
- Skin scarred by lichen sclerosus is somewhat more likely to develop skin cancer.
What is lichen sclerosus?
Lichen sclerosus is a long-term problem that usually affects the skin of the genital and anal areas. The disease can also appear on the upper body, breasts, and upper arms.
The disease does not cause skin cancer but may increase your risk for cancer if your skin is scarred. You should see your doctor every six to 12 months in order to follow and treat skin changes.
Lichen Sclerosus Treatment
Tacrolimus ointment suppresses the immune system and the inflammation by inhibiting an enzyme (calcineurin) crucial for the multiplication of T-cells, cells that are required for activation of the immune system.
The most common side effects of tacrolimus ointment are skin reactions at the site of use, including:
- Flu-like symptoms,
- allergic reactions, and
Who gets it?
Lichen sclerosus appears:
- Most often in women (usually after menopause).
- Less often in men.
- Rarely in children.
What are the symptoms?
You may have no symptoms if you have a mild form of the disease. If you do have signs, they can include:
- Small white spots on the skin (early in the disease).
- Spots that grow into bigger patches. The skin over these patches become thin and crinkled.
- Skin that tears and bruises.
- Skin that becomes scarred.
- Itching, which is very common.
What causes it?
You can’t give lichen sclerosus to someone else. No one knows what exactly causes the disease. Some possible causes include:
- An overactive immune system.
- Hormone problems.
- Inheriting the risk for getting the disease from your parents.
- An injury that damaged or scarred the skin.
Is there a test for it?
Usually a doctor will take a small piece of skin and look at it under a microscope to diagnose lichen sclerosus. In more severe cases, doctors can just look at you to diagnose the disease based upon how it has affected your skin.
How is it treated?
Patches on the arms or upper body usually go away after time without treatment. The disease may also go away after puberty.
Patches of the genital skin should be treated, even if they aren’t painful or itchy. These patches can scar, causing problems with urination or sex. There is also a very small chance that skin cancer may develop in the patches. You should see your doctor every six to 12 months in order to follow and treat any skin changes.
Possible treatments for the disease include:
- Ointments and creams, which can help with itching and to keep the disease from coming back.
- Surgery to remove the genital patches in men.
You should talk to your doctor about the best treatment for you.