Updates

Lichen Sclerosis

Conditions

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Lichen sclerosis is a skin condition that typically affects a girl’s vulva and anal areas. An estimated 10 to 15% of cases occur in young girls. 

Patients can be seen by Texas Children's experts in Pediatric and Adolescent Gynecology.

Causes & Risk Factors

The exact cause is not yet known. Genetics, changes in hormones, or an overactive immune system may play a role.

Since the condition is a skin disorder and not an STD (sexually transmitted disease), it is not contagious.

Symptoms & Types

Some girls may have no symptoms.

For others, symptoms can range from mild to severe and may include the following changes in the vulvar area:

  • Mild to severe itching
  • Skin that appears fragile, pale, and/or white
  • Bruised skin with broken blood vessels or "blood blisters"
  • Small tears in the skin
  • Scar tissue covering the labia or clitoris
  • Bleeding or tearing of skin when having bowel movements

Diagnosis & Tests

Diagnosis can be difficult but may include:

  • A pelvic exam – to look for skin changes in the vulva area
  • A biopsy – involves removing a small piece of affected skin from the vulva and examining it under a microscope
  • A vaginal culture – to rule out infection

Treatment & Care

Even if there are no symptoms, it is important to treat the condition to prevent scarring of the vulva, which can lead to problems urinating or pain with sexual intercourse.

Treatment typically involves:

  • Prescription steroid creams – to reduce the itching and inflammation and restore the health of the skin; any scarring that has already occurred may not be reversible in all cases
  • Oral or injectable steroids
  • Avoiding irritants to the vulva – including tight-fitting clothing and harsh soaps and detergents
  • Close observation for 6 to 12 months to monitor for recurrence
  • Surgery, in very rare cases, to treat scarring

Living & Managing

Regular check-ups are important after treatment of lichen sclerosis to watch for changes in the vulva skin, catch and treat symptoms early, and ensure no cancerous changes have occurred. Skin that has been scarred from lichen sclerosis is slightly more likely to develop skin cancer.