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 using the toilet 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 or nurse advice line (811 in most provinces and territories) 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.