Lichen Sclerosus et Atrophicus

What is Lichen Sclerosus et Atrophicus?

Lichen Sclerosus (LS) is a chronic skin condition. It consists of inflammation in the skin that makes it look white, shiny and sometimes with bruising, blood blisters and little tears. It usually affects the genitals and perianal areas but may occur in other locations on the body.

This most often affects women who have gone through menopause and young girls before puberty. However, it can affect men and boys too. In males it is called “balanitis xerotica obliterans”.

We don’t know what causes LS but it seems to be an autoimmune process. Sometimes it is associated with other autoimmune diseases like thyroid disease, vitiligo, and alopecia areata. We do know that LS is not contagious and you can’t spread it to another person.

Many people with LS will complain of itching, burning and pain in the genital area. Sometimes there is pain with urination, bowel movements or intercourse. Sometimes people have no symptoms in the area. In advanced cases there may be scarring, loss of the inner labia, and narrowing of the opening to the vagina. In men, it can cause difficulty in retracting the foreskin or problems passing urine. 

Often this condition is diagnosed by a doctor during an examination. However, sometimes it requires a skin biopsy (sampling of the skin) to make the diagnosis. 

How do You Treat Lichen Sclerosus et Atrophicus?

Lichen sclerosus is treated with high potency topical steroids applied to the affected area daily. You should apply a small amount of ointment and gently rub into the area for 90 seconds. Soaking in a bath tub prior to application is very helpful. Typically, after about 1 month, the condition will improve and your doctor may taper the topical steroid to using it less frequently (1-3x per week). Ointments work better than creams for treatment. The treatment is meant to improve the symptoms and prevent progression of the condition.

Patients also may find it useful to use barrier ointments like Vaseline Petroleum Jelly, A&D ointment, zinc paste or Cerave Healing Ointment to the affected area to soothe the symptoms once the condition is under control. Unfortunately there is not a “cure” but this condition can be managed. In young girls, about 60% will notice the condition goes away at puberty. However, sometimes it can reoccur or persist into adulthood. In advanced cases where there is significant scarring, sometimes surgery can be helpful. 

Is there a Cancer Risk?

There may be a slightly increased risk (about 5% of cases) of developing a skin cancer called squamous cell carcinoma in the area affected by lichen sclerosus. This typically does not affect children with the condition. However, adults should have at least yearly examinations to monitor the lichen sclerosis. If you notice a sore or thickening in the skin that doesn’t heal after a month of using the topical steroid you should notify your doctor as this area may need to be biopsied. 

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Why Iowa Dermatology Consultants?

Iowa Dermatology Consultants believes in a patient focused approach to care.  We work with patients forming an active partnership in treatment to help repair the physical and emotional damage of skin disease.  Our Ankeny and Ames locations allow us to conveniently treat patients across the Des Moines metro area and all of Central Iowa including Ames, Carroll, Fort Dodge, Iowa Falls, Marshalltown, Huxley, Slater, and Indianola.  

At Iowa Dermatology Consultants, all of our physicians are board-certified dermatologists. Your care provided by Dr. Snider, Dr. Smith, or Dr. Myers is founded in knowledge and experience which exceeds that of a general practitioner.  Together they have almost 50 years of combined experience in diagnosing and treating a vast array of skin conditions.  This includes over 16,000 hours of patient care training to ensure that a board-certified dermatologist can expertly diagnosis and treat over 3000 dermatologic conditions.

Whether you’re coming to us for help with skin cancer or diseases like acne, psoriasis, and eczema; or to reverse the signs of aging with Botox, chemical peels or other cosmetic procedures, at Iowa Dermatology Consultants you will be getting the best dermatologic care in Central Iowa.