Materiały źródłowe

• #1 Lichen sclerosus | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/vulva-vagina/vulva-vagina-problems/lichen-sclerosus

  Lichen sclerosus (said ‘like-en skler-oh-sus’) is a skin condition that makes patches of skin look white, thickened and crinkly. It most often affects the skin around the vulva or anus. […] It can be itchy, painful and cause permanent scarring. Four in 100 (or four per cent of) women with this condition go on to develop vulvar cancer. […] Lichen sclerosus affects around one in 80 women. It can happen at any age, but is most common in middle-aged and elderly women. For most women it is a lifelong condition. […] Symptoms include: chronic itchiness in the vulvar or anal area (which may go away and come back later), skin that looks pale, thicker or crinkled, pain if the skin has split because of scratching. […] Skin affected by lichen sclerosus can also scar and join up with nearby skin. This can change the structure of your vulva – for example, your labia minora may appear flattened, your clitoris can become buried under its hood and/or the opening of your vagina may shrink. This can sometimes affect your ability to have and/or enjoy sex.

• #2 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  Lichen sclerosus (LS) is an underdiagnosed inflammatory mucocutaneous condition affecting the anogenital areas. The typical clinical picture includes chronic whitish atrophic patches along with itching and soreness in the vulvar, perianal and penile regions. In addition to genital scarring, and sexual and urinary dysfunction, LS may also lead to squamous cell carcinoma. The clinical picture of anogenital LS (gLS) includes ivory-white patches, atrophy and severe pruritus, altering the quality of life (QoL). The lesions could evolve to scarring of the vaginal introitus, phimosis and functional impairment. Furthermore, it has been described as an intrinsic risk factor for malignancy in untreated patients, but there is no evidence of increased neoplasm development after long-term treatments. The established diagnosis of LS based on the clinical features is usually sufficient, and a skin biopsy should only be performed in case of clinical doubts, differential diagnosis or suspected malignancy. The first-line therapy is ultrapotent or potent topical glucocorticoids and in case of anatomical changes due to scarring, surgical procedures should be performed. In order to prevent complications, aside from an early diagnosis and a correct treatment, a long-term follow-up is imperative.

• #3 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #4 What is vulval lichen sclerosus? | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/what-is-vulval-ls/

  In time, the collagen in your dermis gets so thick that blood vessels and other structures disappear this is called fibrosis and its what causes the scarring people with LS often see. […] This process can make your skin look white, and become brittle, itchy and prone to cracking. Over time, it can also change the appearance and shape of your vulva these are called structural (or architectural) changes. […] The most serious potential complication with LS is an increased risk of cancer. But its important to remember that vulval cancer is very rare, so your risk will still be very low. If your LS is properly treated, its thought this risk is even lower. […] LS is a long-term skin condition and, right now, there isnt a cure. But while many people have it for many years, its really important to remember that you dont have to live with constant symptoms or discomfort. Help is out there, and weve put together this guide to help you find it.

• #5 Lichen Sclerosus > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/lichen-sclerosus

  Lichen sclerosus is a rare skin disease that causes itchy and painful patches of thin, white, wrinkled-looking skin. […] The condition can lead to scarring and tightening of the skin around the genitals and anus. […] Lichen sclerosus is a chronic disease, meaning that once it develops, it lasts for a long time, often for the rest of a patients life. Though it often worsens over time, the good news is that treatments are now available that can reduce symptoms and stop progression of the disease. […] Lichen sclerosus is a life-long condition for which there is no cure. If the disease progresses or is left untreated, it may cause serious, debilitating symptoms. […] Fortunately, treatment generally reduces and, in some cases, eliminates symptoms, though relapses still tend to occur periodically. […] A long-term maintenance treatment regimen is very important, and not just to prevent or treat symptom recurrence. Treatment to maintain normal skin color and texture reduces scarring and may prevent progression to skin cancer.

• #6 Lichen sclerosus

  https://www.rch.org.au/kidsinfo/fact_sheets/Lichen_sclerosus/

  Left untreated, lichen sclerosus found on or near the vulva may cause the labia to shrink and the opening to the vagina may become narrow and tight. […] Current research suggests that lichen sclerosus around the anal and genital area can get better naturally, before or around the time your child starts having periods. However, the condition can continue past this time in some cases, or it can also be latent (sleeping) and start again at an older age. […] Changes in the vulva architecture, such as shrinking of the labia and narrowing of the vaginal opening can happen without other symptoms. Furthermore, very rarely, a skin cancer can develop when there has been long-standing chronic inflammation of the skin. […] Studies have shown that skin that has been affected by lichen sclerosus is slightly more likely to develop skin cancer, later in life. That is why it is important to have a checkup each year, so the doctor can monitor any changes to the skin. The risk of cancer is higher in adults with lichen sclerosus, compared to children with the condition.

• #7 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  Lichen sclerosus (LS) is an underdiagnosed inflammatory mucocutaneous condition affecting the anogenital areas. The typical clinical picture includes chronic whitish atrophic patches along with itching and soreness in the vulvar, perianal and penile regions. In addition to genital scarring, and sexual and urinary dysfunction, LS may also lead to squamous cell carcinoma. The clinical picture of anogenital LS (gLS) includes ivory-white patches, atrophy and severe pruritus, altering the quality of life (QoL). The lesions could evolve to scarring of the vaginal introitus, phimosis and functional impairment. Furthermore, it has been described as an intrinsic risk factor for malignancy in untreated patients, but there is no evidence of increased neoplasm development after long-term treatments. The established diagnosis of LS based on the clinical features is usually sufficient, and a skin biopsy should only be performed in case of clinical doubts, differential diagnosis or suspected malignancy. The first-line therapy is ultrapotent or potent topical glucocorticoids and in case of anatomical changes due to scarring, surgical procedures should be performed. In order to prevent complications, aside from an early diagnosis and a correct treatment, a long-term follow-up is imperative.

• #8 Lichen Sclerosus

  https://healthlibrary.uwmedicine.org/Library/Encyclopedia/134,552

  Lichen sclerosus causes skin changes. Very early on, you might not have any symptoms at all. A little later, you may see small white spots on your skin. […] Common symptoms might include: Vulvar itching (very common), Anal itching, bleeding, or pain, Pain during sex, Skin bruising and tearing, Blisters, Easy bleeding from minor rubbing of the skin, Pain or bleeding when having a bowel movement, Trouble urinating or pain with urination, Painful erections (in men). […] Symptoms in the genital and anal area don’t often get better without treatment. […] If untreated, the condition tends to get worse over time. […] Untreated advanced lichen sclerosus may permanently change the look of your genitals. The vagina’s opening may narrow. The outer and inner lips of the vulva may stick together. You may need surgery to fix these changes. In men, the foreskin may scar and shrink. This leads to trouble pulling back the foreskin. In both men and women, the condition may cause pain during sex. […] These treatments often reduce most of the symptoms and keep the condition from getting worse.

• #9 Lichen sclerosus – Autoimmune Association

  https://autoimmune.org/disease-information/lichen-sclerosus/

  Lichen sclerosus is a skin disorder that can affect men, women, or children, but is most common in women. […] Early in the disease, small white spots appear on the skin. The spots are usually shiny and smooth. Later, the spots grow into bigger patches. The skin on the patches becomes thin and crinkled. Then the skin tears easily, and bright red or purple bruises are common. Sometimes, the skin becomes scarred. If the disease is a mild case, there may be no symptoms. […] Symptoms can include white lesions or plaques, pain during urination, itching, and pain during intercourse. Some people have no symptoms, while others may experience itchiness (sometimes severe), discomfort, or blistering. LS can last for years and can cause permanent scarring and damage if left untreated. […] Treatment is focused on managing the symptoms and stopping the progression of the disease.

• #10 Lichen sclerosus – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/symptoms-causes/syc-20374448

  Lichen sclerosus is a skin condition characterized by discolored, blotchy patches of skin. […] Lichen sclerosus commonly affects the genital area. […] Lichen sclerosus may affect skin on any part of your body but often involves the skin of the genital area. […] It’s possible to have mild lichen sclerosus with no symptoms. When symptoms do occur, they usually affect the skin of the genital and anal areas. The back, shoulders, upper arms and breasts may also be affected. Symptoms may include: Smooth discolored skin patches, Blotchy, wrinkled skin patches, Itching, Soreness or a burning feeling, Easy bruising, Fragile skin, Changes in the tube for urine flow (urethra), Bleeding, blistering or open sores, Painful sex. […] Complications of lichen sclerosus include painful sex and scarring, including covering of the clitoris. Scarring of the penis can cause painful erection, poor urine flow and an inability to retract the foreskin. […] People with vulvar lichen sclerosus are also at an increased risk of squamous cell carcinoma.

• #11 Lichen Sclerosus Signs and Symptoms: Does the Difference Matter? TLLC

  https://www.lostlabia.com/lichen-sclerosus-signs-and-symptoms-does-the-difference-matter/

  Lichen Sclerosus Signs […] Skin discoloration (e.g., whitening of the skin that may present as general whiteness or thickened white plaques of skin). […] Fusing, phimosis, and scarring. […] Thickened, wax-textured skin. […] Skin that appears crinkled and thinned out, despite the fact that below the surface level, the skin is thickened. […] Splitting of the skin (e.g., cuts, fissures, tears). […] Bruising (e.g., if you scratch aggressively, this can cause bruising). […] Swelling (e.g., if you scratch aggressively, this can cause minor swelling). […] *Please note, you do not have to have all the signs to have lichen sclerosus. […] […] […] Lichen Sclerosus Symptom Examples […] Vulvar itch […] Vulvar pain […] Burning or stinging […] Paper-cut-like sensations (fissures)

• #12 Vulvar Lichen Sclerosus Specialist Melbourne | Dr Len Kliman

  https://drlenkliman.com.au/services/vulval-and-vaginal-skin-disorders/vulvar-lichen-sclerosus/

  Lichen sclerosus (LS) is a long-term skin disease that mainly affects the genital skin. It usually starts around the age of menopause but may occur at any age including children. The most common symptoms associated with Lichen Sclerosus include: […] Itchiness: This is the most common symptom, and can be quite severe […] Soreness Burning: Some people experience soreness burning during intercourse. Small cracks in the skin (known as fissures) and ulcers can occur as a result of scratching the skin and these can be very sore. If the anal skin is split there can be pain with bowel movements. […] Pale/Patchy Skin: The skin becomes pale and white in appearance. This may be patchy or involve the entire vulva extending down the skin around the anus. […] Bruising: Small purplish/red areas may be seen on the white background. These are bruises due to tiny areas of bleeding into the skin often because of scratching.

• #13 Lichen Sclerosus: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16564-lichen-sclerosus

  Lichen sclerosus is a chronic (life-long) condition. Without treatment, it can lead to scarring, making it difficult or painful to have sexual intercourse (dyspareunia), urinate (pee) or have a bowel movement (poop). Untreated lichen sclerosus can also increase your chances of developing a type of skin cancer (penile cancer and vulvar squamous cell carcinoma). There isnt a cure for lichen sclerosus, though treatment can help manage your symptoms. […] The primary symptoms of lichen sclerosus include white, raised spots on your vulva, anus, foreskin or the tip of your penis (glans). They cause itching, soreness, discomfort or burning. Other symptoms include: Ulcers and sores. Inflammation. Scarring. Cracking. Pain while peeing (dysuria). Pain while having sex. Weak pee stream. Your pee may spray instead of coming out in a stream. Tightening of your foreskin. Inability to pull your foreskin back (phimosis). Fluid that comes out of your penis that isnt pee or semen (penile discharge).

• #14 Lichen sclerosus in females – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/lichen-sclerosus-in-females/

  The skin has a white shiny appearance which is usually thinned but can sometimes become raised and thickened. When the skin around the anus is affected, it is described as a figure of eight pattern. Skin fragility and scratching may lead to breaking of some small blood vessels in the skin which appear as tiny blood blisters. Occasionally, blisters and small cracks called fissures can be seen. If not treated, there may be a change in the normal appearance of the vulva. […] There is no permanent cure for lichen sclerosus, but the symptoms and signs of the disease can be well controlled with the application of ointments to the affected skin. If it starts in childhood, and is properly treated, then it goes away by the time of puberty in the majority of girls.

• #15 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #16 Lichen sclerosus: Symptoms, Causes, and Treatment

  https://patient.info/womens-health/vulval-problems-leaflet/lichen-sclerosus

  If left untreated, over months or years the vulva may shrink (doctors call this 'atrophy’). In some cases the changes of the vulval skin may make the entrance to the vagina narrower. This can make it difficult or painful to have sex. […] Symptoms may slowly get worse but not all the above symptoms may occur. It can take months or years from the first small spots to progress to more severe symptoms. […] White spots develop on the foreskin and end of the penis. These can be sore. In time, the changes to the affected skin may cause difficulty in retracting the foreskin and in passing urine. Erections may become painful. […] The itch and discomfort may cause a lot of distress. If untreated, lichen sclerosis can cause scarring of the vulva, which can make it painful to pass urine. Scarring can make the vaginal opening narrower, which can make penetrative sex painful and sometimes impossible.

• #17 What is vulval lichen sclerosus? | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/what-is-vulval-ls/

  Over time, if it isnt treated, LS can also cause whats known as scarring or fusion, which is where parts of your vulval skin start to stick together. […] It means your inner lips (labia minora) might shrink and become stuck down, while your outer lips (labia majora) might start to stick (or fuse) together. Sometimes this can make the entrance to your vagina narrower, and the skin surrounding your clitoris stiffer and less flexible. […] When you first get LS, it increases inflammatory cells (called T cells) which collect where your epidermis and dermis meet. These cells release tiny proteins called cytokines which upset the normal balance of your skin, affecting the way it works and renews itself. As LS develops, your epidermis (the top layer of your skin) becomes thinner. This is called epidermal atrophy, and it can make your skin look thin and wrinkled.

• #18 Lichen sclerosus

  https://www.nhs.uk/conditions/lichen-sclerosus/

  Lichen sclerosus is a skin condition that causes itchy white patches, most commonly on the genitals. There’s no cure, but treatment can help relieve the symptoms. […] It causes patches on the skin that are usually: itchy, white, smooth or crinkled, easily damaged they may bleed or hurt if rubbed or scratched. […] Having sex can be painful because the vulva may shrink or tighten. In men, the foreskin may tighten making erections painful. […] Lichen sclerosus cannot be cured, but using a strong prescription steroid ointment usually helps relieve the symptoms. […] Although treatment for lichen sclerosus can help, the affected skin can sometimes become scarred and tight over time. […] The vulva may shrink, with the clitoris and small inner lips (labia minora) around the opening of the vagina often affected.

• #19 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #20 Lichen Sclerosus: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/skin-problems-and-treatments/lichen-sclerosis

  It starts as small, shiny, and smooth white patches on your skin. These patches can become bigger and grow together into plaques. The skin may become thin and wrinkled, and it can be easily damaged by scratching or by clothing rubbing against it. […] You can usually get relief from the symptoms of lichen sclerosus with treatment, especially if you catch it early. But it probably won’t go away entirely. You’ll likely go through periods where it flares up for the rest of your life. […] It can cause serious complications, including scarring and sexual dysfunction. […] You’ll also need to be screened regularly for skin cancer.

• #21 Lichen sclerosus – Wikipedia

  https://en.wikipedia.org/wiki/Lichen_sclerosus

  Lichen sclerosus (LS) is a chronic, inflammatory skin disease, of unknown cause, which can affect any body part of any person, but has a strong preference for the genitals (penis, vulva), and is also known as balanitis xerotica obliterans when it affects the penis. […] LS in adult age women is normally incurable, although treatment can lessen its effects, and it often gets progressively worse if not treated properly. […] LS can occur without symptoms. White patches on the LS body area, itching, pain, dyspareunia (in genital LS), easier bruising, cracking, tearing and peeling, as well as hyperkeratosis, are common symptoms in both men and women. […] In males, the disease may take the form of whitish patches on the foreskin and its narrowing (preputial stenosis), forming an „indurated ring”, which can make retraction more difficult or impossible (phimosis).

• #22 Looking after LS in the long term | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/the-long-term/

  Whether youre going through a flare-up or a more comfortable time, if you have vulval lichen sclerosus (LS), its really important to stay on top of your treatment. Without that ongoing treatment, LS can progress and start to cause structural changes to your vulva, which are often irreversible. These are also sometimes called architectural or anatomical changes, and in this section well explore the signs to look out for. […] Not everyone will experience these changes, but its important to be aware of what can happen, carry out monthly vulva checks at home and make sure youre examined every year by a health professional. […] Unfortunately, sometimes people already have structural changes by the time they get the right diagnosis. While these often cant be reversed without surgery, it should be possible to stop them getting worse.

• #23 Pain from Lichen Sclerosus: The Fundamentals – LSSN

  https://lssupportnetwork.org/pain-from-lichen-sclerosus-the-fundamentals/

  Pain from lichen sclerosus is a common symptom. While many of us experience pain from lichen sclerosus, that pain presents differently for each person. For example, some folks may rate their pain as mild-moderate. In contrast, others will describe their pain as debilitating and severe. Some people experience their pain every day, whereas others experience it occasionally. […] A common cause of pain from lichen sclerosus is pain with sex. This can be penis-in-vagina sex, sex with a toy, fingering, etc. […] One of the reasons sex can cause pain for folks with lichen sclerosus is because LS causes the skin to thicken and become inflexible. […] Some folks experience pain only during penetration; others experience it for days after, even if they have not had any more penetration. […] A common adjective used to describe the pain from lichen sclerosus is burning.

• #24 Lichen sclerosus: Symptoms, Causes, and Treatment

  https://patient.info/womens-health/vulval-problems-leaflet/lichen-sclerosus

  Lichen sclerosus is an uncommon skin condition. It most commonly affects the genital skin (vulva) of women. It can occur at any age. […] Symptoms include itch, soreness and changes in the appearance of affected skin. Treatment with a steroid cream or ointment often eases the symptoms. […] The initial symptoms of lichen sclerosus typically include small pearly white spots, which are usually but not always itchy. The itch tends to be worse at night which can disturb sleep. […] Over time, the white spots may become larger and join together. The whole vulva and/or anal skin may then become white and be more fragile than normal. The fragile skin may become damaged, inflamed, raw and prone to painful splitting and cracking. It may become painful to have sex. If the anal skin is affected, passing poo (faeces) may cause pain.

• #25 Vulvar Lichen Sclerosus Specialist Melbourne | Dr Len Kliman

  https://drlenkliman.com.au/services/vulval-and-vaginal-skin-disorders/vulvar-lichen-sclerosus/

  Lichen sclerosus (LS) is a long-term skin disease that mainly affects the genital skin. It usually starts around the age of menopause but may occur at any age including children. The most common symptoms associated with Lichen Sclerosus include: […] Itchiness: This is the most common symptom, and can be quite severe […] Soreness Burning: Some people experience soreness burning during intercourse. Small cracks in the skin (known as fissures) and ulcers can occur as a result of scratching the skin and these can be very sore. If the anal skin is split there can be pain with bowel movements. […] Pale/Patchy Skin: The skin becomes pale and white in appearance. This may be patchy or involve the entire vulva extending down the skin around the anus. […] Bruising: Small purplish/red areas may be seen on the white background. These are bruises due to tiny areas of bleeding into the skin often because of scratching.

• #26 Pain from Lichen Sclerosus: The Fundamentals – LSSN

  https://lssupportnetwork.org/pain-from-lichen-sclerosus-the-fundamentals/

  Some folks describe their pain as general soreness or discomfort. It is not entirely burning or stabbing pain, but it is uncomfortable. It may feel raw or tender. […] Pain was a huge part of my LS journey. My very first LS symptom was painful sex. It began in my early 20s as general discomfort during sex. Over the years, that pain grew in complexity and intensity. […] In my late 20s, my pain was constant. Even if I abstained from sex, I was still in pain. […] If your pain is severe, call your doctor. […] In sum, pain from lichen sclerosus is common. It can feel like stinging, stabbing, burning, rawness, tenderness, or general discomfort.

• #27 Patient education: Vulvar lichen sclerosus (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/vulvar-lichen-sclerosus-beyond-the-basics

  Lichen sclerosus (LS) is a skin disorder that causes the skin to become thin, whitened, and wrinkled and can cause itching or pain. […] Vulvar LS usually occurs in postmenopausal females, although premenopausal females and children may be affected. […] The most common symptoms include: Vulvar itching – The most common symptom of vulvar LS is itching. It may be so severe that it interferes with sleep. […] Painful sexual intercourse (dyspareunia) – This can occur as a result of repeated cracking of the skin (fissuring) or from narrowing of the vaginal opening due to scarring. […] Vulvar LS may progress and change the appearance of the genital area as the outer and inner lips of the vulva fuse (stick together) and cover the clitoris. […] The opening of the vagina can become narrowed, and cracks, fissures, and thickened, scarred skin in the genital and anal area can make sexual intercourse or genital examination painful.

• #28 More information about Pediatric Vulvar Lichen Sclerosus – Great Neck, NY: Adolescent Young Adult Medicine of Great Neck

  https://www.tragermd.com/contents/services/lichen-sclerosus/pediatric-vulvar-lichen-s

  Lichen sclerosus is a skin disease that mainly involves the genital area. It can occur in girls, boys, women and men but is most common in young girls before puberty and in women after menopause. […] The most common things that girls with lichen sclerosus feel are vulvar itching and soreness. These symptoms can range from mild to severe. […] Lichen sclerosus can also cause painful urination and even constipation. Painful urination happens when urine passes over vulvar skin, which may be irritated and inflamed. […] Some girls with lichen sclerosus will have a discharge that is noticed on their underpants. The discharge may be bloody due to small spots of vulvar bleeding from skin irritation and scratching. […] It is also possible for some girls with lichen sclerosus to have no symptoms at all. In this case, the skin disease is only discovered during a routine check-up.

• #29 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Whitish patches and nodules (hyperkeratosis and sclerosis) that can coalesce into bigger areas (plaques) are typically found in the anogenital region. […] In the anogenital area, at first only a slight redness may be seen. White hyperkeratosis, atrophic skin, lacerations and ecchymosis typically occur later in the course of disease. Scarring in the area of the clitoris and the labia minora may develop and possibly lead to complete burying of the clitoris, a narrow vaginal introitus resulting in dyspareunia (pain during sexual intercourse) or also perianal stenosis and painful defecation. […] The development of indurated plaques or nodes and ulcers that do not heal indicate malignant transformation. Prompt clarification by means of a biopsy is imperative. […] Lichen sclerosus is usually chronic, especially in women and girls. The incidence of spontaneous remission is unknown, in girls it is estimated at 25%. Lichen sclerosus is typically a lifelong disease.

• #30 Lichen Sclerosus Clinical Presentation: History, Physical Examination, Complications

  https://emedicine.medscape.com/article/1123316-clinical

  Extragenital lichen sclerosus (LS) may be asymptomatic (approximately one third of cases), or it may itch or be tender. The most common complaint in vulvar LS is itch, and the most common complaint in penile LS is sexual or urinary dysfunction. […] Patients with vulvar LS usually present with progressive pruritus, dyspareunia, dysuria, or genital bleeding. Penile LS usually is preceded by pruritus, but patients may present with sudden phimosis of previously retractable foreskin, and urinary obstruction can result. […] Vulvar LS may progress to gradual obliteration of the labia minora and stenosis of the introitus. The most common variation occurs when the inflammation is intense enough to cause separation of a large area of epidermis, creating blisters or large, occasionally hemorrhagic, bullae. […] Male genital lichen sclerosus may present with a sclerotic ring at the edge of the prepuce or anywhere on the glans itself. Advanced disease at the urethral os may lead to urinary obstruction.

• #31 Vulvar Lichen Sclerosus Specialist Melbourne | Dr Len Kliman

  https://drlenkliman.com.au/services/vulval-and-vaginal-skin-disorders/vulvar-lichen-sclerosus/

  Scarring: There may be scarring that causes loss of vulval tissue (eg: the inner lips), or shrinkage at the entrance to the vaginal area which can cause pain and interfere with sexual intercourse, and rarely even causes problems with urination – it does not involve the vagina. […] Some people have no symptoms and diagnosis may be made when the area is examined for another reason. In about 10% of women with vulvar LS white patches may be seen on the skin elsewhere. The common sites for this are on the back, waist area and under the breasts.

• #32 Lichen Sclerosus: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16564-lichen-sclerosus

  Lichen sclerosus is a chronic (life-long) condition. Without treatment, it can lead to scarring, making it difficult or painful to have sexual intercourse (dyspareunia), urinate (pee) or have a bowel movement (poop). Untreated lichen sclerosus can also increase your chances of developing a type of skin cancer (penile cancer and vulvar squamous cell carcinoma). There isnt a cure for lichen sclerosus, though treatment can help manage your symptoms. […] The primary symptoms of lichen sclerosus include white, raised spots on your vulva, anus, foreskin or the tip of your penis (glans). They cause itching, soreness, discomfort or burning. Other symptoms include: Ulcers and sores. Inflammation. Scarring. Cracking. Pain while peeing (dysuria). Pain while having sex. Weak pee stream. Your pee may spray instead of coming out in a stream. Tightening of your foreskin. Inability to pull your foreskin back (phimosis). Fluid that comes out of your penis that isnt pee or semen (penile discharge).

• #33 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #34 Lichen Sclerosus: What It Is and How To Treat It

  https://www.verywellhealth.com/lichen-sclerosus-faqs-lichen-sclerosis-3520857

  Mild cases usually start as shiny white spots on the skin of the vulva in women or on the foreskin of uncircumcised men. […] If the disease worsens, itching is the most common symptom, which in rare cases can be extreme enough to interfere with sleep and daily activities. Rubbing or scratching to relieve the itching can cause: […] In severe cases in women, lichen sclerosus can lead to scarring that causes the inner lips of the vulva to shrink and disappear, the clitoris to become covered with scar tissue, and the opening of the vagina to narrow. […] In men with severe lichen sclerosus, the foreskin can scar, tighten, and shrink over the head of the penis, making it hard to pull back the foreskin and decreasing sensation in the tip of the penis. […] When lichen sclerosus develops around the anus, the discomfort can lead to constipation, particularly in children.

• #35 Looking after LS in the long term | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/the-long-term/

  Skin fusion (also known as adhesion) is when parts of the skin on your vulva start to stick together, changing its structure. This can affect your labia or your clitoris. […] Labial fusion is when your labia minora and labia majora stick together. This can give your vulva a flat appearance, or mean that the individual labia are hard to see or even invisible. […] This fusion can make it difficult to insert a tampon, or make certain sexual activity painful or (for some people) impossible. […] Labial fusion can also cause changes when you go to the toilet. You might notice spraying or dribbling when you pee, because the liquid cant leave your body in the normal way. […] In very severe cases, pee, vaginal discharge and menstrual (period) blood can build up under the fused skin. This is rare, but if it happens to you, get medical help immediately.

• #36 Lichen Sclerosus Overview – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-overview/

  Unfortunately, most will suffer from secondary symptoms the hardest. The mental health issues related to a Lichen Sclerosus diagnosis can run deep. […] While all Lichen Sclerosus symptoms are difficult, mental health issues can cause the most harm. Most patients suffer alone. So they cycle in and out of loneliness, anxiety, and depression, not realizing they need help. This vicious cycle is why having a support system, whether a counselor, therapist, or support group, is important.

• #37 Lichen Sclerosus > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/lichen-sclerosus

  Lichen sclerosus is a rare skin disease that causes itchy and painful patches of thin, white, wrinkled-looking skin. […] The condition can lead to scarring and tightening of the skin around the genitals and anus. […] Lichen sclerosus is a chronic disease, meaning that once it develops, it lasts for a long time, often for the rest of a patients life. Though it often worsens over time, the good news is that treatments are now available that can reduce symptoms and stop progression of the disease. […] Lichen sclerosus is a life-long condition for which there is no cure. If the disease progresses or is left untreated, it may cause serious, debilitating symptoms. […] Fortunately, treatment generally reduces and, in some cases, eliminates symptoms, though relapses still tend to occur periodically. […] A long-term maintenance treatment regimen is very important, and not just to prevent or treat symptom recurrence. Treatment to maintain normal skin color and texture reduces scarring and may prevent progression to skin cancer.

• #38 Lichen Sclerosus: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/skin-problems-and-treatments/lichen-sclerosis

  It starts as small, shiny, and smooth white patches on your skin. These patches can become bigger and grow together into plaques. The skin may become thin and wrinkled, and it can be easily damaged by scratching or by clothing rubbing against it. […] You can usually get relief from the symptoms of lichen sclerosus with treatment, especially if you catch it early. But it probably won’t go away entirely. You’ll likely go through periods where it flares up for the rest of your life. […] It can cause serious complications, including scarring and sexual dysfunction. […] You’ll also need to be screened regularly for skin cancer.

• #39 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #40 Looking after LS in the long term | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/the-long-term/

  Skin fusion (also known as adhesion) is when parts of the skin on your vulva start to stick together, changing its structure. This can affect your labia or your clitoris. […] Labial fusion is when your labia minora and labia majora stick together. This can give your vulva a flat appearance, or mean that the individual labia are hard to see or even invisible. […] This fusion can make it difficult to insert a tampon, or make certain sexual activity painful or (for some people) impossible. […] Labial fusion can also cause changes when you go to the toilet. You might notice spraying or dribbling when you pee, because the liquid cant leave your body in the normal way. […] In very severe cases, pee, vaginal discharge and menstrual (period) blood can build up under the fused skin. This is rare, but if it happens to you, get medical help immediately.

• #41 Lichen sclerosus | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-vaginal-conditions/lichen-sclerosus

  LS can lead to changes in your vulva and other affected areas, including: small white spots that grow into larger white areas and may become wrinkled, thickened patches of white skin with splits or fissures, smooth white patches on your skin, a buried clitoris due to your clitoris hood sticking together, shrinkage of your inner lips, tightening of your vaginal entrance. […] LS doesnt cause cancer, but it is associated with an increased risk of vulval cancer especially if the condition is left untreated.

• #42 Looking after LS in the long term | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/the-long-term/

  Clitoral fusion is when the hood of your clitoris sticks to and scars over the head of your clitoris. […] This fusion can be mild, moderate or severe. It might make it difficult to pull back the clitoral hood to reveal the head, and that can lead to complications. […] In some people, fusion can also lead to reduced sensation in the clitoris which, in turn, can make it more difficult to have an orgasm (climax). […] Some people with LS notice that their skin tears during sexual activity. When your skin tears, scar tissue can form as your vulva heals. Unfortunately, scar tissue tends to be thick and rigid, so it doesnt easily expand and stretch when you put things into your vagina. […] This loss of flexibility can lead to more tearing, scarring and pain, with some people finding that a band of scar tissue builds up at the entrance of their vagina, causing the opening itself to become narrower.

• #43 Lichen Sclerosus

  https://healthlibrary.uwmedicine.org/Library/Encyclopedia/134,552

  Lichen sclerosus causes skin changes. Very early on, you might not have any symptoms at all. A little later, you may see small white spots on your skin. […] Common symptoms might include: Vulvar itching (very common), Anal itching, bleeding, or pain, Pain during sex, Skin bruising and tearing, Blisters, Easy bleeding from minor rubbing of the skin, Pain or bleeding when having a bowel movement, Trouble urinating or pain with urination, Painful erections (in men). […] Symptoms in the genital and anal area don’t often get better without treatment. […] If untreated, the condition tends to get worse over time. […] Untreated advanced lichen sclerosus may permanently change the look of your genitals. The vagina’s opening may narrow. The outer and inner lips of the vulva may stick together. You may need surgery to fix these changes. In men, the foreskin may scar and shrink. This leads to trouble pulling back the foreskin. In both men and women, the condition may cause pain during sex. […] These treatments often reduce most of the symptoms and keep the condition from getting worse.

• #44 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #45 Looking after LS in the long term | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/the-long-term/

  Skin fusion (also known as adhesion) is when parts of the skin on your vulva start to stick together, changing its structure. This can affect your labia or your clitoris. […] Labial fusion is when your labia minora and labia majora stick together. This can give your vulva a flat appearance, or mean that the individual labia are hard to see or even invisible. […] This fusion can make it difficult to insert a tampon, or make certain sexual activity painful or (for some people) impossible. […] Labial fusion can also cause changes when you go to the toilet. You might notice spraying or dribbling when you pee, because the liquid cant leave your body in the normal way. […] In very severe cases, pee, vaginal discharge and menstrual (period) blood can build up under the fused skin. This is rare, but if it happens to you, get medical help immediately.

• #46 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  LS in genital areas has a risk of neoplastic transformation to squamous cell carcinoma (SCC). Vulvar SCC was observed in 3.5 to 7% of women with VLS, while up to 65% of vulvar carcinomas arise on a background of VLS. Hence, early detection of premalignant lesions and a lifelong follow-up are required.

• #47 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  LS in genital areas has a risk of neoplastic transformation to squamous cell carcinoma (SCC). Vulvar SCC was observed in 3.5 to 7% of women with VLS, while up to 65% of vulvar carcinomas arise on a background of VLS. Hence, early detection of premalignant lesions and a lifelong follow-up are required.

• #48 Lichen sclerosus – Wikipedia

  https://en.wikipedia.org/wiki/Lichen_sclerosus

  On the non-genital skin, the disease may manifest as porcelain-white spots with small visible plugs inside the orifices of hair follicles or sweat glands on the surface. Thinning of the skin may also occur. […] The disease can last for a considerably long time. Occasionally, „spontaneous cure” may occur, particularly in young girls. […] Lichen sclerosus is associated with a higher risk of cancer. Skin that has been scarred as a result of lichen sclerosus is more likely to develop skin cancer. […] Lichen sclerosus is associated with from 3 to 7% of all cases of vulvar squamous cell carcinoma. […] In women, it has been reported that 33.6 times higher vulvar cancer risk is associated with LS. […] A study in men noted that: „the reported incidence of penile carcinoma in patients with balanitis xerotica obliterans is 2.65.8%”.

• #49 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Treatment with potent topical corticosteroids suppresses symptoms such as itching and pain in 75-90% of female patients. Scarring is irreversible. A cohort study on vulvar lichen sclerosus indicates, however, that early and consistent long-term treatment decreases scarring by 36.6% and the development of carcinoma by 4.7% after an observation period of 4.7 years. […] In patients with lichen sclerosus the risk of developing a squamous cell carcinoma in the genital area is slightly increased and is defined with an estimated lifetime risk of approximately 4 to 5%. This risk seems to be significantly decreased by consistent long-term treatment.

• #50 Lichen sclerosus

  https://www.nhs.uk/conditions/lichen-sclerosus/

  The scarring and tightness can cause discomfort when peeing, pooing and during sex. Having an erection can be painful. […] Lichen sclerosus increases your risk of getting cancer on your vulva, penis or anus. […] Symptoms to look for include a lump, a change in skin texture, such as thickening, or an ulcer that does not go away.

• #51 Looking after LS in the long term | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/the-long-term/

  The symptoms of dVIN can be the same as those of many other vulval conditions (including LS) and include itching, soreness, painful sex and changes to your vulval skin. […] Not everyone has these symptoms, but you might notice visual signs of dVIN instead. These might include a patch of skin on your vulva that looks or feels different in texture and doesnt go away when you treat it with steroid ointments or creams. […] The symptoms of vulval cancer can be the same as those of many other vulval conditions (including LS) and include itching, soreness, painful sex and bleeding (or a blood-stained discharge). […] You might also notice visual signs, including: A lump, wart-like growth or raised rough area. […] If your doctor is concerned that you might have vulval cancer, they should refer you to a gynaecologist or vulval specialist urgently.

• #52 Lichen sclerosus fact sheet – Melbourne Sexual Health Centre (MSHC)

  https://www.mshc.org.au/sexual-health/sexual-health-fact-sheets/lichen-sclerosus-fact-sheet

  Lichen sclerosus is an uncommon, chronic, inflammatory skin condition that affects the genital area, resulting in white patches and scarring. […] Symptoms of itch, burning and soreness of the genital skin are common. […] Symptoms can include: itching, burning and soreness of the genital skin, skin dryness through loss of oil producing skin glands, skin surface can be thickened and white, skin surface can be pale, thinned and fragile in long standing disease, scratching can result in very thickened white skin, blood blisters and skin-picking, skin fragility can result in splitting, damaged skin is prone to secondary infection by yeasts or bacteria which may result in skin soreness, chronic inflammation can result in scarring and change in the shape of skin surface. […] Changes to the genital skin may include: covering over of the clitoris by skin, loss of the inner lips (labia minora), bands of joined skin above and below the vaginal opening, that can make the vaginal entrance small and result in painful intercourse.

• #53 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #54 Lichen sclerosus

  https://www.rch.org.au/kidsinfo/fact_sheets/Lichen_sclerosus/

  Lichen sclerosus is an uncommon skin condition that causes a distinctive rash, and usually affects the genital skin around the vulva (external female genital area) and anus. It most often looks like white patches on the skin. It can last for years and in some cases, cause permanent scarring of the affected area. […] While lichen sclerosus can affect females and males of any age, it is most common in females, and it usually occurs before puberty or around menopause. […] Lichen sclerosus can occur anywhere on the body, but it usually affects the genital skin around the vulva and anus. It does not affect the inside of the vagina. The general health of a person with lichen sclerosus remains normal. […] The most common symptoms include: itchiness, constipation (due to painful cracks in the skin around the anus), pain when urinating, small tears in the skin, which may bleed, red and inflamed skin at the beginning, that later looks like white, shiny, wrinkled or thickened patches.

• #55 Looking after LS in the long term | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/the-long-term/

  The menopause is a natural process that can affect people physically and mentally in a whole range of different ways. […] Your vulval skin contains hormone receptors that respond to oestrogen. So, when your oestrogen levels start to drop during perimenopause and menopause, the skin can become thinner and less able to make its own natural lubrication. This can cause symptoms like vaginal dryness, vulval dryness, itching and pain. […] The symptoms of GSM can be the same as the symptoms of LS (itching, soreness, dryness and painful sex). […] Its not unusual to have both conditions, and some people with well-controlled LS notice their symptoms get worse during perimenopause and menopause. […] We know that people who have vulval LS are more likely to have urinary incontinence than people who dont have LS.

• #56 Lichen sclerosus (LS) | University of Iowa Health Care

  https://uihc.org/health-topics/lichen-sclerosus-ls

  It is a long-term skin condition. It can be on any part of the body. It is most often in the vulva and anal area. […] Signs and symptoms can be different from person to person. They may get better then worse at different times in your life. It may be worse during hot summer months when you are sweating more. More moisture can irritate skin. […] It tends to be a long-term condition. Symptoms can often be kept under control when treated. […] People with LS may have a higher risk of getting vulvar skin cancer. Have regular follow up with your provider. Call your provider if you have any skin changes. […] Mild scarring can happen. Severe scarring is rare. This can cause the opening of the vagina to be narrow. Protect and treat your skin to prevent this from happening.

• #57 Frontiers | Lichen sclerosus: The 2023 update

  https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1106318/full

  Lichen sclerosus (LS) is an underdiagnosed inflammatory mucocutaneous condition affecting the anogenital areas. The typical clinical picture includes chronic whitish atrophic patches along with itching and soreness in the vulvar, perianal and penile regions. In addition to genital scarring, and sexual and urinary dysfunction, LS may also lead to squamous cell carcinoma. The clinical picture of anogenital LS (gLS) includes ivory-white patches, atrophy and severe pruritus, altering the quality of life (QoL). The lesions could evolve to scarring of the vaginal introitus, phimosis and functional impairment. Furthermore, it has been described as an intrinsic risk factor for malignancy in untreated patients, but there is no evidence of increased neoplasm development after long-term treatments. The established diagnosis of LS based on the clinical features is usually sufficient, and a skin biopsy should only be performed in case of clinical doubts, differential diagnosis or suspected malignancy. The first-line therapy is ultrapotent or potent topical glucocorticoids (TC) and in case of anatomical changes due to scarring, surgical procedures should be performed. In order to prevent complications, aside from an early diagnosis and a correct treatment, a long-term follow-up is imperative. The incidence of pediatric LS is estimated at 0.04 to 0.06%, with a female-to-male ratio of 1:1.7. In a systematic review, the age-onset in children was 6.5 years in females and 8.6 years in males, with a mean diagnostic delay of 18 and 12.5 months, respectively. The diagnosis of LS in adults and children is typically clinical, involving a thorough medical history and physical examination. The clinical scoring system in VLS is a validated useful tool to ease the diagnosis and to evaluate related symptoms and the therapy response. The follow-up visits in LS enables the assessment of the response to treatment and gives the opportunity to educate the patient as well as to rule out complications. The efficacy of the therapy should be evaluated by the improvement of the symptoms and clinical manifestations with photographic documentation, performed with every visit.

• #58 Lichen sclerosus

  https://www.rch.org.au/kidsinfo/fact_sheets/Lichen_sclerosus/

  Lichen sclerosus is an uncommon skin condition that causes a distinctive rash, and usually affects the genital skin around the vulva (external female genital area) and anus. It most often looks like white patches on the skin. It can last for years and in some cases, cause permanent scarring of the affected area. […] While lichen sclerosus can affect females and males of any age, it is most common in females, and it usually occurs before puberty or around menopause. […] Lichen sclerosus can occur anywhere on the body, but it usually affects the genital skin around the vulva and anus. It does not affect the inside of the vagina. The general health of a person with lichen sclerosus remains normal. […] The most common symptoms include: itchiness, constipation (due to painful cracks in the skin around the anus), pain when urinating, small tears in the skin, which may bleed, red and inflamed skin at the beginning, that later looks like white, shiny, wrinkled or thickened patches.

• #59 More information about Pediatric Vulvar Lichen Sclerosus – Great Neck, NY: Adolescent Young Adult Medicine of Great Neck

  https://www.tragermd.com/contents/services/lichen-sclerosus/pediatric-vulvar-lichen-s

  Lichen sclerosus is a skin disease that mainly involves the genital area. It can occur in girls, boys, women and men but is most common in young girls before puberty and in women after menopause. […] The most common things that girls with lichen sclerosus feel are vulvar itching and soreness. These symptoms can range from mild to severe. […] Lichen sclerosus can also cause painful urination and even constipation. Painful urination happens when urine passes over vulvar skin, which may be irritated and inflamed. […] Some girls with lichen sclerosus will have a discharge that is noticed on their underpants. The discharge may be bloody due to small spots of vulvar bleeding from skin irritation and scratching. […] It is also possible for some girls with lichen sclerosus to have no symptoms at all. In this case, the skin disease is only discovered during a routine check-up.

• #60 Frontiers | Lichen sclerosus: The 2023 update

  https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1106318/full

  Lichen sclerosus (LS) is an underdiagnosed inflammatory mucocutaneous condition affecting the anogenital areas. The typical clinical picture includes chronic whitish atrophic patches along with itching and soreness in the vulvar, perianal and penile regions. In addition to genital scarring, and sexual and urinary dysfunction, LS may also lead to squamous cell carcinoma. The clinical picture of anogenital LS (gLS) includes ivory-white patches, atrophy and severe pruritus, altering the quality of life (QoL). The lesions could evolve to scarring of the vaginal introitus, phimosis and functional impairment. Furthermore, it has been described as an intrinsic risk factor for malignancy in untreated patients, but there is no evidence of increased neoplasm development after long-term treatments. The established diagnosis of LS based on the clinical features is usually sufficient, and a skin biopsy should only be performed in case of clinical doubts, differential diagnosis or suspected malignancy. The first-line therapy is ultrapotent or potent topical glucocorticoids (TC) and in case of anatomical changes due to scarring, surgical procedures should be performed. In order to prevent complications, aside from an early diagnosis and a correct treatment, a long-term follow-up is imperative. The incidence of pediatric LS is estimated at 0.04 to 0.06%, with a female-to-male ratio of 1:1.7. In a systematic review, the age-onset in children was 6.5 years in females and 8.6 years in males, with a mean diagnostic delay of 18 and 12.5 months, respectively. The diagnosis of LS in adults and children is typically clinical, involving a thorough medical history and physical examination. The clinical scoring system in VLS is a validated useful tool to ease the diagnosis and to evaluate related symptoms and the therapy response. The follow-up visits in LS enables the assessment of the response to treatment and gives the opportunity to educate the patient as well as to rule out complications. The efficacy of the therapy should be evaluated by the improvement of the symptoms and clinical manifestations with photographic documentation, performed with every visit.

• #61 Pediatric lichen sclerosus (LS) – Children’s Health Gynecology

  https://www.childrens.com/specialties-services/conditions/lichen-sclerosis

  Pediatric lichen sclerosus (LS) is a skin condition that affects the vulva and/or peri-anal area. An estimated 10 to 15 percent of cases occur in young girls. […] Symptoms include: Itching, Skin that appears fragile pale, and/or white, Bruised skin with blood blisters, Small tears in the skin, Scar tissue covering the vulvar area, Bleeding or tearing of the skin during bowel movements. […] Some girls with lichen sclerosus have no symptoms. […] If your daughter is diagnosed with lichen sclerosus, even without symptoms, she should be treated to prevent scarring of the vulva, which can lead to problems with urination. […] Regular check-ups are important so symptoms can be treated early. […] It can recur, so its important that your daughter gets regular check-ups for timely treatment and reduced scarring. Lichen sclerosis often resolves by puberty, and there is a good chance she will not need treatment beyond that stage.

• #62 Lichen sclerosus in females – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/lichen-sclerosus-in-females/

  Lichen sclerosus is a chronic inflammatory skin condition which can affect any part of the skin, but it most often affects the genital skin (vulva) and the skin around the anus. It can start in childhood or adulthood, most commonly after menopause. […] The most common symptom of vulval lichen sclerosus is itching, which may be severe. If the skin breaks from scratching, it can be sore. Until the condition is treated, there can be a change in the appearance of the vulva with some loss of tissue. If there is narrowing of the entrance of the vagina, sexual intercourse can be painful. The skin can also be prone to tearing, particularly after sex. If there is severe scarring, this can interfere with urination although this is very rare. It can also affect the skin around the anus. […] In children, constipation is a very common symptom.

• #63 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Whitish patches and nodules (hyperkeratosis and sclerosis) that can coalesce into bigger areas (plaques) are typically found in the anogenital region. […] In the anogenital area, at first only a slight redness may be seen. White hyperkeratosis, atrophic skin, lacerations and ecchymosis typically occur later in the course of disease. Scarring in the area of the clitoris and the labia minora may develop and possibly lead to complete burying of the clitoris, a narrow vaginal introitus resulting in dyspareunia (pain during sexual intercourse) or also perianal stenosis and painful defecation. […] The development of indurated plaques or nodes and ulcers that do not heal indicate malignant transformation. Prompt clarification by means of a biopsy is imperative. […] Lichen sclerosus is usually chronic, especially in women and girls. The incidence of spontaneous remission is unknown, in girls it is estimated at 25%. Lichen sclerosus is typically a lifelong disease.

• #64 Lichen sclerosus – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000340

  Lichen sclerosus (LS, also known as balanitis xerotica obliterans in men) is an inflammatory skin condition with a chronic relapsing and remitting course. […] Characteristic findings on examination of the cutaneous lesions are atrophic white plaques, typically found in the anogenital area, which may lead to scarring and anatomical changes. […] There is a small but significant risk (approximately 5%) of vulvar squamous cell carcinoma in women with anogenital LS, especially if left untreated. […] In women, it predominantly affects the vulva and anus and is associated with pruritus, pain, and dyspareunia; it can also lead to scarring and increases the risk of malignancy. […] In men, genital disease almost exclusively occurs in those who are uncircumcised and may cause pain, dyspareunia, and scarring-related signs and symptoms such as changes in urinary stream and phimosis. […] Girls may present with similar symptoms as women; however, boys with the condition are usually asymptomatic and often present with phimosis.

• #65 More information about Pediatric Vulvar Lichen Sclerosus – Great Neck, NY: Adolescent Young Adult Medicine of Great Neck

  https://www.tragermd.com/contents/services/lichen-sclerosus/pediatric-vulvar-lichen-s

  The prognosis of pediatric lichen sclerosus is usually very good. Most girls will improve significantly with treatment. However, the signs and symptoms of lichen sclerosus may come and go over several years. […] The main complications of lichen sclerosus have to do with scarring. Scarring is caused by chronic (long-term) inflammation of the vulvar skin and may lead to a shrinking of the vulvar tissue. […] Lichen sclerosus does not cause skin cancer. However, skin that is scarred by lichen sclerosus in adulthood may be more likely to develop a particular skin cancer called squamous cell carcinoma. […] Parents may have concerns about how lichen sclerosus will affect their daughter’s sexual functioning later in life. Since treatment is so effective, young girls with lichen sclerosus who do not have significant scarring can be expected to have normal sexual functioning. […] Having a long-term, itchy, painful, disease involving the genital area may be very upsetting to a young girl. Girls with lichen sclerosus may need a great deal of emotional support and encouragement to deal with their disease.

• #66 Lichen Sclerosus Overview – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-overview/

  Lichen sclerosus (LS) is a chronic, inflammatory skin condition. It can lead to skin changes, painful sex, and, in rare cases, vulvar cancer. […] Around one-third of these people will not feel symptoms but may have structural skin changes. […] This is great news and gives us hope for the future. Awareness and education of patients and practitioners are important to prevent the unknown progression of this disease. […] Prepubescent and post-menopausal vulva owners’ main symptoms tend to be vulvar itching. In contrast, people of reproductive-aged years mostly complain of painful sex. […] Patients can have one or a variety of common symptoms, for example, itching, white skin patches, and/or burning. Some patients are asymptomatic and don’t realize they have LS until they start experiencing painful sex or problems urinating. Others, who have often gone untreated, develop severe symptoms such as fusing/scarring or, less commonly, vulvar precancer or cancer.

• #67 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Lichen sclerosus is a chronic inflammatory skin disease. It is thought to be underdiagnosed and undertreated. If it is not treated, lichen sclerosus is associated with a greater degree of scarring and an elevated risk of cancer in the genital area. […] Anogenital lichen sclerosus often causes itching and pain. Functional impairment due to fissures and scars can arise over the course of the condition. […] Anogenital itching and clinical features such as erythema, white skin changes (such as hyperkeratosis and sclerosis), and fissures should arouse suspicion of lichen sclerosus. The diagnosis should be confirmed with a skin biopsy, and early, thorough treatment should be initiated. In this way, a mutilating disease course can be averted, and the risk of cancer can be lessened. […] The typical lichen sclerosus patient is a woman of roughly 50 years of age with external genital itch. The urge to scratch is very strong. When asked explicitly, pain during sexual intercourse is often described.

• #68 Lichen sclerosus fact sheet – Melbourne Sexual Health Centre (MSHC)

  https://www.mshc.org.au/sexual-health/sexual-health-fact-sheets/lichen-sclerosus-fact-sheet

  Lichen sclerosus is an uncommon, chronic, inflammatory skin condition that affects the genital area, resulting in white patches and scarring. […] Symptoms of itch, burning and soreness of the genital skin are common. […] Symptoms can include: itching, burning and soreness of the genital skin, skin dryness through loss of oil producing skin glands, skin surface can be thickened and white, skin surface can be pale, thinned and fragile in long standing disease, scratching can result in very thickened white skin, blood blisters and skin-picking, skin fragility can result in splitting, damaged skin is prone to secondary infection by yeasts or bacteria which may result in skin soreness, chronic inflammation can result in scarring and change in the shape of skin surface. […] Changes to the genital skin may include: covering over of the clitoris by skin, loss of the inner lips (labia minora), bands of joined skin above and below the vaginal opening, that can make the vaginal entrance small and result in painful intercourse.

• #69 Lichen Sclerosus | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/lichen-sclerosus/

  Lichen sclerosus is a skin condition most common among postmenopausal women though it can occur in anyone. Treatment is important to control symptoms and disease activity, as well as decreasing the risk of scarring and skin cancer. […] Symptoms may include: Pain or discomfort, Itching (especially in the vulva), Skin redness, Skin patches that are either smooth and white or blotchy and wrinkled, Skin tearing, bruising, or bleeding, Pain during sex, Constipation, Pain or bleeding during a bowel movement, Urinary retention or pain during urination, Fusing of the outer and inner lips of the vulva, Narrowing of the vaginal opening, Painful erections, Inability to retract the foreskin in uncircumcised men. […] In extreme cases, a person may develop blistering, bleeding, or ulcerated sores. […] Women with lichen sclerosus have a slightly higher risk of developing vulvar cancer or squamous cell carcinoma, a type of skin cancer, in the affected areas. Men with lichen sclerosis on the penis also have a slightly elevated risk of developing squamous cell carcinoma.

• #70 Looking after LS in the long term | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/the-long-term/

  The menopause is a natural process that can affect people physically and mentally in a whole range of different ways. […] Your vulval skin contains hormone receptors that respond to oestrogen. So, when your oestrogen levels start to drop during perimenopause and menopause, the skin can become thinner and less able to make its own natural lubrication. This can cause symptoms like vaginal dryness, vulval dryness, itching and pain. […] The symptoms of GSM can be the same as the symptoms of LS (itching, soreness, dryness and painful sex). […] Its not unusual to have both conditions, and some people with well-controlled LS notice their symptoms get worse during perimenopause and menopause. […] We know that people who have vulval LS are more likely to have urinary incontinence than people who dont have LS.

• #71 Lichen Sclerosus | Doctor

  https://patient.info/doctor/lichen-sclerosus-pro

  Urethral involvement occurs in 20% of men which can cause urethral stricture. […] In most females it is a chronic condition, although symptom control is often successful. In men there is a higher chance of remission or cure. Scarring is not reversible with pharmacological treatment. […] Symptom remission can be achieved in 98% of compliant and 75% of non-compliant women by using potent topical steroids. […] In males, particularly young boys, a course of steroids may prevent the need for circumcision. […] Most men are either cured by topical treatment with ultrapotent steroid (50-60%) or by circumcision (75%). […] However, in some cases LS recurs. More complex cases may be an overlap syndrome with lichen planus, and may be more difficult to treat. […] 75% of girls who develop LS prepubertally will continue to need maintenance treatment after menarche. […] The lifetime risk of SCC is around 4-5% in both males and females. […] Extragenital lesions are less likely to be chronic, and have a better chance of cure.

• #72 Looking after LS in the long term | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/the-long-term/

  When it comes to birth, the studies show that only a small number of people with LS needed a caesarean section instead of a vaginal birth, and well look at this more in our birth information later in this section. […] Again, there have only been a small number of studies into how LS is affected by pregnancy and birth, but the evidence so far is relatively positive. […] One of the real positives about pregnancy and LS is that, for people whove been living with undiagnosed LS, it can be an opportunity to finally get a diagnosis. […] Yes. Even if youre using a very potent topical steroid to treat your vulval LS, its safe for you to carry on throughout your pregnancy. […] Yes. Lots of people with LS have vaginal deliveries and, in the studies so far, only a small number needed a caesarean section instead.

• #73 Lichen sclerosus – Wikipedia

  https://en.wikipedia.org/wiki/Lichen_sclerosus

  Lichen sclerosus (LS) is a chronic, inflammatory skin disease, of unknown cause, which can affect any body part of any person, but has a strong preference for the genitals (penis, vulva), and is also known as balanitis xerotica obliterans when it affects the penis. […] LS in adult age women is normally incurable, although treatment can lessen its effects, and it often gets progressively worse if not treated properly. […] LS can occur without symptoms. White patches on the LS body area, itching, pain, dyspareunia (in genital LS), easier bruising, cracking, tearing and peeling, as well as hyperkeratosis, are common symptoms in both men and women. […] In males, the disease may take the form of whitish patches on the foreskin and its narrowing (preputial stenosis), forming an „indurated ring”, which can make retraction more difficult or impossible (phimosis).

• #74 Lichen sclerosus – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000340

  Lichen sclerosus (LS, also known as balanitis xerotica obliterans in men) is an inflammatory skin condition with a chronic relapsing and remitting course. […] Characteristic findings on examination of the cutaneous lesions are atrophic white plaques, typically found in the anogenital area, which may lead to scarring and anatomical changes. […] There is a small but significant risk (approximately 5%) of vulvar squamous cell carcinoma in women with anogenital LS, especially if left untreated. […] In women, it predominantly affects the vulva and anus and is associated with pruritus, pain, and dyspareunia; it can also lead to scarring and increases the risk of malignancy. […] In men, genital disease almost exclusively occurs in those who are uncircumcised and may cause pain, dyspareunia, and scarring-related signs and symptoms such as changes in urinary stream and phimosis. […] Girls may present with similar symptoms as women; however, boys with the condition are usually asymptomatic and often present with phimosis.

• #75 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #76 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #77 Lichen sclerosus: Symptoms, causes & treatment | Healthy Male

  https://healthymale.org.au/mens-health/lichen-sclerosus

  Lichen sclerosus affects around 1 in 250-1000 boys (average age of 7 years) and up to around 1 in 1000 men. […] If you have lichen sclerosus, you might not have any symptoms, or you might experience: Altered sensation in your penis, Itchiness, Pain during urination. […] Usually, the end of the foreskin is white and hardened, which can lead to phimosis or paraphimosis. […] Lichen sclerosus rarely goes away on its own. If untreated, lichen sclerosus can get worse and cause phimosis, paraphimosis, painful erections and urinary problems that usually require surgery. […] Lichen sclerosus is associated with an increased risk of penis cancer, which develops in 4-8% of men who have the disease. […] A yearly review by your doctor will be necessary to keep an eye on whether your lichen sclerosus returns or progresses. […] If lichen sclerosus is ignored, you can develop serious complications that will affect your sexual and urinary function, and your health more widely.

• #78 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #79 Lichen sclerosus in males – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/lichen-sclerosus-in-males/

  Lichen sclerosus is a chronic inflammatory skin condition which can affects any part of the skin, but in men is most often seen on the foreskin and tip of the penis. […] The affected skin may feel uncomfortable, sometimes itchy, burning, and sore, especially during or after sex. Often the foreskin gets tighter and more difficult to retract, leading to painful erections. The skin may tear and bleed during sexual intercourse. […] The affected skin of the penis can look red, with little cracks, sores, bleeding points or small blood-blisters. When the skin has been inflamed for some time, it can turn white and become thinned. […] Although circumcision can cure lichen sclerosus in some men, in others the condition may continue or change after surgery. Lichen sclerosus will not go away on its own but may not cause any symptoms when the correct treatments are used.

• #80 Lichen Sclerosus | Doctor

  https://patient.info/doctor/lichen-sclerosus-pro

  Urethral involvement occurs in 20% of men which can cause urethral stricture. […] In most females it is a chronic condition, although symptom control is often successful. In men there is a higher chance of remission or cure. Scarring is not reversible with pharmacological treatment. […] Symptom remission can be achieved in 98% of compliant and 75% of non-compliant women by using potent topical steroids. […] In males, particularly young boys, a course of steroids may prevent the need for circumcision. […] Most men are either cured by topical treatment with ultrapotent steroid (50-60%) or by circumcision (75%). […] However, in some cases LS recurs. More complex cases may be an overlap syndrome with lichen planus, and may be more difficult to treat. […] 75% of girls who develop LS prepubertally will continue to need maintenance treatment after menarche. […] The lifetime risk of SCC is around 4-5% in both males and females. […] Extragenital lesions are less likely to be chronic, and have a better chance of cure.

• #81 Lichen Sclerosus: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/skin-problems-and-treatments/lichen-sclerosis

  Lichen sclerosus is a rare skin condition that usually shows up on your genital or anal areas, though you can also have it in other places. It usually starts as white, shiny, itchy patches that get bigger. The affected skin becomes thin and fragile. […] It’s a long-term condition that tends to go through cycles where symptoms flare up, then calm down. Although there’s no cure, there are treatments to manage your symptoms. […] Changes in the appearance of your skin are the main symptom of lichen sclerosus. You usually see it around your genitals or anus. But less often it can also affect your neck, shoulders, upper back, upper arms, armpits, torso, breasts, wrists, buttocks, and inner thighs. Rarely, you can have it in your mouth. Some people have no other symptoms. But for most people, the lichen sclerosus patches are very itchy. You may also have: Pain, Burning, Tears or cracks in your skin, Sores, Scarring, Bruising, Blisters, Pain when you pee or poop, Pain when you have sex, Constipation.

• #82 Lichen Sclerosus: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16564-lichen-sclerosus

  Lichen sclerosus is a chronic condition. Most people respond well to treatment, but your symptoms may come back later. You may develop scarring, which can make going to the bathroom and having sexual intercourse difficult or uncomfortable. For men with lichen sclerosus of the meatus (opening of the urethra at the end of your penis), getting treatment sooner may prevent scar tissue from forming in the rest of the urethra. […] The sooner a healthcare provider can diagnose lichen sclerosus and provide treatment, the better the outlook. However, even with early diagnosis and treatment, symptoms may appear randomly for the rest of your life.

• #83 Lichen Sclerosus

  https://healthlibrary.uwmedicine.org/Library/Encyclopedia/134,552

  Lichen sclerosus causes skin changes. Very early on, you might not have any symptoms at all. A little later, you may see small white spots on your skin. […] Common symptoms might include: Vulvar itching (very common), Anal itching, bleeding, or pain, Pain during sex, Skin bruising and tearing, Blisters, Easy bleeding from minor rubbing of the skin, Pain or bleeding when having a bowel movement, Trouble urinating or pain with urination, Painful erections (in men). […] Symptoms in the genital and anal area don’t often get better without treatment. […] If untreated, the condition tends to get worse over time. […] Untreated advanced lichen sclerosus may permanently change the look of your genitals. The vagina’s opening may narrow. The outer and inner lips of the vulva may stick together. You may need surgery to fix these changes. In men, the foreskin may scar and shrink. This leads to trouble pulling back the foreskin. In both men and women, the condition may cause pain during sex. […] These treatments often reduce most of the symptoms and keep the condition from getting worse.

• #84 Lichen Sclerosus: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/skin-problems-and-treatments/lichen-sclerosis

  It starts as small, shiny, and smooth white patches on your skin. These patches can become bigger and grow together into plaques. The skin may become thin and wrinkled, and it can be easily damaged by scratching or by clothing rubbing against it. […] You can usually get relief from the symptoms of lichen sclerosus with treatment, especially if you catch it early. But it probably won’t go away entirely. You’ll likely go through periods where it flares up for the rest of your life. […] It can cause serious complications, including scarring and sexual dysfunction. […] You’ll also need to be screened regularly for skin cancer.

• #85 What is Lichen Sclerosus? Causes, Symptoms, and Treatment

  https://www.drtahery.com/what-is-lichen-sclerosus-causes-symptoms-and-treatment

  Lichen sclerosus is a non-STD inflammatory condition that can severely impact a woman’s quality of life. Once it develops, lichen sclerosus can cause itchy and painful patches of thin, wrinkled, and discolored skin to develop. The lichen sclerosus symptoms can change the appearance of the labia while causing significant pain during intercourse and when urinating. While lichen sclerosus is chronic, many treatments are available to relieve symptoms. […] Lichen sclerosus symptoms can be mild, and many people don’t realize they have the condition for years because they don’t show any symptoms. But when they develop, the symptoms can worsen over time. […] The first symptoms to appear are typically small, pink, or white lesions. However, those lesions can graduate to larger patches of white, wrinkly, tissue-like skin. As the skin worsens, those patches can get itchy and painful. Due to the skin’s delicate texture and sensitive location, even mild scratching can cause bleeding.

• #86 Lichen Sclerosus: Symptoms, Causes, Treatment

  https://www.healthline.com/health/lichen-sclerosus

  Mild cases of lichen sclerosus sometimes go unnoticed because they dont cause any symptoms aside from the visible and physical symptoms of white, shiny skin. […] If you do experience symptoms from lichen sclerosus, you may notice: itching, which can range from mild to severe, discomfort, pain, smooth white patches, often on private areas such as the vulva and anus, painful sexual intercourse, painful urination. […] Because the skin affected by lichen sclerosus is thinner than normal, it can bruise or blister more easily. You may experience bruises or blisters from wearing tight clothes or sitting down. In severe cases, these injuries can result in ulcerated lesions, or open wounds. […] Lichen sclerosus can affect a small area or spread to surrounding skin. […] Lichen sclerosus can lead to bruises, blisters, and even ulcerated lesions, which are open wounds. If these wounds arent kept clean, they can become infected. […] There is also a 5 percent risk that vulvar lichen sclerosus can develop into a type of skin cancer called squamous cell carcinoma. […] The disease may relapse and remit.

• #87 Lichen Sclerosus

  http://library.oumedicine.com/Search/134,552

  Lichen sclerosus causes skin changes. Very early on, you might not have any symptoms at all. A little later, you may see small white spots on your skin. […] Common symptoms might include: Vulvar itching (very common), Anal itching, bleeding, or pain, Pain during sex, Skin bruising and tearing, Blisters, Easy bleeding from minor rubbing of the skin, Pain or bleeding when having a bowel movement, Trouble urinating or pain with urination, Painful erections (in men). […] These treatments often reduce most of the symptoms and keep the condition from getting worse. You will likely need to use medicine on a regular, long-term basis. If untreated, the condition tends to get worse over time. […] Untreated advanced lichen sclerosus may permanently change the look of your genitals. The vagina’s opening may narrow. The outer and inner lips of the vulva may stick together. You may need surgery to fix these changes. In men, the foreskin may scar and shrink. This leads to trouble pulling back the foreskin. In both men and women, the condition may cause pain during sex.

• #88 Lichen Sclerosus – Skin Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/skin-disorders/psoriasis-and-scaling-disorders/lichen-sclerosus

  Lichen sclerosus is a disorder that tends to cause itching and can cause scarring in the area around the anus and genitals. […] At first, the skin around the anus and genitals tends to bruise and may blister. Itching, sometimes severe, is typical. After some time, the skin can thin, lose its normal color, and develop cracks and scales. In some people, the disorder develops differently, causing skin thickening. […] Severe and longstanding cases of lichen sclerosus cause scarring that distorts the normal structures of the area around the anus and genitals. […] Rarely, squamous cell carcinoma (a skin cancer) develops in areas that have been affected by lichen sclerosus for a long time. […] Because this disorder is typically incurable and causes scarring, people are treated long-term and examined periodically for squamous cell carcinoma.

• #89 Lichen Sclerosus | Doctor

  https://patient.info/doctor/lichen-sclerosus-pro

  Urethral involvement occurs in 20% of men which can cause urethral stricture. […] In most females it is a chronic condition, although symptom control is often successful. In men there is a higher chance of remission or cure. Scarring is not reversible with pharmacological treatment. […] Symptom remission can be achieved in 98% of compliant and 75% of non-compliant women by using potent topical steroids. […] In males, particularly young boys, a course of steroids may prevent the need for circumcision. […] Most men are either cured by topical treatment with ultrapotent steroid (50-60%) or by circumcision (75%). […] However, in some cases LS recurs. More complex cases may be an overlap syndrome with lichen planus, and may be more difficult to treat. […] 75% of girls who develop LS prepubertally will continue to need maintenance treatment after menarche. […] The lifetime risk of SCC is around 4-5% in both males and females. […] Extragenital lesions are less likely to be chronic, and have a better chance of cure.

• #90 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Treatment with potent topical corticosteroids suppresses symptoms such as itching and pain in 75-90% of female patients. Scarring is irreversible. A cohort study on vulvar lichen sclerosus indicates, however, that early and consistent long-term treatment decreases scarring by 36.6% and the development of carcinoma by 4.7% after an observation period of 4.7 years. […] In patients with lichen sclerosus the risk of developing a squamous cell carcinoma in the genital area is slightly increased and is defined with an estimated lifetime risk of approximately 4 to 5%. This risk seems to be significantly decreased by consistent long-term treatment.

• #91 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Treatment with potent topical corticosteroids suppresses symptoms such as itching and pain in 75-90% of female patients. Scarring is irreversible. A cohort study on vulvar lichen sclerosus indicates, however, that early and consistent long-term treatment decreases scarring by 36.6% and the development of carcinoma by 4.7% after an observation period of 4.7 years. […] In patients with lichen sclerosus the risk of developing a squamous cell carcinoma in the genital area is slightly increased and is defined with an estimated lifetime risk of approximately 4 to 5%. This risk seems to be significantly decreased by consistent long-term treatment.

• #92 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Treatment with potent topical corticosteroids suppresses symptoms such as itching and pain in 75-90% of female patients. Scarring is irreversible. A cohort study on vulvar lichen sclerosus indicates, however, that early and consistent long-term treatment decreases scarring by 36.6% and the development of carcinoma by 4.7% after an observation period of 4.7 years. […] In patients with lichen sclerosus the risk of developing a squamous cell carcinoma in the genital area is slightly increased and is defined with an estimated lifetime risk of approximately 4 to 5%. This risk seems to be significantly decreased by consistent long-term treatment.

• #93 Looking after LS in the long term | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/the-long-term/

  Steroid treatment can help you get symptoms under control and reduce your risk of developing vulval cancer. But if youve already got skin fusion or scarring, steroids may not be able to reverse it. […] This fusion or scarring can change the way your vulva looks, feels and works, so if its causing pain, making sex difficult or stopping you peeing properly, surgery might be an option to consider. […] Its important to remember though: most people with LS wont need surgery. […] If your LS is causing skin fusion, your doctor might first recommend that you try to gently separate the parts of your vulva that are sticking together and then apply a topical steroid to these areas (for example under the hood of your clitoris or between your labia). […] If you do have dVIN, it should be treated with surgery.

• #94 Lichen sclerosus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/diagnosis-treatment/drc-20374452

  With treatment, symptoms often improve or go away. Treatment for lichen sclerosus depends on how severe your symptoms are and where it is on your body. Treatment can help ease itching, improve how your skin looks and decrease the risk of scarring. Even with successful treatment, the symptoms often come back. […] Your health care provider will monitor you for side effects associated with prolonged use of topical corticosteroids, such as further thinning of the skin. […] Long-term treatment is needed to control itching and irritation and prevent serious complications.

• #95 Lichen Sclerosus: Causes, Symptoms, Diagnosis, Treatment – Modern Women’s Health Lisa M. Jukes

  https://www.modernwomenshealth.com/blog/lichen-sclerosus-causes-symptoms-diagnosis-treatment/

  Vulvar itching is one of the main symptoms of lichen sclerosus. […] The symptoms of lichen sclerosus include itching, discomfort, pain, a white appearance of the skin, patches on the skin that become thin and wrinkled, tears in the skin, scarring of the skin, bleeding and even blistering. […] The key is early detection and treatment to avoid scarring of the labia. Regular exams every 6-12 months are recommended.

• #96 Lichen Sclerosus: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16564-lichen-sclerosus

  Lichen sclerosus is a chronic condition. Most people respond well to treatment, but your symptoms may come back later. You may develop scarring, which can make going to the bathroom and having sexual intercourse difficult or uncomfortable. For men with lichen sclerosus of the meatus (opening of the urethra at the end of your penis), getting treatment sooner may prevent scar tissue from forming in the rest of the urethra. […] The sooner a healthcare provider can diagnose lichen sclerosus and provide treatment, the better the outlook. However, even with early diagnosis and treatment, symptoms may appear randomly for the rest of your life.

• #97 Lichen Sclerosus: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16564-lichen-sclerosus

  Lichen sclerosus is a chronic condition. Most people respond well to treatment, but your symptoms may come back later. You may develop scarring, which can make going to the bathroom and having sexual intercourse difficult or uncomfortable. For men with lichen sclerosus of the meatus (opening of the urethra at the end of your penis), getting treatment sooner may prevent scar tissue from forming in the rest of the urethra. […] The sooner a healthcare provider can diagnose lichen sclerosus and provide treatment, the better the outlook. However, even with early diagnosis and treatment, symptoms may appear randomly for the rest of your life.

• #98 Lichen sclerosus | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/vulva-vagina/vulva-vagina-problems/lichen-sclerosus

  Unfortunately there is no cure or way to get rid of lichen sclerosus completely. There are however ways to reduce or lessen the symptoms so that you can live comfortably with it. […] You might find sex painful however, because scarring can make the vulvar skin (and vaginal opening) tight and more likely to split. […] Lichen sclerosus is often mistaken for thrush so see your doctor if you are often itchy in the vulvar or anal area. […] There are treatments that can help you successfully manage the symptoms. […] Lichen sclerosus is not contagious.

• #99 Lichen Sclerosus | Doctor

  https://patient.info/doctor/lichen-sclerosus-pro

  Urethral involvement occurs in 20% of men which can cause urethral stricture. […] In most females it is a chronic condition, although symptom control is often successful. In men there is a higher chance of remission or cure. Scarring is not reversible with pharmacological treatment. […] Symptom remission can be achieved in 98% of compliant and 75% of non-compliant women by using potent topical steroids. […] In males, particularly young boys, a course of steroids may prevent the need for circumcision. […] Most men are either cured by topical treatment with ultrapotent steroid (50-60%) or by circumcision (75%). […] However, in some cases LS recurs. More complex cases may be an overlap syndrome with lichen planus, and may be more difficult to treat. […] 75% of girls who develop LS prepubertally will continue to need maintenance treatment after menarche. […] The lifetime risk of SCC is around 4-5% in both males and females. […] Extragenital lesions are less likely to be chronic, and have a better chance of cure.

• #100 Pediatric lichen sclerosus (LS) – Children’s Health Gynecology

  https://www.childrens.com/specialties-services/conditions/lichen-sclerosis

  Pediatric lichen sclerosus (LS) is a skin condition that affects the vulva and/or peri-anal area. An estimated 10 to 15 percent of cases occur in young girls. […] Symptoms include: Itching, Skin that appears fragile pale, and/or white, Bruised skin with blood blisters, Small tears in the skin, Scar tissue covering the vulvar area, Bleeding or tearing of the skin during bowel movements. […] Some girls with lichen sclerosus have no symptoms. […] If your daughter is diagnosed with lichen sclerosus, even without symptoms, she should be treated to prevent scarring of the vulva, which can lead to problems with urination. […] Regular check-ups are important so symptoms can be treated early. […] It can recur, so its important that your daughter gets regular check-ups for timely treatment and reduced scarring. Lichen sclerosis often resolves by puberty, and there is a good chance she will not need treatment beyond that stage.

• #101 Lichen Sclerosus > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/lichen-sclerosus

  Lichen sclerosus is a rare skin disease that causes itchy and painful patches of thin, white, wrinkled-looking skin. […] The condition can lead to scarring and tightening of the skin around the genitals and anus. […] Lichen sclerosus is a chronic disease, meaning that once it develops, it lasts for a long time, often for the rest of a patients life. Though it often worsens over time, the good news is that treatments are now available that can reduce symptoms and stop progression of the disease. […] Lichen sclerosus is a life-long condition for which there is no cure. If the disease progresses or is left untreated, it may cause serious, debilitating symptoms. […] Fortunately, treatment generally reduces and, in some cases, eliminates symptoms, though relapses still tend to occur periodically. […] A long-term maintenance treatment regimen is very important, and not just to prevent or treat symptom recurrence. Treatment to maintain normal skin color and texture reduces scarring and may prevent progression to skin cancer.

• #102 More information about Pediatric Vulvar Lichen Sclerosus – Great Neck, NY: Adolescent Young Adult Medicine of Great Neck

  https://www.tragermd.com/contents/services/lichen-sclerosus/pediatric-vulvar-lichen-s

  The prognosis of pediatric lichen sclerosus is usually very good. Most girls will improve significantly with treatment. However, the signs and symptoms of lichen sclerosus may come and go over several years. […] The main complications of lichen sclerosus have to do with scarring. Scarring is caused by chronic (long-term) inflammation of the vulvar skin and may lead to a shrinking of the vulvar tissue. […] Lichen sclerosus does not cause skin cancer. However, skin that is scarred by lichen sclerosus in adulthood may be more likely to develop a particular skin cancer called squamous cell carcinoma. […] Parents may have concerns about how lichen sclerosus will affect their daughter’s sexual functioning later in life. Since treatment is so effective, young girls with lichen sclerosus who do not have significant scarring can be expected to have normal sexual functioning. […] Having a long-term, itchy, painful, disease involving the genital area may be very upsetting to a young girl. Girls with lichen sclerosus may need a great deal of emotional support and encouragement to deal with their disease.

• #103 Lichen Sclerosus Overview – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-overview/

  Unfortunately, most will suffer from secondary symptoms the hardest. The mental health issues related to a Lichen Sclerosus diagnosis can run deep. […] While all Lichen Sclerosus symptoms are difficult, mental health issues can cause the most harm. Most patients suffer alone. So they cycle in and out of loneliness, anxiety, and depression, not realizing they need help. This vicious cycle is why having a support system, whether a counselor, therapist, or support group, is important.

• #104 Can Lichen Sclerosus be Caused by Stress

  https://coyleinstitute.com/lichen-sclerosus-and-stress/

  According to a study published in 2019 in the Open Access Journal of Urology, oxidative stress (OS) plays a role in the development, pathogenesis, and progression of LS. Researchers state that DNA damage and peroxidation of the lipids caused by OS may directly contribute to the development of LS skin lesions. […] High levels of stress take a toll on the immune system over time. The stress-induced release of cortisol generates high levels of inflammatory markers in the blood. These inflammatory markers can, in turn, have a negative impact on many body systems, including the skin. Therefore, stress could very well be an underlying factor in the development of LS. […] If you have what you suspect to be LS, it is always a good idea to seek a doctors advice. Creating a comprehensive treatment plan may slow the progression of the condition and deter later complications like skin scarring and painful intercourse.

• #105 What is vulval lichen sclerosus? | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/what-is-vulval-ls/

  LS symptoms can make all sorts of ordinary, everyday activities, like sitting, walking and exercising, feel uncomfortable or difficult. […] Common symptoms you might feel include itching, painful sex, pain or soreness, burning, irritation, feeling of dryness, change in sensation, pain when you pee or poo, and disturbed stream when you pee. […] LS can also be asymptomatic, which means some people can have the condition without experiencing those uncomfortable or painful symptoms. Even if thats the case, they might still notice some visible signs of LS. […] LS can often cause white or pale patches of skin on your vulva and around your bottom. You might also notice these patches merging into areas of crinkly or thickened skin. […] Its common to experience swelling, particularly around your clitoris, or to notice small cracks (fissures) appearing in your skin. You might also see blood under the skin or bruising.

• #106 Lichen sclerosus: Symptoms, Causes, and Treatment

  https://patient.info/womens-health/vulval-problems-leaflet/lichen-sclerosus

  Lichen sclerosus is an uncommon skin condition. It most commonly affects the genital skin (vulva) of women. It can occur at any age. […] Symptoms include itch, soreness and changes in the appearance of affected skin. Treatment with a steroid cream or ointment often eases the symptoms. […] The initial symptoms of lichen sclerosus typically include small pearly white spots, which are usually but not always itchy. The itch tends to be worse at night which can disturb sleep. […] Over time, the white spots may become larger and join together. The whole vulva and/or anal skin may then become white and be more fragile than normal. The fragile skin may become damaged, inflamed, raw and prone to painful splitting and cracking. It may become painful to have sex. If the anal skin is affected, passing poo (faeces) may cause pain.

• #107 What is vulval lichen sclerosus? | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/what-is-vulval-ls/

  LS symptoms can make all sorts of ordinary, everyday activities, like sitting, walking and exercising, feel uncomfortable or difficult. […] Common symptoms you might feel include itching, painful sex, pain or soreness, burning, irritation, feeling of dryness, change in sensation, pain when you pee or poo, and disturbed stream when you pee. […] LS can also be asymptomatic, which means some people can have the condition without experiencing those uncomfortable or painful symptoms. Even if thats the case, they might still notice some visible signs of LS. […] LS can often cause white or pale patches of skin on your vulva and around your bottom. You might also notice these patches merging into areas of crinkly or thickened skin. […] Its common to experience swelling, particularly around your clitoris, or to notice small cracks (fissures) appearing in your skin. You might also see blood under the skin or bruising.

• #108 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  The clinical manifestations of LS in boys and adult men are usually localized to glans penis and foreskin, whereas involvement of perianal area is rare. Typical symptoms include pruritus and soreness, sometimes accompanied by dysuria. Clinically, porcelain-like whitish sclerotic scarring on the distal portion of prepuce is usually observed. This scarring leads to phimosis in previously retractable foreskin, or adhesions of the foreskin to glans penis. In some cases, erosions, ulcers and even bullous lesions may be present. In around 17% of patients, external meatus urethrae can also be involved, which is often accompanied by dysuria and poor urinary stream. Sometimes meatal stenosis can appear years after the initial manifestation of LS, without any signs of persistent or recurrent LS. […] Lichen sclerosus in women leads to skin fragility, bleeding, chronic fissuring scars and secondary infections. It may evolve to a fusion of the labias, complete loss of the vulvar architecture, and narrowing of the vaginal introitus, preventing normal sexual intercourse. Furthermore, chronic anterior scarring can trap the clitoris within the clitoral hood, leading to phimosis and painful clitoral engorgement during arousal (clitoral pseudocyst). After a long-term severe scarring may occur urinary retention, anal stenosis, obstruction and constipation. In MGLS, preputial scarring leads to a frenulum contracture and a progressive fibrous phimosis with trans- and subcoronal adhesions.

• #109 Symptoms of Lichen Sclerosus • Lichen Sclerosus Support Network

  https://www.lssupport.net/symptoms-of-lichen-sclerosus-2/

  Everyone suffers from different symptoms of Lichen Sclerosus. Some are affected by one or a variety of common symptoms such as itching and burning. While others, who have gone untreated, can develop severe symptoms such as fusing or vulval cancer. Consequently, these symptoms are what the doctors look for and treat. Unfortunately, most of us will suffer harder from secondary symptoms. The mental health issues that develop because of a Lichen Sclerosus diagnosis. They are many and can run deep. The scariest part is we may not even realize we are suffering or need help. […] Common Symptoms: Itching (mostly at night), Burning and soreness, White ashy skin or patches, Fissures, ulcers, nonhealing legions, and blood blisters, Excessive sweating between your legs, Misshapen vulva, Chronic urinary tract or yeast infections.

• #110 Pain from Lichen Sclerosus: The Fundamentals – LSSN

  https://lssupportnetwork.org/pain-from-lichen-sclerosus-the-fundamentals/

  Some folks describe their pain as general soreness or discomfort. It is not entirely burning or stabbing pain, but it is uncomfortable. It may feel raw or tender. […] Pain was a huge part of my LS journey. My very first LS symptom was painful sex. It began in my early 20s as general discomfort during sex. Over the years, that pain grew in complexity and intensity. […] In my late 20s, my pain was constant. Even if I abstained from sex, I was still in pain. […] If your pain is severe, call your doctor. […] In sum, pain from lichen sclerosus is common. It can feel like stinging, stabbing, burning, rawness, tenderness, or general discomfort.

• #111 Lichen Sclerosus Overview – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-overview/

  Unfortunately, most will suffer from secondary symptoms the hardest. The mental health issues related to a Lichen Sclerosus diagnosis can run deep. […] While all Lichen Sclerosus symptoms are difficult, mental health issues can cause the most harm. Most patients suffer alone. So they cycle in and out of loneliness, anxiety, and depression, not realizing they need help. This vicious cycle is why having a support system, whether a counselor, therapist, or support group, is important.

• #112 Symptoms of Lichen Sclerosus • Lichen Sclerosus Support Network

  https://www.lssupport.net/symptoms-of-lichen-sclerosus-2/

  Severe Symptoms: The fusing of the labia, The fusing of the clitoral hood, Valvular scarring. […] Secondary Symptoms: Depression, Isolation, Fatigue, Anxiety, Low self-esteem, Loss of sleep, Loss of relationships, Pain during sex, urinating or having a bowel movement, Valvular cancer. […] All the symptoms of Lichen Sclerosus are bad but, mental health issues can cause the most harm. Most of us suffer alone. So we cycle in and out of loneliness, anxiety, and depression not realizing we need help.

• #113 Symptoms of Lichen Sclerosus • Lichen Sclerosus Support Network

  https://www.lssupport.net/symptoms-of-lichen-sclerosus-2/

  Severe Symptoms: The fusing of the labia, The fusing of the clitoral hood, Valvular scarring. […] Secondary Symptoms: Depression, Isolation, Fatigue, Anxiety, Low self-esteem, Loss of sleep, Loss of relationships, Pain during sex, urinating or having a bowel movement, Valvular cancer. […] All the symptoms of Lichen Sclerosus are bad but, mental health issues can cause the most harm. Most of us suffer alone. So we cycle in and out of loneliness, anxiety, and depression not realizing we need help.

• #114 More information about Pediatric Vulvar Lichen Sclerosus – Great Neck, NY: Adolescent Young Adult Medicine of Great Neck

  https://www.tragermd.com/contents/services/lichen-sclerosus/pediatric-vulvar-lichen-s

  The prognosis of pediatric lichen sclerosus is usually very good. Most girls will improve significantly with treatment. However, the signs and symptoms of lichen sclerosus may come and go over several years. […] The main complications of lichen sclerosus have to do with scarring. Scarring is caused by chronic (long-term) inflammation of the vulvar skin and may lead to a shrinking of the vulvar tissue. […] Lichen sclerosus does not cause skin cancer. However, skin that is scarred by lichen sclerosus in adulthood may be more likely to develop a particular skin cancer called squamous cell carcinoma. […] Parents may have concerns about how lichen sclerosus will affect their daughter’s sexual functioning later in life. Since treatment is so effective, young girls with lichen sclerosus who do not have significant scarring can be expected to have normal sexual functioning. […] Having a long-term, itchy, painful, disease involving the genital area may be very upsetting to a young girl. Girls with lichen sclerosus may need a great deal of emotional support and encouragement to deal with their disease.

• #115 Symptoms of Lichen Sclerosus • Lichen Sclerosus Support Network

  https://www.lssupport.net/symptoms-of-lichen-sclerosus-2/

  Severe Symptoms: The fusing of the labia, The fusing of the clitoral hood, Valvular scarring. […] Secondary Symptoms: Depression, Isolation, Fatigue, Anxiety, Low self-esteem, Loss of sleep, Loss of relationships, Pain during sex, urinating or having a bowel movement, Valvular cancer. […] All the symptoms of Lichen Sclerosus are bad but, mental health issues can cause the most harm. Most of us suffer alone. So we cycle in and out of loneliness, anxiety, and depression not realizing we need help.

• #116 Symptoms of Lichen Sclerosus • Lichen Sclerosus Support Network

  https://www.lssupport.net/symptoms-of-lichen-sclerosus-2/

  Severe Symptoms: The fusing of the labia, The fusing of the clitoral hood, Valvular scarring. […] Secondary Symptoms: Depression, Isolation, Fatigue, Anxiety, Low self-esteem, Loss of sleep, Loss of relationships, Pain during sex, urinating or having a bowel movement, Valvular cancer. […] All the symptoms of Lichen Sclerosus are bad but, mental health issues can cause the most harm. Most of us suffer alone. So we cycle in and out of loneliness, anxiety, and depression not realizing we need help.

• #117 Can Lichen Sclerosus be Caused by Stress

  https://coyleinstitute.com/lichen-sclerosus-and-stress/

  According to a study published in 2019 in the Open Access Journal of Urology, oxidative stress (OS) plays a role in the development, pathogenesis, and progression of LS. Researchers state that DNA damage and peroxidation of the lipids caused by OS may directly contribute to the development of LS skin lesions. […] High levels of stress take a toll on the immune system over time. The stress-induced release of cortisol generates high levels of inflammatory markers in the blood. These inflammatory markers can, in turn, have a negative impact on many body systems, including the skin. Therefore, stress could very well be an underlying factor in the development of LS. […] If you have what you suspect to be LS, it is always a good idea to seek a doctors advice. Creating a comprehensive treatment plan may slow the progression of the condition and deter later complications like skin scarring and painful intercourse.

• #118 Pain from Lichen Sclerosus: The Fundamentals – LSSN

  https://lssupportnetwork.org/pain-from-lichen-sclerosus-the-fundamentals/

  Pain from lichen sclerosus is a common symptom. While many of us experience pain from lichen sclerosus, that pain presents differently for each person. For example, some folks may rate their pain as mild-moderate. In contrast, others will describe their pain as debilitating and severe. Some people experience their pain every day, whereas others experience it occasionally. […] A common cause of pain from lichen sclerosus is pain with sex. This can be penis-in-vagina sex, sex with a toy, fingering, etc. […] One of the reasons sex can cause pain for folks with lichen sclerosus is because LS causes the skin to thicken and become inflexible. […] Some folks experience pain only during penetration; others experience it for days after, even if they have not had any more penetration. […] A common adjective used to describe the pain from lichen sclerosus is burning.

• #119 Is There Hope for Lichen Sclerosus Treatment – Coyle Institute

  https://coyleinstitute.com/is-there-hope-for-lichen-sclerosus-treatment/

  Itching. Pain. Irritation. Burning. […] The symptoms of lichen sclerosus can be easily confused with many other conditions that affect vaginal and vulvar health. […] Lichen sclerosus symptoms include: Painful sex, Itching, Smooth, white patches on vulvar skin, Blotchy, wrinkled patches on vulvar skin, Spots that grow into larger patches, Redness, Blistering or ulcerated sores, Skin that easily tears and bruises, Scarred skin on the affected area. […] Even with treatment, it can last for years and cause permanent scarring and other complications. […] Because skin is more sensitive and likely to scar, people with lichen sclerosus often experience symptoms that include painful sex, urinary retention and constipation because these bodily functions become incredibly uncomfortable. […] Ongoing follow-up care is required to monitor the condition and detect any changes that indicate an increased risk of complications.

• #120 Symptoms of Lichen Sclerosus • Lichen Sclerosus Support Network

  https://www.lssupport.net/symptoms-of-lichen-sclerosus-2/

  Severe Symptoms: The fusing of the labia, The fusing of the clitoral hood, Valvular scarring. […] Secondary Symptoms: Depression, Isolation, Fatigue, Anxiety, Low self-esteem, Loss of sleep, Loss of relationships, Pain during sex, urinating or having a bowel movement, Valvular cancer. […] All the symptoms of Lichen Sclerosus are bad but, mental health issues can cause the most harm. Most of us suffer alone. So we cycle in and out of loneliness, anxiety, and depression not realizing we need help.

• #121 Lichen Sclerosus Overview – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-overview/

  Unfortunately, most will suffer from secondary symptoms the hardest. The mental health issues related to a Lichen Sclerosus diagnosis can run deep. […] While all Lichen Sclerosus symptoms are difficult, mental health issues can cause the most harm. Most patients suffer alone. So they cycle in and out of loneliness, anxiety, and depression, not realizing they need help. This vicious cycle is why having a support system, whether a counselor, therapist, or support group, is important.

• #122 Symptoms of Lichen Sclerosus • Lichen Sclerosus Support Network

  https://www.lssupport.net/symptoms-of-lichen-sclerosus-2/

  Severe Symptoms: The fusing of the labia, The fusing of the clitoral hood, Valvular scarring. […] Secondary Symptoms: Depression, Isolation, Fatigue, Anxiety, Low self-esteem, Loss of sleep, Loss of relationships, Pain during sex, urinating or having a bowel movement, Valvular cancer. […] All the symptoms of Lichen Sclerosus are bad but, mental health issues can cause the most harm. Most of us suffer alone. So we cycle in and out of loneliness, anxiety, and depression not realizing we need help.

• #123 The Silent Struggle: Coping with Life with Vulvar Lichen Sclerosus

  https://liquenia.es/en/the-silent-struggle-coping-with-life-with-vulvar-lichen-sclerosus/

  Vulvar Lichen Sclerosus can cause a variety of symptoms, which can vary from person to person. Some common symptoms include: […] The affected area may also itch, hurt, or both. In severe cases, the vulva may become scarred, which can cause problems with urination, sexual intercourse and childbirth. […] If you experience any of these symptoms, it is important to see your physician for an accurate diagnosis. […] Lichen sclerosus cannot be cured, but it can be controlled with proper treatment and self-care. […] Rarely, lichen sclerosus can cause vulvar cancer. It is important to see your doctor regularly to monitor any changes. […] Living with vulvar Lichen Sclerosus can be challenging, but it is not impossible. With proper treatment, self-care and emotional support, you can manage this condition and lead a better life.

• #124 The Silent Struggle: Coping with Life with Vulvar Lichen Sclerosus

  https://liquenia.es/en/the-silent-struggle-coping-with-life-with-vulvar-lichen-sclerosus/

  Vulvar Lichen Sclerosus can cause a variety of symptoms, which can vary from person to person. Some common symptoms include: […] The affected area may also itch, hurt, or both. In severe cases, the vulva may become scarred, which can cause problems with urination, sexual intercourse and childbirth. […] If you experience any of these symptoms, it is important to see your physician for an accurate diagnosis. […] Lichen sclerosus cannot be cured, but it can be controlled with proper treatment and self-care. […] Rarely, lichen sclerosus can cause vulvar cancer. It is important to see your doctor regularly to monitor any changes. […] Living with vulvar Lichen Sclerosus can be challenging, but it is not impossible. With proper treatment, self-care and emotional support, you can manage this condition and lead a better life.

• #125 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  Lichen sclerosus (LS) is an underdiagnosed inflammatory mucocutaneous condition affecting the anogenital areas. The typical clinical picture includes chronic whitish atrophic patches along with itching and soreness in the vulvar, perianal and penile regions. In addition to genital scarring, and sexual and urinary dysfunction, LS may also lead to squamous cell carcinoma. The clinical picture of anogenital LS (gLS) includes ivory-white patches, atrophy and severe pruritus, altering the quality of life (QoL). The lesions could evolve to scarring of the vaginal introitus, phimosis and functional impairment. Furthermore, it has been described as an intrinsic risk factor for malignancy in untreated patients, but there is no evidence of increased neoplasm development after long-term treatments. The established diagnosis of LS based on the clinical features is usually sufficient, and a skin biopsy should only be performed in case of clinical doubts, differential diagnosis or suspected malignancy. The first-line therapy is ultrapotent or potent topical glucocorticoids and in case of anatomical changes due to scarring, surgical procedures should be performed. In order to prevent complications, aside from an early diagnosis and a correct treatment, a long-term follow-up is imperative.

• #126 Lichen Sclerosus > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/lichen-sclerosus

  Lichen sclerosus is a rare skin disease that causes itchy and painful patches of thin, white, wrinkled-looking skin. […] The condition can lead to scarring and tightening of the skin around the genitals and anus. […] Lichen sclerosus is a chronic disease, meaning that once it develops, it lasts for a long time, often for the rest of a patients life. Though it often worsens over time, the good news is that treatments are now available that can reduce symptoms and stop progression of the disease. […] Lichen sclerosus is a life-long condition for which there is no cure. If the disease progresses or is left untreated, it may cause serious, debilitating symptoms. […] Fortunately, treatment generally reduces and, in some cases, eliminates symptoms, though relapses still tend to occur periodically. […] A long-term maintenance treatment regimen is very important, and not just to prevent or treat symptom recurrence. Treatment to maintain normal skin color and texture reduces scarring and may prevent progression to skin cancer.

• #127 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Treatment with potent topical corticosteroids suppresses symptoms such as itching and pain in 75-90% of female patients. Scarring is irreversible. A cohort study on vulvar lichen sclerosus indicates, however, that early and consistent long-term treatment decreases scarring by 36.6% and the development of carcinoma by 4.7% after an observation period of 4.7 years. […] In patients with lichen sclerosus the risk of developing a squamous cell carcinoma in the genital area is slightly increased and is defined with an estimated lifetime risk of approximately 4 to 5%. This risk seems to be significantly decreased by consistent long-term treatment.

• #128 Lichen Sclerosus > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/lichen-sclerosus

  Lichen sclerosus is a rare skin disease that causes itchy and painful patches of thin, white, wrinkled-looking skin. […] The condition can lead to scarring and tightening of the skin around the genitals and anus. […] Lichen sclerosus is a chronic disease, meaning that once it develops, it lasts for a long time, often for the rest of a patients life. Though it often worsens over time, the good news is that treatments are now available that can reduce symptoms and stop progression of the disease. […] Lichen sclerosus is a life-long condition for which there is no cure. If the disease progresses or is left untreated, it may cause serious, debilitating symptoms. […] Fortunately, treatment generally reduces and, in some cases, eliminates symptoms, though relapses still tend to occur periodically. […] A long-term maintenance treatment regimen is very important, and not just to prevent or treat symptom recurrence. Treatment to maintain normal skin color and texture reduces scarring and may prevent progression to skin cancer.

• #129 Lichen sclerosus: The 2023 update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9978401/

  LS in genital areas has a risk of neoplastic transformation to squamous cell carcinoma (SCC). Vulvar SCC was observed in 3.5 to 7% of women with VLS, while up to 65% of vulvar carcinomas arise on a background of VLS. Hence, early detection of premalignant lesions and a lifelong follow-up are required.

• #130 Vulvar Lichen Sclerosus – Symptoms, Diagnosis & Treatment (PDF)

  https://gynqi.com/vulvar-lichen-sclerosus/

  In more advanced cases, the disease can alter the normal vulvar anatomy, causing scarring, loss of labia minora (the inner lips), fusion over the clitoris, and narrowing of the vaginal opening. […] As a result of any anatomical changes, many individuals can experience a disruption of normal function as a result. This can include: Inability to properly urinate, Painful sexual intercourse, Painful bowel movements. […] A treatment plan should be implemented to include: Symptom control and management of painful symptoms such as itching, burning, or pain during intercourse. […] Preventing disease progression and preserving the normal anatomy and function of the vulva. […] Prevention of vulvar cancer. Approximately 5% of vulvar lichen sclerosus will progress to vulvar cancer (vulvar squamous cell carcinoma) if left untreated. […] Unfortunately, anatomical skin changes that have already occurred before starting treatment are irreversible. […] Ongoing treatment with topical steroids is essential to control symptoms and prevent progression, including the risk of vulvar cancer if untreated.

• #131 Lichen Sclerosus Overview – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-overview/

  Unfortunately, most will suffer from secondary symptoms the hardest. The mental health issues related to a Lichen Sclerosus diagnosis can run deep. […] While all Lichen Sclerosus symptoms are difficult, mental health issues can cause the most harm. Most patients suffer alone. So they cycle in and out of loneliness, anxiety, and depression, not realizing they need help. This vicious cycle is why having a support system, whether a counselor, therapist, or support group, is important.

• #132 The Silent Struggle: Coping with Life with Vulvar Lichen Sclerosus

  https://liquenia.es/en/the-silent-struggle-coping-with-life-with-vulvar-lichen-sclerosus/

  Vulvar Lichen Sclerosus can cause a variety of symptoms, which can vary from person to person. Some common symptoms include: […] The affected area may also itch, hurt, or both. In severe cases, the vulva may become scarred, which can cause problems with urination, sexual intercourse and childbirth. […] If you experience any of these symptoms, it is important to see your physician for an accurate diagnosis. […] Lichen sclerosus cannot be cured, but it can be controlled with proper treatment and self-care. […] Rarely, lichen sclerosus can cause vulvar cancer. It is important to see your doctor regularly to monitor any changes. […] Living with vulvar Lichen Sclerosus can be challenging, but it is not impossible. With proper treatment, self-care and emotional support, you can manage this condition and lead a better life.

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