CANBERRA SEXUAL HEALTH CENTRE

LICHEN SCLEROSUS

FACT SHEET
Lichen sclerosus (LS) is a skin disorder that can happen at any age to men and women, but is more common in
postmenopausal women. LS usually affects the genitals, and occasionally other areas of the body. In women LS mostly occurs
near the clitoris, on the labia and in the anal region, and in males it most commonly occurs on the foreskin of the penis.

What are the symptoms and signs of lichen sclerosus?

In women:
Vulval and anal itching
Skin splits which can cause bleeding and pain
Bruising and blood blisters
Painful sex
LS results in a white thickening of the skin of the vulva. It can be localised to one area of the genitals or affect the whole
area. Sometimes the clitoris disappears, the labia shrinks and the entrance to the vagina tightens due to changes in the skin.

In men:
LS may occur on the head of the penis which can become itchy, firm, and discoloured or white in appearance
The foreskin can become tight and shrunken and difficult to retract
Decreased sensation at the tip of the penis
Difficulty passing urine

LS can also affect other parts of the body in 10% of people who have the condition. White patches of skin may be found on
the inner thigh, buttocks, under the breasts, neck, shoulders and armpits.

What causes lichen sclerosus?

The cause of LS is unknown but may include genetic, hormonal and irritant factors. LS is thought to occur due to auto-
immune processes where antibodies affect a component in the skin.

How is lichen sclerosus diagnosed?

The condition is diagnosed after careful clinical examination and history. A biopsy of the skin (removal of a very small piece
of skin under local anaesthetic) is taken to confirm the diagnosis.

What is the treatment for lichen sclerosus?

Strong topical steroid ointments are used to treat LS. They should be applied as a thin smear to the affected areas. Most
patients will be told to apply the ointment once a day initially. The itch will usually settle within a few days but it can take
weeks or months for the skin to improve. Once the skin has improved, the ointment can be applied less often but it usually
needs to be continued on a regular basis (perhaps once a week) to prevent the LS recurring.
Good skin care is needed and involves gentle washing in the shower or bath with plain water or a non-soap cleanser. Try to
avoid rubbing and scratching.
It is important to attend for follow-up appointments with your medical practitioner, and a lifelong yearly assessment is
recommended in most cases so that the condition can be monitored.

What to expect?
The good news is that treatments are very effective. Most patients with LS, who use treatment as prescribed, have vast
improvement in their current symptoms.

What about surgery?

Surgery is rarely used in the management of LS. In women it may sometimes be needed to reduce difficulty urinating and
allow for intercourse where the urinary opening or vaginal opening are narrowed. In men circumcision may be necessary in
some cases.

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Canberra Sexual Health Centre Version 1 May 2014
CANBERRA SEXUAL HEALTH CENTRE

FACT SHEET
What can happen if lichen sclerosus is not treated?
LS is associated with an increased risk of vulval and penile cancers. Long-term treatment and follow-up is therefore
recommended.

Where can I get treatment for lichen sclerosus in Canberra?

Canberra Sexual Health Centre Sexual Health and Family Planning ACT
Building 5, Level 1, North Wing Level 1, 28 University Avenue
Yamba Drive Garran Canberra ACT 2601
Ph: (02) 6244 2184 Ph: (02) 6247 3077

General Practitioners (GPs) in Canberra Winnunga Nimmityjah Aboriginal Health Service

http://health.act.gov.au/health-services/find-a-health-service 63 Boolimba Crescent
Narrabundah ACT 2604
Phone: (02) 6284 6222
Free call: 1800 110 290 or 1800 120 859

Useful websites
www.dermnetnz.org
www.caredownthere.com.au
www.anzvs.org

To access information about lichen sclerosus in other languages:

http://dermnetnz.org/immune/lichen-sclerosus.html

References:
DermNetNZ (2013) Lichen sclerosus.
Retrieved July 22 2013 from http://dermnetnz.org/immune/lichen-sclerosus.html

Melbourne Sexual Health Centre (2012) Lichen Sclerosus Factsheet.

Retrieved July 22 2013 from www.mshc.org.au

Stewart, E. (2013) Patient Information: Lichen sclerosus (Beyond the Basics) http://www.uptodate.com/contents/lichen-
sclerosus--beyond-the-basics

This fact sheet is designed to provide you with general information only. It is not intended to replace the need for a consultation with a
health practitioner. All clients are advised to enquire about any specific questions or concerns they may have. Every effort has been made to
ensure that this information is correct at the time of publishing.

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Canberra Sexual Health Centre Version 1 May 2014