Lichen Sclerosus

What is Lichen Sclerosus (LS)?

This is a skin condition that mainly affect the skin of the genitals. It is not infectious and the cause is not really known. Many theories have been proposed and there are some links with other conditions such as thyroid disease.

It can affect other areas of the body – arms, back, breasts and shoulders.

It most commonly affects women of older age groups but both men and children can develop the condition. In men it is known as BXO (balanitis xerotica obliterans) when it affect the (glans) penis (“bell end”).

It is a condition that is usually long term and the symptoms come and go; they are usually controlled with steroid treatment (see below).

A skin condition affecting both men and women

NOT an STI

Needs lifelong follow up

Treated with creams

What are the symptoms?

Men/ I have a penis: sore /itchy white patches on the penis, particularly around the tip, but sometimes on the shaft, the skin at the tip of the penis becoming firm and white, difficulty pulling the foreskin back, which can make peeing difficult and lead to painful erections if left untreated.

Women/I have a vagina: white areas of skin which become cracked and sore; itchiness, which tends to be worse at night and may disturb sleep, fragile and thin skin which can become red or purple with blood blisters; pain when having sex. Usually the anal area can be affected in women; pain when passing stools and itching or soreness with white skin.

How is it diagnosed?

Sometimes just examining a patient is all that is needed ( especially by a doctor who is very specialised in skin conditions and who has seen a lot of patients with LS)

The most reliable diagnostic test is a biopsy of the skin which is done under a local anaesthetic within a sexual health clinic or another specialised setting.

Occasionally circumcision is needed to remove a very tight foreskin.

What is the treatment?

Washing with emollients and avoiding soaps and shower gels.

Using an emollient as a moisturiser at night can also help the skin to repair and protect itself.

Steroid creams or ointments which are applied to the affected skin – these are used frequently at first but then are reduced over time.

Useful information

For more information visit the NHS website.