What is Lichen Sclerosus?
Lichen Sclerosus (LS) is a progressive, dermatological inflammatory affecting the vulva and anus. The exact cause of LS is unknown. However, studies have associated the condition with autoimmune diseases, infection, inflammatory responses, genetics and hormonal imbalances. Lichen Sclerosus affects men, women and children, and more commonly, postmenopausal women.
What are the symptoms of Lichen Sclerosus?
The most common symptoms of LS are pruritus (itching), irritation and pain of the vulvus and perianal area. White skin spots on the vulva and perianal area is a classic presentation of Lichen Sclerosus. However, skin bruising, tearing, blistering and ulcerations have also been documented. In advanced states of LS, the vulvar anatomy may change as the labia minora and majora lose distinction, the clitoris gets trapped and the vaginal opening (introitus) narrows. Pain with intercourse or difficulty urinating may be present in the advanced states secondary to introital narrowing, fissures or excoriation. It should also be noted that women with LS may be asymptomatic.
How is it diagnosed?
Lichen Sclerosus is diagnosed upon physical exam by a provider and biopsy. A punch biopsy of the affected tissue is completed prior to starting treatment to confirm diagnosis and rule out other possible causes. A punch biopsy is a simple small cookie cutter of only 1/8 inch in diameter. Upon physical exam, white silvery plaques may be noted to the vulva and anus. The tissue and skin generally appear thin, excoriating and fissuring may be present.
What are my treatment options?
Treatment varies between patients. Women may choose not to undergo treatment if they are asymptomatic. Traditional treatment options include topical steroids (ie clobetasol proprionate), topical calcineurin inhibitors, topical retinoids, photodynamic therapy, radiofrequency energy and injections of hyaluronic acid and platelets. Surgical interventions may be necessary if precancerous or cancerous cells are present, or the vaginal introitus is narrowed requiring widening. Visit our webpage on Lichen Sclerosus for more in-depth information on treatment options.
Is Lichen Sclerosus contagious?
No, Lichen Sclerosus is not contagious. The cause is thought to be autoimmune, inflammatory or hormonal in nature. Men can also have genital lichen sclerosus.
Is Lichen Sclerosus associated with cancer?
There is data to support that women with LS have an increased risk of squamous cell cancer of the vulva. This risk is less than 5%. Skin biopsies are taken to help diagnosis precancerous or cancerous cells.
Will I be able to have sex?
The ability to be intimate and have intercourse varies between patients. Some women are asymptomatic and able to have intercourse without difficulty. However, others might be greatly affected by LS causing pain during intercourse or might not be able to have sex at all due to vaginal introitus narrowing.
Can ThermiVa help with my symptoms?
Yes! ThermiVa is a great complimentary therapy for Lichen Sclerosus. Gentle, radiofrequency energy heat is applied to the affected areas of the vulva vagina and perianal area. Heating the tissue helps to increase collagen and blood flow to the treated areas. ThermiVa treatment help manage the symptoms of Lichen Sclerosus to improve quality of life. In addition, hyaluronic acid and platelet injections are often used with ThermiVa treatments. Hyaluronic acid helps build collagen while platelets release a growth factor to help revive and restore tissue.