Michael Frey, MD

While it can occur on any part of the body, it usually appears on the vulva. Post-menopausal women and prepubescent girls are the most likely to develop lichen. 

 

What Are The Symptoms Of Lichen Sclerosus?

Sometimes, lichen can be extremely painful and itchy — to the point it may cause difficulty sleeping. Other times, symptoms are mild, and the only thing present is the patches of skin that have lost their pigment.

 

What Causes Lichen Sclerosus?

As with so many conditions that affect the female population, lichen sclerosus hasn’t been widely studied, and therefore we don’t have a definitive cause of it, per see. Doctors generally agree that a few things could cause lichen sclerosis.

 

Trauma Can Trigger Lichen Sclerosus

The medical community has recognized trauma to the area of the skin as a cause of the disease.

 

Sometimes, activities like horseback riding, bike riding, or even waxing can irritate the vulva's delicate skin. Many women report lichen sclerosis after experiencing some sort of difficulty with an activity that created friction in the vulva area.

 

Sexual abuse, trauma, or under-lubricated sex can also trigger lichen sclerosus.

 

Is Lichen Sclerosus An Autoimmune Disease?

Lichen sclerosus could be related to autoimmunity.

 

Because lichen sclerosus is at its core inflammatory, and gut dysbiosis contributes to inflammation, it may just be a root cause of the condition. 

 

How Is Lichen Sclerosus Diagnosed?

Generally, lichen sclerosis is diagnosed with a physical exam and biopsy to confirm a suspected case.

 

What Is The Best Treatment For Lichen Sclerosus?

Lichen sclerosus can be challenging to treat, and many women struggle with it for some time before finding relief. Conventional treatment typically focuses on the management of the symptoms and prevention of scarring. While lichen sclerosus is a life-long condition, it is possible to put the symptoms into remission. With the right steps, many women can eventually experience total relief. It may not be an easy or straightforward road to recovery, but it is possible.

 

Steroids For Lichen Sclerosus

The most common treatment for lichen sclerosus is steroid cream. It may not be the ideal long-term treatment, but many women find it necessary.

 

The itching gets worse at night because your cortisol naturally takes a dip at night. As cortisol goes down, inflammation rises. Many women find relief from a steroid cream, which helps them get some much-needed sleep.

 

Calendula Salve For Lichen Sclerosus

I also recommend calendula salve as a natural alternative. It won’t stop the itch, but it will help with the dryness and irritation.

 

Calendula has anti-inflammatory, antifungal, and antibacterial properties that also may help reduce swelling and combat any infections in the affected area.

 

Curcumin For Lichen Sclerosus

Curcumin is the active part of turmeric. There have been studies showing the benefits of turmeric in inflammatory skin conditions.

 

While not a cure or specific treatment for lichen sclerosus, curcumin can offer anti-inflammatory support and antioxidant protection of the skin. 

 

Other Important Recommendations For Lichen Sclerosis

Some of my most important recommendations for treating lichen sclerosus involve developing good habits.

​

Tightening up your diet and minimizing processed foods while increasing your intake of organic vegetables, fruits, and proteins is essential in most cases.

 

Optimizing your supplement protocol with aloe, and slippery elm, and professional-grade probiotics can be a good idea.

​

Use lube for intercourse, especially if you’re post-menopausal

Just be careful what lube you choose, what’s in commercial lubricants can be irritants or endocrine disruptors. Try selecting one that will be gentle to your already sensitive lady parts.

 

Wear cotton underwear, or at least with cotton on the inside

Cotton helps your vulva to breathe and cuts down on sweat. Synthetic fabrics could lead to irritation and harbor bacteria, which could make matters worse.

 

Wear loose pants

Now is not the time to rock your tightest-fitting jeans. Choose fabrics that allow airflow near your delicate areas.

 

Always wipe front to back

Wiping front to back helps prevent the spread of bacteria and is a habit that helps prevent urinary tract infections.

 

Urinate and or wash off with water after sex

Semen is actually not the ideal pH for your vagina. After sex, a quick rinse of the area will help get things back to a normal pH.

 

Wash your vulva with water only — no soap required

Your vagina is not meant to smell like vanilla sugar cookies. Please don’t buy into the myth that all women are supposed to emit a scent of champagne and berries from their lady parts. A simple rinse with water for the vulva is all you need, and there’s never a need to wash your vagina, ever.

 

Is Lichen Sclerosus Contagious?

Lichen sclerosus is not contagious. You cannot get it from or pass it to another person. It is not an infection, let alone a sexually transmitted infection.

 

Is Lichen Sclerosus Cancerous?

Women with lichen sclerosus are at a higher risk of developing squamous cell carcinoma skin cancer of the vulva.

 

While lichen sclerosus is not cancerous itself, it is important to address any suspected vulvar issues immediately and treat them. As with any disease, early detection and treatment are the best defenses we have against their further development.

 

​