Lichen sclerosus

Lichen sclerosus is a common but little-known skin disorder. The condition is characterized by itching, inflammation and whitish changes in the skin. This most often affects the skin in the abdomen. The skin disorder can occur at any age, but is more common in women than men. The disease is also called "lichen sclerosus et atrophicus" and "balanitis xerotica obliterans".

What is lichen sclerosus?

Lichen sclerosus is a chronic, itchy skin condition. It particularly affects the skin in the abdomen in both women and men. It can also occur on the body, but this is rare. The condition in the abdomen is characterized by itching, discomfort, inflammation and pain during intercourse. In addition, spots or sores appear which may be white, red, pigmented or raised. If the condition occurs on the body, there will be whitish changes in the skin with a thin, "paper-like" surface.

For women, it is common to get the skin disorder before puberty or after menopause. The disease will not affect the mucous membranes of the vagina or the uterus, nor will it have any effect on pregnancy. The disease can also affect men and boys who have not been circumcised. The condition rarely affects children.

Causes of lichen sclerosus

The cause is unknown, but there are a number of theories:

• Genetically

• Autoimmune disease: that is, the body mistakenly produces antibodies that themselves contribute to the development of the disease.

• The disease can also be associated with other autoimmune diseases such as metabolic problems, hair loss (alopecia) or lack of pigmentation of the skin (vitiligo).

The condition cannot be contagious or transmitted through sexual contact.

Symptoms in women

Women can experience

• Strong itching on the labia, clitoris or around the rectum.

• Pain.

• The skin may become whitish in colour, thin and wrinkled.

• Some people may experience small skin bleeding, bruises or small tears.

• The skin condition will lead to painful intercourse.

• If the disease is untreated, it can change the appearance of the abdomen. It will lead to scarring and adhesions of the skin in the genitals.

• The condition can also affect other places on the body such as thighs, breasts, wrists, shoulders, neck and inside the mouth. There will be whitish changes in the skin with a thin "papery" surface. It will not itch as much as in the abdomen.

Symptoms in men

Men can experience

• Itching on the head of the penis.

• The skin may turn whitish and some may experience small skin haemorrhages.

• Painful erection.

• The foreskin is tight.

• Problems with retracting the foreskin.

• Problems with urinating.

• The condition can also affect other places on the body, such as thighs, breasts, wrists, shoulders, neck and inside the mouth. There will be whitish changes in the skin with a thin "papery" surface. It will not itch as much as in the abdomen.

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Disease course in lichen sclerosus

The condition is usually a chronic condition, but some children can get rid of the skin changes during puberty. This is a troublesome condition that causes itching, burning and will also affect cohabitation. There is no cure for the disease, but the use of local steroids for periods can reduce the symptoms. By using the correct treatment, worsening of the condition and scarring can be prevented. Women who have had this disease for many years also have an increased risk of developing skin cancer. It is therefore important that women go for regular check-ups with the doctor.