Lichen Sclerosis as a Gynecological Complication

For many women, gynecological health is at the forefront of our daily lives. Living with the daily awareness of our reproductive health often leads to changes in diet, exercise and even sexual activities. For women suffering from Lichen sclerosis, reproductive health, most notably vaginal health, can lead to frightening complications. Understanding the dynamics of Lichen sclerosis, including the cause, origin symptoms and treatment, can lead to an improved quality of life.

Lichen sclerosis, also known as LS, is an inflammatory disease of the skin. While the exact cause and origin is not well defined, it is important to understand the condition is not limited to just the vaginal and groin area and is not the result of a sexually transmitted disease. While the condition does occur in men, Lichen sclerosis is far more common in women, especially those over age 50, and may be associated with an autoimmune disease with some health care professionals linking the condition to those patients who may suffer from thyroid complications.

White skin patches commonly appear anywhere and respond well to topical creams and lotions. Around the vaginal area, especially the vulva, Lichen sclerosis can be limited to just this area or expand to other areas of the body. When suffering from vaginal, or vulva, Lichen sclerosis, the most common first symptom in a women will be a noticeable itching. Upon visual examination, a woman will notice areas of white patchy skin, in and around the vaginal area, that appear flat and ivory with a slight indentation in the center. When untreated, these areas may begin bruising at the center and turn into ulcerations.

Diagnosing Lichen sclerosis in women is usually confirmed through biopsy of the vaginal tissue. For many women, this biopsy will differentiate the LS from other skin disorders and provide for a foundation to manage the symptoms.

Treating LS, in most recent years, has been achieved through the use of a strong steroid cream, applied topically twice a day, called clobetasol. While clobetasol is not a cure for Lichen sclerosis, it does minimize the further progression of the disease and works to control the permanent damage. Generally, treatment is provided in twice daily applications over a 90 day period however many women still suffer from recurrence, requiring lifelong maintenance programs with the use of clobetasol. When clobetasol is not effective in treating vaginal Lichen sclerosis, a woman may need to seek the counsel of a dermatologist who can provide further treatment suggestions.

In addition to potent steroid use, some women may require vaginal surgery to remove scar tissue which develops as a result of Lichen sclerosis. While laser surgery is not appropriate forms of treating LS, it is effective and removing scar tissue which developed and may be impairing the vaginal opening. Even with these treatments, some women suffering from LS, will continue to experience itching, burning and complications of the vaginal nerve fibers for many years to come.

As with any gynecological complication, the key to optimal health outcomes lies in the early diagnosis and intervention. While much is not known about Lichen sclerosis, what is known is that the disease can be managed with topical creams, leading to impaired progression and a restoration to somewhat normal healthy living.