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White, wrinkled skinBruisesCracked skin that sometimes bleeds
In men, lichen sclerosus is most common in men who are not circumcised. Men who are not circumcised have extra skin over the tip of the penis. The skin is called the "foreskin. " � Symptoms in men can include: � �
- A tight foreskin " � It might be hard to pull back for cleaning.
- Skin changes on the foreskin that look like scars
- A penis that is less sensitive than usual
- Painful erections
- Trouble urinating
Lichen sclerosus can cause white patches in areas other than the genitals. These can happen in women and men, but children do not usually get them. The patches are most common on the upper body. People with dark skin might have patches that are darker or lighter than their normal skin. � �
Should I see a doctor or nurse? " � See your doctor or nurse if: � �
- You or your child has itching, bleeding, or pain in the vulva or penis
- You have white, light, or dark patches on your skin
Will I need tests? " � Yes. Your doctor or nurse will do an exam and learn about your symptoms. � �
Adults with lichen sclerosus often have a test called a "biopsy. " � In this test, a doctor takes a small sample of skin from the area with symptoms. Another doctor looks at the sample under a microscope. It can show if lichen sclerosus or a different condition is causing symptoms. Children do not usually need a biopsy. � �
People with lichen sclerosus sometimes have other health conditions. The doctor might do tests for these, such as: � �
- Tests on a sample of fluid from the vagina, for women " � These tests can show if there is an infection in the vagina.
- Blood tests " � These can show signs of other medical conditions.
How is lichen sclerosus treated? " � Doctors cannot get rid of lichen sclerosus that affects the vulva, but they can treat it. It is important for women with this condition to get treatment as soon as possible. Lichen sclerosus that is not treated can make scars form in the vulva. The scars can cause permanent damage. � �
Lichen sclerosus treatments for women include: � �
- Learning how to keep the vulva healthy (table 1)
- Medicines to relieve symptoms and keep scars from forming " � These can be an ointment to put on the skin, a shot, or pills taken by mouth.
- Surgery to remove scar tissue, if scars have formed.
Lichen sclerosus treatments for men include medicines and surgery. The most common surgery is called "circumcision. " � In this surgery, a doctor removes the foreskin. � �
Lichen sclerosus that is not on the vulva or penis might not need treatment. If it bothers you, your doctor or nurse can suggest different treatments to relieve symptoms. � �
What will my life be like? " � Lichen sclerosus is usually a lifelong condition. Adults who get lichen sclerosus on the genitals have a higher risk of cancer in the genital area. They should see a doctor or nurse at least 1 or 2 times a year. The doctor will check for cancer and any other changes. Women should check the vulva every month for any changes. A doctor or nurse can show the right way to check. � �
Doctors do not think children who get lichen sclerosus have the same cancer risk as adults who get it. � �
All topics are updated as new evidence becomes available and our peer review process is complete. � �
This topic retrieved from UpToDate on: Nov 04, 2014. � �
Topic 83960 Version 2.0 � �
Release: 22.8 - C22.206 � �
� � 2014 UpToDate, Inc. All rights reserved. � �
figure 1
Adult female external genitalia
This drawing shows the parts of a womans genitals.
Graphic 53704 Version 7.0
View Originalfigure 1
Adult female external genitalia
This drawing shows the parts of a woman's genitals.
Graphic 53704 Version 7.0
View Original
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table 1Healthy vulval hygiene practicesView Largetable 1Healthy vulval hygiene practices
Do not use
Instead use
Pantyhose
Stockings with a garter belt
Thigh high or knee high stockings
Synthetic underwear
Cotton underwear or no underwear
Jeans and other tight pants
Loose pants, skirts, dresses
Swimsuits, leotards, thongs, or lycra clothes
Loose-fitting cotton clothes
Pantyliners
Tampons or cotton pads
Scented soaps or shampoos
Fragrance free pH neutral soap (such as Basis, Neutrogena, Dove soap)
Bubble bath
Tub baths in the morning and at night with nothing added to the water and at a comfortable temperature
Scented detergents
Unscented detergents
Washcloths
Use fingertips for washing
Feminine sprays, douches, powders
These are not necessary. Do not use them.
Dyed toilet paper and other products
Toilet paper and other products without dyes
Hair dryers to dry vulva skin without contact
Dry vulva by gentle patting with a clean towel. Do not rub dry.
Graphic 58896 Version 2.0
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� � 2014 UpToDate, Inc. All rights reserved. � �