Women are more frequently affected
Lichen sclerosus is a chronic inflammatory skin disease in which immune system dysfunction plays a significant role. It mainly occurs in the genital and anal areas, while other body parts are less commonly affected. Women are much more likely to develop lichen sclerosus than men. Around one in ten patients has family members who are also affected.
Symptoms vary!
Lichen Sclerosus in women
In women, lichen sclerosus often develops in connection with menopause. Severe itching (pruritus) in the external genital area is the most common initial symptom. Skin changes in the anogenital region include redness, mild swelling, whitish thickened areas, and/or small cracks (fissures). If left undiagnosed and untreated, lichen sclerosus can lead to severe consequences such as scarring, hardening (sclerosis), and tissue shrinkage (atrophy, e.g., of the clitoris and labia minora), narrowing of the vaginal opening, pain during intercourse, and difficulties with urination or bowel movements.
Lichen Sclerosus in men
In men, itching is significantly less common than in women. Instead, lichen sclerosus typically leads to erectile dysfunction and pain due to increasing narrowing and hardening (sclerosis) of the foreskin (phimosis). The disease may be confined to the foreskin and glans but can also extend to the penile shaft and scrotum. Additionally, it can affect the urethral opening and even the urethra itself, leading to urination problems, which is a serious complication.
Medical treatment of lichen sclerosus
For both men and women, the primary treatment goal is to prevent the progression of lichen sclerosus and avoid serious complications. The main treatment involves applying a glucocorticoid (cortisone) ointment to the affected areas. In most cases, long-term cortisone therapy is necessary, particularly for women. Initially, the ointment is applied daily, but for long-term management, applying it once or twice a week is usually sufficient.
For men, complete circumcision (removal of the foreskin) is an option. In most cases, this can even lead to complete healing of lichen sclerosus. However, circumcision is only effective in the early stages of the disease.
Supporting measures: Proper genital and anal hygiene
In addition to medical treatment, the genital and anal areas should be carefully cleaned, maintained, and subjected to minimal mechanical irritation.
When it comes to hygiene with lichen sclerosus, the following should be observed:
- Avoid using regular soaps or shower gels when washing. Even mild cleansing lotions (e.g., Deumavan Washing Lotion) should be used sparingly, and excessive washing should be avoided.
- Only soft towels should be used for drying. The anogenital area should be gently patted dry instead of rubbed.
- After each wash or shower, rich, fragrance-free ointments (e.g., Deumavan Protective Ointment Neutral) are recommended. Additionally, such an ointment should be applied before and after using the toilet to reduce contact with urine or stool.
Vaginal douching, wet (scented) wipes, and rough toilet paper should be avoided. Intimate shaving is also not recommended for individuals with lichen sclerosus.
You are looking for support?
The Lichen Sclerosus Association is a good place to start.
Those affected can find support and information on dealing with lichen sclerosus at the “Lichen sclerosus association”. The association is committed across Europe and is supported in its work by leading experts and provides technical advice. The association's website has been bringing together current expert information since 2013 and offers those affected a point of contact.
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