Lichen sclerosus (LS) is a chronic skin condition mainly affecting the genital area in females. It can present at any age but tends to have two peaks of onset: prepubertal and peri/postmenopausal. The actual cause is unknown. Genetics, hormones, immune system abnormalities, and infections have been suggested contributing factors.
Some patients have no symptoms. However, most seek treatment for itching and burning. LS generally worsens with time. Itching becomes unbearable. Burning may occur with urination and bowel movements. If left untreated, painful intercourse and sexual dysfunction can result due to scarring from long term inflammation. All of these can negatively impact relationships and quality of life.
Dianosis is made by physical exam and confirmed with biopsy of the involved area.
Initial treatment consists of topical creams, usually steroids. Many women seek additional therapeutic options due to inconvenience, poor response, or desire to limit exposure to conventional medications. Such options include laser, platelet rich plasma (PRP) and minor surgery. We use the MonaLisa Touch laser in our office to apply laser energy to the area of LS. The laser helps stimulate production of blood vessels, collagen and elastin, which are all components of healthy skin. PRP can be placed in the skin alone or in conjunction with the MonaLisa Touch to help speed up tissue healing. Both of these require a series of treatments for best results. They are not FDA approved and are therefore used "off-label" for treatment of LS. Studies have shown improvements in patient outcome with low risk of harm and side effects. A surgical procedure may be necessary to reverse scarring and regain sexual function, which can usually be done in the office under local anesthesia.
Many women experience frustration, hopelessness and disappointment on their journey to relief from lichen sclerosus. It is a chronic condition that can be managed but not cured. Diligence is a must.
If you have LS or think you may, please call us for an appointment or more information: 940-665-6679.