Causes and Risk Factors

The exact cause of LS is unknown. However, it is believed to be linked to:

• Genetic predisposition (about 10% of sufferers have a family history)
• Autoimmune diseases
• Hormonal imbalances
• Skin trauma or injury

It is not contagious and cannot be spread through sexual contact.

Common Signs and Symptoms

Watch out for the following, especially in the genital area:

• Smooth or wrinkled white patches
• Fragile, blotchy, or thinning skin
• Persistent itching or burning
• Pain or discomfort during urination or sex
• Bruising, bleeding, blistering, or open sores
• Changes in the skin around the genitals or anus
• Scarring, which may lead to problems like painful sex or erectile dysfunction

In men, LS can cause tightening of the foreskin and difficulty with urination or erections.

Diagnosis

Lichen Sclerosus is usually diagnosed by a doctor through:

• Physical examination
• Skin biopsy (a small skin sample is tested under a microscope)

In rural or resource-limited settings, clinical diagnosis based on symptoms and appearance may be used when biopsy is not readily available.

Why Early Diagnosis is Important

If left untreated, LS can cause:

• Severe itching and pain
• Sexual dysfunction
• Narrowing of the vaginal or urethral opening
• Genital scarring
• Increased risk of genital cancer (especially vulvar or penile cancer)

Treatment Options

There is no permanent cure, but effective treatment can control symptoms and prevent complications.

Main treatment:

• Topical corticosteroid ointments – These helps reduce inflammation, restore skin colour, and prevent scarring.

Important:

• Even after symptoms improve, long-term follow-up with your healthcare provider is needed as symptoms may return.

Self-Care Tips

• Apply prescribed ointments exactly as instructed.
• Wear loose, cotton underwear and clothes; avoid nylon and tight-fitting fabrics.
• Avoid scented soaps, bubble baths, and douching.
• Use fragrance-free moisturizers if recommended by your doctor.
• For men, gently clean under the foreskin if uncircumcised and dry thoroughly.
• For itching relief, use a cold compress on the affected area.
• After bathing, gently pat the area dry with a clean towel.

When to Seek Medical Attention

Go to the hospital or clinic if:

• You notice an itchy white patch in the genital or anal area.
• You experience pain during sex or urination.
• Your symptoms worsen or do not improve with treatment.
• You develop fever, swelling, pus, or redness in the affected area.
• You see red streaks or new skin changes in the area.

Prevention and Lifestyle Tips

While LS cannot be completely prevented, you can reduce flare-ups and discomfort by:

• Avoiding tight clothing and synthetic fabrics.
• Using unscented laundry detergents and soaps.
• Avoiding long bike rides or horseback riding.
• Changing out of wet clothes or swimwear quickly.
• Circumcision (in some boys and men) may reduce the risk of LS.

Cultural Considerations in Sub-Saharan Africa

• Encourage open, non-judgmental communication about genital health.
• Use community education to reduce stigma.
• Traditional healers and religious leaders can be engaged to promote early medical consultation.
• Promote genital health education in schools and women’s groups.