Lichen sclerosus is an autoimmune condition that causes white, shiny skin to develop. These areas may be itchy and painful or may be entirely unnoticeable. This wide range of symptoms means that many people do not get properly diagnosed with lichen sclerosus, and some may never need to seek any treatment for their condition. For those who do experience discomfort along with discoloration of the skin, lichen sclerosus requires the continuing care of a physician. Lichen sclerosus is most common in the genital area, but it can occur anywhere on the body. Luckily, there are many treatments available, including several ways to reduce the number of symptom flare-ups that occur.
When you are first diagnosed with lichen sclerosus, your physician will likely prescribe some form of corticosteroids. Most commonly, these are ointments or creams that can be applied directly to the area. Corticosteroids may also be given orally, depending on the severity of your symptoms. Your doctor will instruct you to apply a thin layer to the affected area each day until symptoms are resolved. After your lichen sclerosus flare-up goes away, your physician will likely continue to prescribe the corticosteroid treatment to keep symptoms at bay, although you may only need to apply it weekly instead.
UV Light Treatment
Some physicians recommend the use of ultraviolet light treatment to relieve the symptoms of lichen sclerosus. UV rays, usually UVB, are most commonly used. Patients will typically enter a machine that shines UVB light onto the area. This treatment is not used in the genital area, so it is only an option for lichen sclerosus that occurs in other areas of the body. Because UV rays can have side effects, like cancer, you should not try to self-treat yourself using tanning booths. Your physician can help you to safely utilize this therapy method if he or she believes it is a good option for your lichen sclerosus.
In severe cases of lichen sclerosus, treatment with immune-modulating medications may be advised. These included medications like ciclosporin and methotrexate, which can help to stop symptoms. Because it is an autoimmune disorder rather than an infection, these drugs can help to suppress the immune system and stop it from triggering flare-ups and symptoms. However, there are serious side effects that occur when using immune-modulating medications, including an increased risk of contracting infections and illnesses. As a result, many physicians will only prescribe drugs that impact the immune system if other, safer options like corticosteroids have failed to work.
Your doctor may prescribe a moisturizing lotion that is safe to use in sensitive genital areas and may be used in combination with your corticosteroid treatment. Although lichen sclerosus is not just dry skin, having dry skin as a symptom puts you at risk for tearing and other injuries. Applying fragrance- and dye-free lotion to the area can help to reduce the chances of these complications, even if it cannot directly treat your lichen sclerosus. Because some chemicals found in moisturizers can worsen the symptoms, it is important to consult with your doctor before you begin self-treating the area.
In extreme cases, some patients may need to have surgery to correct lichen sclerosus. This is especially true in cases where the condition affects the foreskin area of an uncircumcised male patient. Surgery can also help to relieve scarring in both men and women. Although most patients do not need surgery, it is essential in severe cases. Without it, activities like urination or sexual intercourse may be impossible. Most patients who have reconstructive surgery still experience symptoms of lichen sclerosus later in life, but it can help to alleviate some of the long-term changes to your body.
Avoid Trigger Activities
Lichen sclerosus is suspected to be an autoimmune disorder, although researchers have not yet determined the cause. Certain activities, however, have been known to trigger a reaction that may worsen existing symptoms or cause a flare. In the case of lichen sclerosus in the genital area, riding a bike or going horseback riding may be a trigger, whereas lichen sclerosus on the buttocks may be exacerbated by sitting in warm environments for long periods of time. If you can identify what causes your flare-ups, you can avoid it as much as possible to alleviate symptoms.
Although you may be tempted to try to relieve lichen sclerosus by using home remedies found online, you should generally avoid anything that would involve chemicals or abrasive substances. Even some soaps and lotions contain chemicals that can exacerbate the symptoms of lichen sclerosus, causing more itching and discoloration. To avoid this reaction, you should only clean the area by rinsing or using fragrance- and dye-free cleanser. Always talk to your doctor before trying new substances on the area, and when possible, only use creams and ointments that are prescribed to you. This will avoid any adverse symptoms triggered by chemical contact.
Wear Loose Clothing
Lichen sclerosus sometimes occurs without symptoms, but when it does occur, it is often painful and itchy. Wearing loose clothing can help you alleviate some of these symptoms. Clothing that is tight or fitted often rubs against the area, which can increase pain and irritation and prolong the length of the symptoms. Also, try to stick to breathable fabrics like cotton or linen. Rather than polyesters, and avoid any material that would be unnecessarily itching, like wool. When possible, allow the area to breathe by leaving it uncovered. Doing this will help your lichen sclerosus to heal.
One way to help heal an occurrence of lichen sclerosus is to avoid scratching or touching the area. The most common symptom of the condition is itching. Scratching can worsen symptoms and lead to complications like tearing, bruising, bleeding, and even infections. Lichen sclerosus can cause thinning of the skin, which means that it is easy to tear the skin. Because the condition typically affects the genital area, the skin is already delicate and prone to easy injury. Talk to your physician about anti-itch ointment or other treatments that are safe to use in combination with your lichen sclerosus treatment plan.
Most people who develop lichen sclerosus will experience recurrences of the condition throughout their lives. If your doctor has prescribed a corticosteroid treatment, you may need to apply it every few days. You will also need to pay close attention to your skin. Both lichen sclerosus and the treatments used to care for it can cause scarring, thinning, and other complications. Lichen sclerosus often develops in areas that may be difficult for you to examine on your own. An annual or biannual exam is typically recommended.