Lichen Sclerosus

Diagnosis

A healthcare provider may diagnose lichen sclerosus by examining the affected skin. Sometimes a biopsy is needed, especially to rule out cancer or when the skin does not respond to steroid creams. A biopsy involves removing a small sample of affected tissue and examining it under a microscope.

You may also be referred to specialists such as:

• Dermatologists (skin specialists)

• Gynecologists (female reproductive system specialists)

• Urologists

• Pain medicine specialists

Treatment

With proper treatment, symptoms of lichen sclerosus often improve or go away. Treatment depends on the severity and location of the condition. The aim is to relieve itching, improve the appearance of the skin, and lower the risk of scarring. Symptoms often return, so ongoing care is important.

Medicated Ointments

• Clobetasol steroid ointment is commonly prescribed.

  • Applied twice daily at first.

  • After several weeks, usually reduced to twice weekly to prevent flare-ups.

• Healthcare providers monitor for side effects such as skin thinning.

• Sometimes a calcineurin inhibitor, such as tacrolimus (Protopic), may be recommended.

Regular follow-up (once or twice a year) is usually needed for long-term management and to prevent complications.

Circumcision

If lichen sclerosus narrows the opening through which urine flows, circumcision (removal of the foreskin) may be recommended as part of treatment.