Lichen Sclerosus: Symptoms and Natural Relief Options for Women

Lichen sclerosus (LS) is a lifelong condition that can cause intense itching, irritation, and damage to your vulvar skin. Proper lichen sclerosus treatment is essential…but not always straightforward. 

The symptoms of LS can look similar to those of yeast infections and other common conditions. While getting a diagnosis can take time, your health and comfort are worth the effort. Let’s discuss lichen sclerosus symptoms, progression, clinical treatment, and natural relief options.   

What is lichen sclerosus?

Lichen sclerosus is a condition that affects the skin on your genitals.* Lichen sclerosus is an autoimmune disease. It happens when your immune system attacks and destroys healthy cells, causing inflammation. The exact cause of lichen sclerosus is still unknown, though genetic predisposition may play a role.

Anyone at any age can have lichen sclerosus. It’s more common in women than men, and affects an estimated 3% of postmenopausal women. However, many people don’t receive a diagnosis of lichen sclerosus, so the actual number may be higher. 

Lichen sclerosus is not contagious. It’s not a sexually transmitted infection (STI), and it’s not related to poor hygiene or low estrogen. This condition is chronic and progressive: it can get worse over time without treatment.

*Lichen sclerosus can develop in other areas of the skin, but it affects the genitals most often. It can affect the penis, particularly in uncircumcised men. In this article, we are only discussing lichen sclerosus of the vulva. 

What triggers or worsens lichen sclerosus?

Scratching, wearing tight clothing, and having sex can all irritate your skin and make lichen sclerosus worse. 

Let’s look at how lichen sclerosus often progresses:

• Attack on your tissues. Lichen sclerosus is considered an autoimmune condition (but researchers still aren’t 100% sure). Your immune system starts attacking your vulvar skin cells, causing damage and inflammation.

• Inflammation increases. Your vulvar skin becomes inflamed, causing painful, itchy lesions. Your tissue becomes thinner and more fragile. 

• Irritation causes damage. Scratching, friction from sex or tight clothing, and using the bathroom can irritate your already-fragile skin. This can cause scarring and discomfort.  

• The cycle continues. Just like scratching a mosquito bite, scratching your skin can cause more irritation…making it itchier. This leads to more scratching, more scarring, and further damage to your skin.  

What are the most common symptoms of lichen sclerosus in women?

Vulvar itching, especially at night, is the most common symptom of lichen sclerosus in women. Because of this, it’s easy to confuse this condition with a yeast infection. However, lichen sclerosus usually affects your genital skin differently than yeast and other infections.

Lichen sclerosus causes genital lesions and skin patches that are:

• Thin, flat, and ivory-white

• Papery or crinkly in texture

• Fragile, sensitive, and quick to crack or bleed

Without treatment, lichen sclerosus can cause:

• Ongoing itching and soreness 

• Skin tearing and severe scarring

• Damage to your vulva

• Painful urination 

• Constipation (mostly in children with LS)

• Painful sex

These symptoms can sound scary and upsetting. Fortunately, treatment options for lichen sclerosus can help you reduce symptoms. The right care can help keep this condition from impacting your life. 

Where on the body does lichen sclerosus typically cause symptoms?

Most lichen sclerosus lesions and skin patches occur on your external genitalia. They typically don’t happen inside your vagina. Instead, symptoms usually develop in an hourglass or figure-eight distribution around your vagina and anus. Lichen sclerosus can cause symptoms on the skin of other parts of your body, but that is rare.    

Lichen sclerosus symptoms often affect the:

• Vulva (the skin surrounding your vaginal opening)

• Labia (the “lips” outside your vagina that are part of the vulva)

• Tissue around the clitoris

• Perineum (the skin between your vaginal opening and anus) 

• Skin around the anus

How do lichen sclerosus symptoms change and progress over time?

Without treatment, lichen sclerosus symptoms can become worse. Symptoms can progress from an annoying itch to painful scarring. Over time, this can cause permanent damage to your vulva. 

Unfortunately, diagnosing lichen sclerosus can be tricky. It is often confused with infections or genitourinary syndrome of menopause (which includes vaginal atrophy). However, diagnosis is absolutely possible and worth pursuing. Early treatment and ongoing monitoring can help control LS symptoms and reduce complications.

How is lichen sclerosus treated and why is clinical management important?

If you’re diagnosed with lichen sclerosus, long-term corticosteroid treatment is essential. Providers usually prescribe topical steroids (in cream or gel form) for lichen sclerosus. You apply the gel or cream directly to the affected skin.

Without clinical treatment and management, lichen sclerosus can develop into vulvar squamous cell carcinoma—a cancer of the vulva. Corticosteroid treatments effectively control lichen sclerosus symptoms and reduce the risk of cancer. 

Current guidelines recommend applying a fingertip of corticosteroid ointment to your affected area once a day for 12 weeks. After that, you then apply treatment twice per week for maintenance. 

It’s important to continue treating lichen sclerosus with corticosteroids, even once your symptoms have cleared. From there, your healthcare provider should schedule a checkup every 6-12 months to make sure your LS hasn’t progressed. They will check for any cancer-like changes to catch and treat these early..    

Clinical treatment options include:

• Topical: Creams with corticosteroids, retinoids, or immunosuppressants 

• Systemic: Medications that suppress your immune system

• Physical: UV light treatment, laser treatment, or in rare cases, surgery

• Injections: Platelet-rich plasma or collagen injections into the patches of LS

What natural, non-invasive approaches can help relieve lichen sclerosus symptoms?

There is no cure for lichen sclerosus. Corticosteroid treatment is necessary to keep symptoms from getting worse and causing complications. That said, natural products can help you relieve itchy, distressing symptoms and support your overall skin comfort and health. 

Natural relief options for lichen sclerosus symptoms include: 

• Vitamin E serum

• Avocado or soybean oil

• Fragrance-free salves and emollients like NeuEve’s Salve-Gentle 

While not a cure or substitute treatment, these options can help support your comfort, protect your skin, and manage painful intimacy related to lichen sclerosus. Use them several times a day, especially after using the bathroom or showering. 

How can topical, all-natural products support skin condition and tissue health in lichen sclerosus?

Lichen sclerosus causes inflammation, scarring, and vulvar tissue damage. All-natural products work to soothe this damage. NeuEve’s lichen sclerosus kit supports your vulvar tissue health by reducing inflammation, promoting wound healing, and softening existing scars. This helps improve your skin’s elasticity and thickness, making you less prone to new scars, tearing, and disruptive symptoms. 

What should women look for and avoid in products applied to lichen sclerosus-affected skin?

If you have lichen sclerosus, stick to products that are suitable for sensitive skin, have simple ingredients, and don’t contain fragrance or perfume. Avoid intimate care products such as vaginal and vulva washes and wet wipes. 

When showering, don’t overdo it! Use just a bit of fragrance-free soap, and dry off with a soft, non-abrasive towel. After you wash, nourish your skin with products such as NeuEve’s vaginal salve for lichen sclerosus.

Lichen sclerosus is a lifelong condition. However, with proper clinical treatment, supportive natural care, and consistency, you can keep symptoms from disrupting your life. 

Sources Cited 

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