Lichen sclerosus: Your questions answered

We know that a lot of our members are affected by vulval skin conditions. Fun fact: we have one of the largest lichen sclerosus (LS) communities online! We also know how difficult it can be to get a diagnosis for the condition, let alone start conversations about it, which is why we love to see our LS community speaking out.

If you have recently been diagnosed or simply want to learn more about lichen sclerosus, here is a round-up of some FAQs about the condition...

Are you more likely to see more physical changes when lichen sclerosus flares up?

Some women with this condition do see physical changes including shrinking of the labia minora, tightening of the vagina or the clitoris may become buried. These happen because of the adhesions and scarring caused by ongoing lichen sclerosus. During flares, symptoms are most active, therefore some acute physical changes will occur during this time (like the splitting of the skin). Changes like resorption of the labia minora are a little different because they are chronic and occur over time.

Do emollients help soothe the symptoms of LS?

Yes - I would recommend using an emollient regularly which is why you need to find one that you like. Usually, I encourage people living with LS to use an emollient at least twice a day. Applying after every time you use the loo can really help too.

Ointments are the best at protecting the skin, they are like a soft Vaseline. If you are using one, you should remember that a little goes a long way as they tend to sit on the skin rather than absorb. The main thing is to use a non-perfumed product and to avoid anything that contains sodium lauryl sulphate.

Is more discharge a symptom of lichen sclerosus?

Discharge is a normal thing that all women have due to the hormonal changes that happen throughout their menstrual cycles. So, discharge is not a symptom of LS alone. That said, women with the condition who use panty liners will experience more discharge. This generally settles when they stop using pads and other irritants like thongs and wet wipes.

Can you use steroid creams on broken skin?

Yes. LS and other skin conditions break the surface of the skin. This skin will not heal until the correct topical steroid therapy is applied. If you have had a biopsy I advise using your emollients twice daily and it is safe to start using your steroids one week afterwards.

What is the difference between lichen sclerosus and scleroderma?

Lichen sclerosus is thought to be a form of localised scleroderma. Although both of the conditions affect the connective tissue, lichen sclerosus does not cause any other internal problems. LS of the skin doesn't lead to scleroderma but the two conditions can co-exist.

Lichen sclerosus can cause cancer - how do I know it is developing?

Cancer can occur with LS but is rare. In fact, less than 3-5% of women with the condition get it. It presents as a tender hard or bleeding area which generally tends to grow quite quickly over weeks and months rather than years.

I have vulval ulceration, what can I do?

Vulval ulceration can be caused by lots of things so  taking viral swabs is very important, particularly if the ulcers are persistent and last a long time. You can seek an appointment with your local sexual health clinic to have these swabs taken. It is really important to get properly examined. Just using Dermovate (a topical corticosteroid cream) is not likely to be successful in treating undiagnosed ulceration. In the longer term, you can use Dermovate twice weekly to maintain and soothe symptoms of LS.

Does the MonaLisa Touch procedure help LS?

The MonaLisa Touch is a CO2 laser treatment for soft tissues. Lots of people say that it is successful as treating LS however it hasn't been subjected to enough clinical 'head-to-head' comparison trials with other types of treatment. This makes it difficult to be sure if it is the right treatment for you. I would stick to topical steroids and emillioents which have a good research record of being effective.

If you need more advice for managing lichen sclerosus, we are hosting an expert online clinic with the British Skin Foundation, find out more here! We also have loads of great resources for women’s health over on our talkwomenshealth hub. 

Information contained in this Articles page has been written by talkhealth based on available medical evidence. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.

Information written by the talkhealth team

Last revised: 31 May 2024
Next review: 31 May 2027