Lichen sclerosus is a disorder that can affect the skin on your vulva (the area outside your vagina), anus or penis. It causes your skin to become discolored, thin, irritated and itchy. Blisters and sores (usually from persistent itching) may also form on your genitals. Rarely do these symptoms appear on other body parts.
Untreated, lichen sclerosus can lead to scarring, making it difficult or painful to have sex, urinate or have a bowel movement. There is no cure for lichen sclerosus, but symptoms can be controlled. Healthcare providers can treat symptoms, but they may return after treatment. Having lichen sclerosus increases your chances of developing a type of skin cancer called squamous cell carcinoma if left untreated.
Lichen sclerosus is rare. About 200,000 people in the United States have the condition. It affects people of all genders. People assigned female at birth are more likely to develop the condition, but people assigned male at birth may be affected, too.
Lichen sclerosus (also called white spot disease) is most common in people who have been through menopause. It’s most likely to develop between ages 40 and 60. Girls who haven’t started puberty also have a higher risk. Less commonly, lichen sclerosus affects men who haven’t been circumcised.
Lichen sclerosus symptoms can range from mild to severe. If you have a mild case of lichen sclerosus, you may not experience any symptoms. In women, symptoms usually affect the vulva, anus and perineum (the area between the anus and the vulva). The condition can also affect skin on other body parts, such as your neck, breasts, torso, upper back, wrists and mouth.
In uncircumcised men, lichen sclerosus causes the foreskin of the penis to be irritated and itchy. The opening at the top of your foreskin can become scarred and narrowed, leading to painful erections.
Healthcare providers aren’t sure what causes lichen sclerosus. Experts believe that lichen sclerosus behaves much like an autoimmune disease. Autoimmune disorders cause the body’s immune system to attack healthy cells.
Genetics and hormonal changes may also determine who gets the disorder. In some cases, lichen sclerosus develops after someone has experienced trauma, such as an injury or sexual abuse. Lichen sclerosus is not a sexually transmitted infection (STI), and it’s not contagious.
Your healthcare provider will examine you and ask about your symptoms. In some cases, your provider may order a biopsy. During this procedure, your provider takes a skin sample and sends it to a lab for testing.
Providers treat lichen sclerosus with:
An essential part of treatment for lichen sclerosus includes regular checkups with your provider. Your provider will watch for signs of skin cancer and help you prevent scarring around your genitals.
There’s no way to prevent lichen sclerosus. You may be able to relieve symptoms with lifestyle changes.
To reduce friction and irritation, you should:
Lichen sclerosus is a chronic (lifelong) condition. Treatment for lichen sclerosus can relieve symptoms, but they may come back. For some people, genital scarring can cause problems going to the bathroom or having sex. Some of these problems may be severe.
Lichen sclerosus isn’t life-threatening, but it can cause extreme discomfort without treatment. People with lichen sclerosus have a higher risk of developing a type of skin cancer called squamous cell carcinoma. If you have lichen sclerosus, it’s essential to see your provider for regular checkups. Your healthcare provider will monitor your lichen sclerosus closely for signs of skin cancer.
If you have irritation, itching or discomfort in the genital or anal area, see your provider. It’s essential to determine what’s causing your symptoms so you can receive treatment. Many conditions cause symptoms that are similar to lichen sclerosus, including sexually transmitted diseases (STDs).
If you have lichen sclerosus and your symptoms return after treatment, see your provider right away. By treating symptoms immediately, you may be able to prevent scarring. Your provider will also monitor you for signs of skin cancer.
There isn’t a recommended lichen sclerosus diet. But some studies show that dietary changes can relieve symptoms. Talk to your provider about foods you should avoid and how to make healthy choices.
There’s not enough data available to classify lichens sclerosis as an autoimmune disease. But people with lichen sclerosus do commonly have autoimmune disorders — like alopecia areata, vitiligo, pernicious anemia, Type 1 diabetes, and some thyroid disorders. The close associations between these conditions and lichens sclerosis suggest that the condition may arise from autoimmune responses in your body.
Lichen sclerosus may result from a variety of causes: an autoimmune response in your body, genetics, hormone changes, or even injury. Research is ongoing to pinpoint exact causes.
Your provider may recommend anti-itch creams, immunosuppressive drugs and phototherapy. You can take care of your skin by avoiding products that contain harsh chemicals, and wearing soft, breathable fabrics that don’t irritate your skin.
No. But treatments are available to ease your symptoms and prevent progression of the disease.
A note from Cleveland Clinic
If you have lichen sclerosus, be open and honest with your healthcare provider about your symptoms. Be sure to tell your provider right away if symptoms get worse or come back after treatment. Through regular checkups, your provider will track your health, treat your symptoms and help you prevent scarring and long-term problems. Because people with lichen sclerosus have a higher risk of squamous cell carcinoma, you’ll need to see your provider often to check for signs of skin cancer.
Last reviewed by a Cleveland Clinic medical professional on 01/27/2022.