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What is Lichen Sclerosis

What the heck is Lichen Sclerosis, you might be wondering... or, if you already know, then you know how miserable it can be... But, there is hope. As science and clinicians seek to understand LS further, there do seem to be some commonalities and solutions emerging!

What is Lichen Sclerosis?

Lichen sclerosus (or sclerosis, or LS) is a rare skin disease that causes itchy and painful patches of thin, white, wrinkled-looking skin. In women, these may occur on the vulva and/or the skin around the anus. In men, it typically affects the head of the penis. However, this condition typically occurs primarily in girls who haven't started menstruating and in postmenopausal women. Lichen sclerosus can cause discomfort, itching, and easy bruising or tearing of the skin. Some women experience the labia 'fusing' or disappearing altogether, as well as significant clitoral and vaginal atrophy that seems to occur concurrently.

Is it the same as Lichen Planus?

No. Lichen planus is a non-infectious, itchy rash that can affect many areas of the body. Affected areas can include the arms, legs, trunk, mouth (oral lichen planus), nails, and scalp. Lichen planus occurs when the immune system mistakenly attacks cells of the skin or mucous membranes. On skin, lichen planus appears as purplish, itchy, flat-topped bumps. On mucous membranes, such as in the mouth, it forms lacy white patches, sometimes with painful sores. Lichen planus usually goes away on its own. If symptoms are bothersome, topical creams and oral antihistamines may help.

The names are similar, but the conditions are distinct.

What Causes it?

Lichen sclerosus is thought to be related to genetics, immune disorders, trauma, or infection. The exact cause of lichen sclerosus isn't known; It's likely a combination of factors, including an overactive immune system, your genetic makeup, and previous skin damage or irritation. Lichen sclerosus isn't contagious and can't be spread through sexual contact.

Lichen sclerosus- which predominantly affects the anogenital area in female patients - has been associated in research studies with increased psychological distress and decreased quality of life. There is also some suggestion from small studies that urogenital prolapse may contribute to LS.

There may be a greater risk for lichen sclerosus for someone with an autoimmune disease such as:

  • Autoimmune-related thyroid disease.
  • Autoimmune-related anemia.
  • Vitiligo.
  • Type 1 diabetes.
  • Alopecia areata.

How Do I Know if I Have it?

Lichen sclerosus appears as white areas of skin that often are shiny or wrinkled. Sometimes these white areas have red or pink changes. In women with a darker skin tone, LS may initially look like vitiligo (a condition in which the skin loses its pigment, causing white patches). As mentioned, many women note fusing of the labia, and severe itching.

If you are concerned you may have LS, the best option is to have a diagnosis from your doctor, typically via a biopsy.

What Can Be Done About it?

There are several different approaches to managing LS. Steroid ointments (eg., clobetasol) are recommended to reduce inflammation and itching and are the treatment of choice for genital LS. Some women find that emu oil and topical estrogen can both be effective for many sufferers of LS.

Emu oil contains molecules called fatty acids which can reduce pain and swelling (inflammation). Emu oil has moisturizing capabilities and acts as an emollient - something that helps the skin retain moisture. Emollients such as emu oil and vitamin E suppositories have been found to be effective in keeping the area well moisturized and thus reducing overall discomfort. You can check out the science here! One popular brand which our ladies with LS swear by is EMU Aid.

LS seems to be associated with a low-estrogen state; women are at most risk of developing the condition before puberty or during perimenopause and post menopause. As such, research suggests that topical estrogens (such as estriol, which is ideal for skin application) are beneficial to those with LS. Some clinicians may recommend an estrogen cream to help to soften the skin around the vaginal opening for those with damage due to LS. In our private group, many women came to us having been diagnosed with LS, and have found Silky Peach Cream a game changer in treating their discomfort. Not all women benefit, sometimes the estriol cream does not help, we are all so different!

For those who do choose to use a topical estriol like Silky Peach, initial application can be painful; in these cases we recommend applying to the very outer labia, inner thigh crease, or mons pubis, until there is less tenderness!

Lastly, for women who have prolonged and severe LS, laser treatment is being considered as an option. Recently, two small studies demonstrated that fractional CO 2 laser (FxCO 2 ) therapy appears to be a promising treatment option for lichen sclerosus. These studies demonstrated that FxCO 2 treatment may stimulate protein synthesis, accelerate tissue reconstruction, and decrease lichenification.

Buy Silky Peach now and see if estriol can help you!