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Am Fam Physician. 2008;77(3):330

See related article on non-neoplastic epithelial disorders of the vulva.

What are lichen sclerosus and lichen simplex chronicus?

Lichen sclerosus (LIKE-en skler-OH-sus) is a skin problem that usually affects the vulva (the outside part of the vagina) or the anal area. Lichen simplex chronicus (LIKE-en SIM-pleks KRAH-neh-kus) is when the skin in and around the vulva gets thicker from constant itching and scratching.

Who gets them?

Any woman can get these skin problems. Lichen sclerosus is more common in women after menopause, but it can happen at any age.

How can I tell if I have one of these problems?

If you have lichen sclerosus, it may hurt when you have sex. The area around your vulva may be very itchy, making it hard for you to sleep. The skin on your vulva may be white and thick. After awhile, the skin may become thin and lose color. Your bowel movements may hurt if the anal area is affected. Your anal area may have small cuts. However, some people don't have any symptoms.

If you have lichen simplex chronicus, the skin on your vulva may itch, change color, or have cuts.

How are these problems treated?

Your doctor may give you a strong steroid cream for the affected skin. As you get better, your doctor may switch you to a medium- or low-strength steroid cream. If you are still having symptoms after several weeks of using the steroid cream, you may need steroid pills. You can try taking a sitz bath, where you sit in a few inches of warm water. Antihistamine skin creams may also help with the pain.

What can I expect?

There is no cure for these problems, and they may need to be treated more than once. Lichen sclerosis slightly increases your risk of skin cancer of the vulva, so it is important to let your doctor know if you have constant itching or pain.

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