A nagging problem: never cured, but now controlled! Lichen sclerosus

January 14, 2018

 

 

 

There is a condition of the vulva that is relatively uncommon, the causes relatively unknown, and the recurrences common. This condition can interfere with sex, birthing, and urination, just to mention a few of the complicaitons. It is called Lichen Sclerosus "lichens'. Mostly it is a local condition of the vulva that can be controlled. If you have, girl part (vulvar) symptoms that have been nagging or chronic you may want to consider these important facts. It is not curable, it can be controlled, and using the non-invasive MonaLisa Touch or the ThermiVa to control symptoms is the first breakthrough in the management since the 1950's.

Lichen sclerosus is a chronic condition that will cause itching, burning, skin changes and eventually changes to your vulvar anatomy. Treatment has always focused on these local symptoms, and restoring normal vulvar anatomy, and still should be. However, at Women's Health Practice and Hada Cosmetic Medicine we want to offer a more holistic approach.

Lichens now has been linked to various autoimmune disorders, and if you have been diagnosed with lichen sclerosus you may want to be evaluated for these conditions as well:


1. thyroid disease,
2. vitiligo,
3. alopecia areata (hair loss),
4. pernicious anemia (B12 deficiency),
5. diabetes mellitus.  
6. Chronic infections, including yeast or bacterial infections


Women of any age can get this, cases as young as girls prior to puberty have been reported. Lichen Sclerosus may have a genetic component, or it may be linked or at least worsened by low estrogen, it's not thought to be caused by infection. Looking at the conditions of the external tissues a physician cannot always make an accurate diagnosis, but the tissue has characteristic thin white paper look that has been called "cigarette paper" look. So the most accurate way to diagnoses is a biopsy. but there may be a situation that wouldn't need a biopsy. But conditions that do not clear up with treatment especially are good cases for a biopsy.

 

One sign physicians look for is how the condition affects you external anatomy. For certain patients, over years of the condition, the nature of your lichen sclerosus will change. Severe changes in the anatomy will occur. The changes occur because of the thinning and scarring of the tissues, and a tendency to change the anatomy of the external vaginal and vulvar tissues by forming bridges between the lips and scaring. Over time there can even be obscuring of the clitoris or covering over the urethra where you urinate. This can be called a hooded clitoris and the tissue changes can interfere with orgasm as well.

 

This is most often due to lichen sclerosus which is pictured above, and really is a very severe case, most are not this severe. Without treatment these anatomy changes will both persist and progress. So if you are noticing skin changes that seem to be persisting, please see your gyno and get an accurate diagnosis to prevent long term complications of this condition. You may think you have yeast or bladder infection, but it is really this condition. The treatments are usually very potent steroids that should be managed by a gyno. You cannot be cured, but the discomfort and dis-figuration can be managed. And now that we know of the links with other autoimmune diseases, diagnosing them properly and getting appropriate treatment may in fact may also help the lichens to be resolved.

 

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