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Lichen

Sclerosus

Lichen Sclerosus is a painful autoimmune skin disorder that can have a devastating impact on lifestyle due to painful bowel movements, painful urination and painful sex. Although it is a lifelong condition with no complete cure, Geniale offers tailored laser and/or PRP treatments to help assist patients to live comfortably with the symptoms.

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What is Lichen Sclerosus?

Lichen sclerosus is a chronic, inflammatory autoimmune skin disorder usually characterised by the formulation of thin, white patches of skin that can be painful, itchy and prone to tearing. Although these patches have the potential to develop anywhere on the body, the most common cases of Lichen sclerosus manifest on the vulva, foreskin and anal areas.
This skin disorder can develop in men and children, however, it is most commonly developed in women, and is classified within a group of vaginal disorders known as vulvodynia.
If untreated, these areas can form bruising, scarring, blisters or infection. As one can imagine, this type of skin condition can be extremely painful and debilitating; particularly during bowel movements, urination and sexual intercourse.

What are the symptoms of Lichen Sclerosus?

Common symptoms of Lichen Sclerosus include:

Itching (pruritus) and redness
Smooth, white patches of skin
Blotchy, crusted or wrinkled patches of skin
Pain during sexual intercourse (dyspareunia)
It can also affect the upper body, upper arms and breast areas

What are the complications of Lichen Sclerosus?

In severe cases, the affected areas of skin can be prone to tearing, bleeding or blistering.
Moreover, Lichen Sclerosus in the genitals can lead to tightening of the vagina or foreskin, which can be very painful during sexual intercourse.
Due to the skin being thinner than usual in the affected areas, these areas can develop into ulcerated lesions or open wounds.
People suffering from Lichen Sclerosus are also at an increased risk of developing squamous cell carcinoma in the affected area. It is common practice for your doctor to biopsy the affected area to determine whether there has been a change in skin cells.

What is the treatment you offer for Lichen Sclerosus?

Although there is no cure for Lichen Sclerosus which is a lifelong condition, it can generally be well-managed with lifestyle changes and medical treatments.
Geniale now offers a variety of tailored programs for Lichen Sclerosis, including Fotona® laser treatment, which assists with keeping bleeding and tearing symptoms in check.
Another very recent option is (Platelet Rich Plasma injections). Using your own platelet-rich plasma and growth factors, which are spun through a centrifuge, this is then injected into the affected tissue which aims to promote healthy tissue growth. Geniale is now delighted to offer this service to women and men.

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Dr. Mike Shenouda as seen in "The Daily Telegraph"

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Can I catch Lichen Sclerosus?

Despite the physical symptoms commonly manifesting in the genital or anal areas, this condition is not a sexually transmitted disease. This is a common misconception when in fact, this condition is not contagious at all.

What is the latest evidence on the effectiveness of PRP (platelet-rich plasma) for Lichen Sclerosus?

According to a recent study on 94 male and female patients with Lichen Sclerosus, reported in the 2020 Journal of Dermatological Treatment, the “PRP procedure was well tolerated by all patients and an overall significant decrease in symptoms was reported 6 months after PRP infiltration.
“Reduction in pain and burning sensation was significant in both genders but more accentuated in women than in men, whereas reduction of itching was similar. On the contrary, dyspareunia evidenced sex-related difference since a significant diminution was observed only in male,” the report found.
Geniale’s Cosmetic Physician Dr Mike Shenouda says: “PRP continues to show great promise as another option for women who have tried everything for Lichen Sclerosus without success. It takes only 90 minutes to perform and the patient can drive home afterwards with generally minimal discomfort.”

What causes Lichen Sclerosus?

Unfortunately, this is one of the many conditions that have no concrete causes. However, there are a few suspected links; such as having an overactive immune system or an imbalance in hormones. There has also been speculation as to whether the risk of acquiring this condition could be inherited.
If you have a known autoimmune condition, such as rheumatoid arthritis, you’re probably already aware that this can make you more susceptible to contracting other illnesses. Unfortunately, Lichen sclerosus is no exception. Data suggest that approximately 20-30% of women with Lichen sclerosus have a pre-existing autoimmune disease.

How common is it and who is most at risk of developing Lichen Sclerosus?

Although this condition is uncommon, there have proved to be higher incidence rates in particular groups. It is most commonly developed in women, with data suggesting it affects 1 in every 80 women. The majority of this contingent is either premenopausal or experiencing menopause.
This condition may be developed in childhood, can often heal independently after puberty without requiring treatment.
Furthermore, in men, Lichen sclerosus is typically found in the foreskin: Thus putting uncircumcised men at higher risk of contracting it.

What other treatments are currently available for Lichen Sclerosus?

Like many mysterious chronic conditions, Lichen sclerosus has no concrete cure or a magic bullet that will fix everyone. However, there are many treatment options to try to alleviate symptoms and possibly reduce the severity of the hypopigmentation.

If you are experiencing patchy skin on your arms or upper body, these usually heal themselves over time without requiring treatment.
Furthermore, Lichen sclerosus in childhood may also go away on its own after puberty.

Phototherapy and ultraviolet light therapy for affected areas not involving the genitals can be used
Patches in the genital area, however, are most important to treat as they are the most susceptible to complications such as infection and scarring.

Topical corticosteroids can be used to reduce itching and inflammation
Immunosuppressive medications such as Tacrolimus (Protopic) may be prescribed by your doctor to help weaken the immune system so that it no longer attacks healthy cells.

Similarly, topical immunomodulating ointments such as Pimecrolimus may also be prescribed to combat atopic dermatitis
In advanced cases, women may experience pain during sexual intercourse due to tightening of the vagina. In such instances, vaginal dilators, water-based lubricants and numbing creams can be prescribed if necessary.

In severe cases of the foreskin, circumcision may be recommended to relieve pain and pressure for men.

“At Geniale, we currently only treat women with Lichens Sclerosus, but hope to offer the service to men in 2022. Generally, two treatments are needed every year, with many patients reporting that this is enough to control bleeding, tearing and pain,” says Cosmetic Physician Dr Mike Shenouda.

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Are there measures I can further take to prevent complications of Lichens Sclerosus?

The answer is yes. There are plenty of self-care measures you can employ to avoid complications if you’re already suffering from Lichen sclerosus.

Firstly, focus on maintaining optimal hygiene, particularly in the affected areas: gently cleaning and drying the area after urinating or having a bowel movement is recommended to avoid infection.

Similarly, avoiding harsh chemical soaps on these areas will also reduce irritation of already inflamed segments of skin.It’s important to monitor your condition and note any changes, especially given that these areas are more susceptible to skin cancer. It is recommended to get a 6 monthly review from your doctor, particularly when undergoing treatment.

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Are there any new diet treatments on the horizon for Lichen sclerosus?

“Despite the limited research surrounding the impact of diet on Lichen sclerosus, the Vulval Pain Society has provided research that does suggest a low oxalate diet may provide potential benefits,” says Dr Shenouda.
Oxalate, which is eliminated through one’s urine and stool, can cause inflammation in the body’s tissues. Thus, by reducing the amount of oxalate in your body you may also reduce the inflamed areas being irritated further.

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Are there any new diet treatments on the horizon for Lichen sclerosus?

“Despite the limited research surrounding the impact of diet on Lichen sclerosus, the Vulval Pain Society has provided research that does suggest a low oxalate diet may provide potential benefits,” says Dr Shenouda.
Oxalate, which is eliminated through one’s urine and stool, can cause inflammation in the body’s tissues. Thus, by reducing the amount of oxalate in your body you may also reduce the inflamed areas being irritated further.

To speak to us about PRP treatment for Lichen Sclerosus contact us today.

9181 3999

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