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, Géniale offers tailored 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.
Géniale now offers a variety of tailored programs for Lichen Sclerosis, including Fotona® light-based treatment, which assists with keeping bleeding and tearing symptoms in check.
Another very recent option is (Growth Factor 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. Géniale is now delighted to offer this service to women and men.
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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?
What causes Lichen Sclerosus?
How common is it and who is most at risk of developing Lichen Sclerosus?
A 2020 study in the Journal of Dermatological Treatment observed 94 patients with Lichen Sclerosus, finding that PRP treatment led to a significant decrease in symptoms after 6 months. Reduction in pain and burning sensation was notable, especially in women, while itching decreased similarly in both genders.
Dr. Mike Shenouda from Géniale notes that PRP shows promise for women struggling with Lichen Sclerosus. The procedure takes 90 minutes and patients can typically drive home afterward with minimal discomfort.
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.
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?
Lichen sclerosus has no definitive cure, but various treatments can alleviate symptoms and potentially reduce severity.
- Patchy skin on arms or upper body often heals on its own over time, as does childhood lichen sclerosus after puberty.
- Phototherapy and ultraviolet light therapy can help affected areas not involving the genitals, while patches in the genital area are crucial to treat to prevent complications like infection and scarring.
- Topical corticosteroids reduce itching and inflammation, and immunosuppressive medications like Tacrolimus may weaken the immune system to stop attacking healthy cells.
- Topical immunomodulating ointments like Pimecrolimus can also help, and for severe cases causing pain during intercourse, vaginal dilators, lubricants, and numbing creams are options. Circumcision may be recommended for severe foreskin cases in men.
Dr. Mike Shenouda from Géniale currently treats women with lichen sclerosus and plans to extend services to men in 2022. Typically, two treatments per year suffice for many patients to manage bleeding, tearing, and pain.
Are there measures I can further take to prevent complications of Lichens Sclerosus?
Yes, self-care measures can help prevent complications if you have Lichen sclerosus. Focus on optimal hygiene by gently cleaning and drying affected areas after urination or bowel movements to avoid infection. Avoid harsh chemical soaps to reduce irritation. Regular monitoring of your condition, especially for skin cancer risk, is vital. It's recommended to have a doctor's review every six months, especially during treatment.
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.
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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