Vulvar lichen sclerosus: what it is and how to treat it

Vulvar lichen sclerosus is a chronic and inflammatory skin disease that mainly affects the genital region, causing intense itching, pain, whitish patches and thinning of the skin. Although it is more common in women after menopause, it can also occur in men and people of any age, including children.

The condition is not contagious and the cause is not yet fully understood, but autoimmune, hormonal and genetic factors may be related.

"In my clinical practice I see a strong association with immunological factors. We observe this pathology associated with other immunological pathologies such as lupus, Crown's disease and other dermatitis, as well as hormonal factors, as we observe a higher prevalence in menopausal patients. Other less common causes that we could suggest as a cause would be trauma or procedures in the specific region and changes in metabolism", details Jardel Pereira Soares, gynecologist and obstetrician.

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Symptoms, according to experts, usually appear gradually and, in many cases, persistent itching leads to lesions and cracks in the skin, making sexual intercourse painful and increasing the risk of local infections.

In more advanced cases, lichen sclerosus can cause scars, anatomical changes and narrowing of the vaginal opening. Experts warn that, without treatment, there is an increased risk of developing vulvar cancer in a small proportion of cases.

"Studies show that, when the patient is monitored, the risk decreases greatly. Generally, the risk of transformation to cancer occurs in approximately 5% of cases of sclerotic fluid. So, an important thing is that the treatment helps to reduce the risk of progressing to cancer", explains Adriana Bittencourt Campaner, president of the National Commission Specialized in Lower Genital Tract of Febrasgo (Brazilian Federation of Associations in Gynecology and Obstetrics).

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The diagnosis is made by a gynecologist or dermatologist, generally based on clinical evaluation and, in some situations, on a biopsy of the affected area. Treatment involves the use of topical corticosteroids, indicated to reduce inflammation and control symptoms.

In addition, it is essential to maintain a skin care routine for the region, such as avoiding aggressive soaps, wearing cotton underwear and avoiding excessive friction.

"Lichen sclerosus has no cure, but we can control it a lot. Even if the symptoms improve, we generally continue to use corticosteroids once a week forever, because we need to maintain this patient to avoid the risk of developing cancer", adds Campaner.

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Source: CNN