Lichen Sclerosis: A Lesser-Known Cause of Vulva Pain

As a Pain Consultant will tell you: “Vulvar lichen sclerosus (LS) is a chronic skin condition that affects the vulva (the skin surrounding the opening of the vagina). This condition can occur in people of any age, and includes females of reproductive age, & those who have gone through the menopause. Lichen sclerosus affects quality of life, & can cause pain, soreness, intense irritation, itching, erosions, ulcers, sexual disturbances, urinary symptoms, & even depression. LS is not however, contagious, nor a sexually transmitted disease” [1, 2]

Did You Know?

“Lichen sclerosus can involve any area of the vulva, including the outer lips (labia majora), inner lips (labia minora), the clitoris and surrounding skin, and the skin around the anus [1].”

So What Are the Symptoms of LS?

“Lichen sclerosus is characterised by skin changes of the external genitalia. The most common distribution is a figure of 8 involving the vulva & perianal area” [2]

Generally speaking, individuals who suffer with lichen sclerosus, experience pain, irritation and itching. – Although in some instances, there are no symptoms. However, before you schedule an appointment with a Pain Doctor, check for the following:

• White areas of skin that appear wrinkled or shiny. (In some cases, these white areas have pink or red changes
• For those with a darker skin tone: at the onset, the condition may resemble vitiligo (a disorder whereby the skin loses its pigment, thereby generating white patches)
• The skin can appear fragile, and may be cracked or bruised
• Experiencing breaks in the skin which can result in painful bowel movements and/or urination
• Scarring (due to LS not being properly diagnosed and treated by a Pain Specialist/Doctor)
• Painful sex and urination due to the scarring
• Narrowing at the opening to the vagina (even though lichen sclerosus does not concern the vagina)
• Skin cancer. (Note: if lichen sclerosus is not properly treated, then the risk of skin cancer escalates) [1]

Booking an Online or In-Person Consultation With a Pain Specialist

Having an accurate diagnosis, and getting started on a Personalised Treatment Plan devised by a Pain Doctor, is essential in order to: stop the pain and discomfort, and prevent the issues of scarring, and risk of skin cancer developing within the lichen sclerosus area.

References

[1]. Kraus, C. Vulvar Lichen Sclerosus. JAMA Dermatol. 2022;158(9):1088.
https://jamanetwork.com/journals/jamadermatology/fullarticle/2793784#:~:text=Vulvar lichen sclerosus (LS,followed by itching and pain.&text=This condition can occur in,who have gone through menopause.

[2]. Nord (2023). “Lichen Sclerosis.”
https://rarediseases.org/rare-diseases/lichen-sclerosus/