Lichen Sclerosus Treatment Overview
Care Plan
When you may need a provider
- If you think you have lichen sclerosus, you should see a doctor to get diagnosed and treated. If treatment is started early, there is a lower risk of scarring and long-term consequences.
- To relieve symptoms, use a lubricant in the area to help prevent pain with sexual activity.
Emergency Care
Go to the ER if you have any of the following symptoms:
- Unable to urinate
- Severe pain that interferes with sleep and daily activities
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Treat
When to see a healthcare provider
You should see your healthcare provider if you think you have lichen sclerosus. If at-home treatments and lifestyle changes, like sitz baths, lubrication, and OTC topical steroids, do not improve your symptoms after two weeks, see a doctor.
The chronic inflammation from lichen sclerosus can lead to the development of skin cancer in the genitals (squamous cell carcinoma). Early signs include any bleeding from the genitals or any lumps or bumps in the area.
All people with lichen sclerosus should be monitored by a physician to screen for cancer.
You should get immediate medical care if you are unable to urinate because of pain in the genitals.
Getting diagnosed
Your doctor will ask questions about your symptoms and examine the area. They may be able to make a diagnosis by looking at the rash, or they may do a biopsy of the rash. During the biopsy, a small piece of skin is removed and sent to the lab.
What to expect from your visit
- Your doctor will likely recommend a prescription topical steroid to help reduce inflammation. Many times, this is enough to help control the disease.
- You may have to use the topical steroid a few times a week over the long term.
- Since steroids have a risk of thinning your skin over time, you may be advised to alternate it with a nonsteroidal anti-inflammatory (NSAID) topical medication.
- If you are female, your doctor may also recommend a vaginal topical estrogen cream.
- If topical medications don’t help, your doctor may recommend other treatments like phototherapy (nbvub), oral immunosuppressant medications (mycophenolate mofetil or methotrexate), or a laser procedure.
- You will need follow-ups with your doctor to monitor your progress.
- Lichen sclerosus may increase your risk of skin cancer (squamous cell carcinoma) so your dermatologist will want you to have regular skin checks.
Prescription lichen sclerosus medications
- Clobetasol propionate ointment (clobex)
- Fluocinonide ointment (Lidex)
- Betamethasone dipropionate ointment (diprolene)
- Pimecrolimus cream (Elidel)
- Tacrolimus ointment (Protopic)
- Methotrexate
- Mycophenolate mofetil (cellcept)
What type of doctors treat lichen sclerosus?
- A primary care physician can diagnose and treat lichen sclerosus.
- A dermatologist is a skin doctor who can treat you and monitor you for skin cancer.
- A gynecologist treats women’s health issues.
- A urologist treats urinary tract disorders.
How to treat lichen sclerosus at home
Most treatments for lichen sclerosus require treatment by a doctor. But there are things you can do at home to help your symptoms.
- Using a lubricant during sexual activity can help reduce pain.
- Sitz baths can also be used to soothe the area.
- OTC topical steroids may help reduce inflammation, but usually prescription-strength topical steroids are needed.
OTC medications
- Hydrocortisone cream or ointment 1% (Cortaid or Cortizone-10)
- Stress can make lichen sclerosus worse. Reducing stress levels by meditating and exercising may lessen inflammation.
- Obesity can also make it worse and harder to treat—losing weight can help.
FAQ