Lichen Sclerosus

UT Southwestern Medical Center provides skilled treatment for skin conditions such as lichen sclerosus, a rare, chronic disorder that results in patches of thin white skin that can be itchy or painful.

Dermatology and gynecology experts at UT Southwestern combine compassionate care with the latest medical resources for accurate diagnostic services and effective treatments that make a difference in patients’ lives.

What Is Lichen Sclerosus?

Lichen sclerosus is a skin condition that develops most often in the genital or anal (anogenital) regions. It causes inflammation that can change the skin’s color, texture, and thickness.

Treatment is important because lichen sclerosus can cause scarring, which can change the normal structure of the genital area. Very rarely, it can lead to skin cancer.

The condition is most common among women older than age 50, but it can affect anyone. Up to 20% of women with lichen sclerosus are diagnosed between the ages of 18 and 45. In men, it is most common among those who are uncircumcised.

What Does Lichen Sclerosus Look Like?

Lichen sclerosus often looks like white or pale, wrinkled skin, usually in the anogenital area. The skin can also appear pink, rough, or shiny.

In the early stages, lichen sclerosus can appear as slight redness. Over time, the skin can develop cracks, bruising, or thickened white patches. Individual white areas can also merge into larger affected areas.

Although lichen sclerosus most commonly affects the anogenital regions, it can also appear on the upper body, breasts, thighs, and mouth.

What Causes Lichen Sclerosus?

The cause of lichen sclerosus has not been determined. However, research suggests it results from an autoimmune reaction in people who are genetically predisposed to the condition. Hormonal imbalance and previous skin damage might also be contributing factors.

People with autoimmune diseases may be at greater risk. These include:

• Vitiligo
• Autoimmune-related anemia
• Type 1 diabetes
• Alopecia areata
• Autoimmune-related thyroid disease

Other factors that might increase risk include having a family history of the condition.

How Is Lichen Sclerosus Diagnosed?

To diagnose lichen sclerosus, we will:

• Ask about the patient’s symptoms
• Discuss the patient’s health history
• Perform a physical exam

Frequently, we can diagnose the condition simply by examining the affected areas. However, in some cases, a skin biopsy may be recommended. This involves removing a small tissue sample to examine in a laboratory.

We may need to rule out similar conditions, such as lichen planus and morphea, both of which cause skin irritation and discolored skin patches.

Why Choose UT Southwestern for Lichen Sclerosus Treatment?

UT Southwestern’s Gynecologic Dermatology Clinic specializes in treating vulvovaginal conditions, including tough-to-treat cases of lichen sclerosus.

Melissa Mauskar, M.D., is an international expert on lichen sclerosus. She lectures worldwide and mentors physicians who want to strengthen their clinical skills. She also serves as editor of a textbook on lichen sclerosus.

Her research includes clinical trials and qualitative studies of the condition. She has also received grant funding to support this work.

What Lichen Sclerosus Support Services Does UT Southwestern Provide?

We understand that living with lichen sclerosus can be challenging and often frustrating. We work with patient support groups, including the Lichen Sclerosus Support Network, to connect patients with helpful information, resources, and peer support.