The exact cause of lichen sclerosus (LS) flares is unknown. Health experts suggest that several factors may cause LS:

  • Genetic factors: LS seems to occur more frequently in certain families. A person may be predisposed to getting the condition because of their genes. Such people may get LS symptoms when exposed to any injury, stress, or sexual abuse.
  • Immune system disorders: In women, LS may be due to autoimmunity (a condition in which the body’s immune system mistakenly attacks and injures the skin). Women with LS may also develop other autoimmune disorders, such as some types of thyroid disease, anemia, diabetes, alopecia areata (a type of hair loss where the hair goes away in circular patches), and vitiligo.
  • Menopause: Although LS can affect people of any age or gender, postmenopausal women are at higher risk of this condition.
  • Hormones: Prepubertal girls and postmenopausal women are more commonly affected by LS. This suggests that hormones may be involved in causing this condition; however, treatments such as hormone replacement therapy or the application of testosterone or progesterone are not effective for women with LS.
  • Being uncircumcised: Uncircumcised men are at higher risk of LS than circumcised men because it commonly affects the foreskin. Research suggests that urine may contribute to male LS. Microscopic urine droplets may get collected between the glans penis and foreskin causing LS in uncircumcised men.

What is lichen sclerosus?

Lichen sclerosus or LS is a long-term (chronic) skin condition. It can affect the skin on any part of the body; however, it often affects the genital or anal areas. LS makes the skin thin, whitened, and wrinkled. It can cause a rash, itching, scarring, and pain.

LS can affect people of any age or gender; however, it is most common in postmenopausal women. The most common sites in women are near the clitoris, on the labia (the inner and outer genital lips), and in the anal region. LS can cause a condition called lichen simplex chronicus in women. In this condition, the woman’s vulva (the outer part of the vagina) is involved. This happens when the skin in and around the vulva becomes thicker from constant itching and scratching.

LS most commonly affects the glans penis (the rounded head or tip of the penis) and foreskin. In around 15-20% of the affected people, LS lesions occur on other skin surfaces, such as the thighs, breasts, wrists, shoulders, neck, and even inside the mouth.

What happens if lichen sclerosus is left untreated?

Lichen sclerosus (LS) can usually be managed with treatment. When left untreated, LS can lead to serious effects. Lesions on the genitals can cause severe pain during sex. The affected person may become emotional or bothered about having a condition in their genital area. Persistent irritation and scratching associated with lichen simplex chronicus can lead to bacterial skin infections. This can lead to permanent scars. LS can increase the risk of skin and vulvar cancers. Thus, you must consult your doctor and get treatment for LS.

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Medically Reviewed on 10/9/2020
References
https://familydoctor.org/condition/lichen-sclerosus/

https://www.uptodate.com/contents/lichen-sclerosus-beyond-the-basics

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