Treatment Of Lichen Sclerosus
Treatment of Lichen Sclerosus
For some, that have no genital involvement, treatment of Lichen sclerosus, may not be needed particularly if there are no symptoms. LS can get better on its own, and often does when it is a mild or less sever case.
Young girls may not need lifelong treatment of lichen sclerosus, which can on occasion, disappear at puberty permanently. Scarring and changes in skin color may remain even after the symptoms have disappeared.
Treatment of Lichen sclerosus is always recommended when the genital or anal areas are affected, or when there is an advanced case on other areas of the body. Treatment will help further scarring and help with the itching. There will also be the benefit of improving the skins appearance.
Most often a strong corticosteroid cream/ointment is used for genital areas and other body areas. Treatment can last from weeks to months. A small smear of the cream is applied to the affected skin daily with your doctor re-assessing the treatment every few weeks/month. Skin can become thin, red and uncomfortable with overuse of the steroid cream. Once your medical professional indicates the affected area is appearing better, a maintenance regiment of once or twice a week is used to keep Lichen Sclerosus from reappearing.
If there is no appreciable improvement with a steroid cream/ointment, or there is an allergy. Other treatment options include calcipotriol cream, topical and systematic retinoids (acitretin), and oral steroids.
Oestergen creams are prescribed for hormonal imbalances, that can cause dry thinned, vulva and vaginal tissues. This will help with strengthening the skin and help to stop fissures.
Tacrolimus and premecrolimus are new immune modulating creams that are showing some promise in the treatment of Lichen Sclerosus. They can cause burning and are a concern for an increase in the potential rate of skin cancer when in the presence of papilloma virus.
In cases where there is narrowing of the vaginal opening, dilators can be used to gently stretch the vaginal opening. surgery is rarely needed to allow for sexual activity. But this surgery could appear successful only to have to be redone due to the disease reoccurring.
Surgery is required if there is urination difficulties and to allow intercourse, these procedures can include:
- A division of adhesion’s called a Simple perineotomy
- An incision that is repaired transversely is called a Fenton procedure
- An excision of involved tissue and vaginal mucosal advancement is a Perineoplasty
- In rare occasions, a vuvalectomy, where the vulva is removed, is needed due to cancer or precancer.
Surgery is normally not a good option for women. Due to the lichen sclerosus patches that are removed from the genitals of women and girls, usually come back.
Stem cell treatments are being used on Lichen sclerosus with some promising results.
Light and ultraviolet light is used for non genital forms and can help with healing and skin appearance.
Penile lichen sclerosus
In men, lichen sclerosus for the most part influences the tip of the penis, which comes to be firm and white (likewise called balanitis xerotica perstans). The urethra may narrow such that it is challenging to pass urine, bringing about a weak stream. Now and then the section needs to be extended with an uncommon operation, called meatal expansion. Sexual function may be influenced. For men with lichen sclerosus on the foreskin, removal of the foreskin (circumcision) is a common treatment in cases resistant to other therapies or in more advanced cases.
Male genital lichen sclerosus is uncommon in men circumcised early. It has been inferred that it may be brought on by long term damage by urine.
Penile lichen sclerosus may incline the patient to penile intraepithelial neoplasia and penile malignancy. Long term follow up is required to make sure these condition/cancers do not appear.
Miscellaneous Lichen Sclerosus information
Wash gently in a shower or bath with plain water alone or with a non-soap cleanser. Avoid rubbing and scratching. Some patients find it helpful to apply an emollient cream or petrolatum several times a day to relieve dryness or itching. Clothing that is loose is more comfortable, pants and underpants can cause irritation.
Sexual Activity is possible for most, but in some cases the damage has caused narrowing of the vulva and intercourse is painful or not possible. Penile damage can bring about similar challenges.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Lichen Sclerosus Information 101 has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.