Lichen sclerosus is an inflammatory autoimmune skin condition that has a predilection for the genital skin in both sexes and is associated with other autoimmune diseases.
What is Lichen Sclerosus?
An autoimmune inflammatory skin condition, Lichen sclerosus (LS) predominantly appears in the genital skin of men and women and is associated with other autoimmune diseases. Women are 6-10 times more affected than men. LS may involve complications of erosion, atrophy, and scarring as a result of inflammation and altered fibroblast functions, leading to fibrosis of the upper dermis.
Symptoms associated with this condition are vulval itching, irritation, painful urination, vaginal dryness, painful intercourse, vaginal narrowing, and fissure formation. LS has a considerable impact on affected patients physically, emotionally, and psychologically. It can affect their quality of life and intimate relationship through pain and embarrassment.
It can also be asymptomatic. The aetiology of LS is unknown.
How is Lichen Sclerosus treated?
Treatment includes vulval care (avoiding soaps and using cotton underwear), lubricants (Vaseline), estrogen cream, topical steroids, and other medical treatments. In severe cases, surgery might be required.
Women with lichen sclerosus should have long-term follow-up with a gynaecologist as there is a 4% lifetime risk of vulval cancer development.
At FBW, we have conducted studies on LS treatment with platelet rich plasma (PRP) which showed 85% clinical improvement in the lesion size and symptoms. PRP is offered as an alternative or adjuvant treatment for vulval lichen sclerosus, since some women may experience severe thinning of the vaginal mucosa from topical therapy or may not respond to steroid treatment.