6 Ways to totally dominate your lichen sclerosus
What is Lichen Sclerosus?
Lichen sclerosus is a chronic skin condition that loves the anogenital region (vulva and perianal skin mostly). Most of my patients will present to see me with an itch that is out of this world. Anyone that has experienced this will know what I mean. It is terrible! It will basically stop you from living - and you definitely can’t sleep at all. We don’t know why vulval lichen sclerosus (VLS) happens but there are some associations with other autoimmune conditions such as thyroid disease, and there is a complicated inheritance risk as well.
What does VLS look like?
Vulval lichen sclerosus looks white. The skin looks ‘sick’. When i say this I mean that it is wrinkled and thin and some parts can be missing and there can be small blood blisters and sores.
Domination 1
Use your treatment daily. You can’t cure VLS so this means that if you stop treatment it will eventually come back. Nobody wants that. Daily treatment can also reduce your risk of flares.
Domination 2
Not everything that itches is lichen sclerosus. It is easy to put everything down to this if you have a lichen sclerosus diagnosis. Don’t forget though that you can also have dermatitis or thrush as well as your lichen sclerosus. So if you keep having flares despite using your treatment as directed then its time to start thinking of other things.
Domination 3
Don’t forget to use a moisturiser. This is in the form of a thicker clearer ointment that can stick better to vulval skin. There are lots on the market but basically they don’t have a fragrance or any colours. An example would be an emulsifying ointment or a white soft paraffin mix. You need to apply the moisturiser on over the top of your treatment rather than underneath it otherwise your treatment ointment can’t penetrate the skin. Or you could use the moisturiser at a time when you are not applying your treatment. For example if you use your treatment ointment at night, then you would put the moisturiser on in the morning.
Domination 4
Use a lubricant during sexual activity, especially if you are post menopausal. This helps to protect the skin from friction and damage, which it’s not so good at after menopause or with skin conditions such as lichen sclerosus.
Domination 5
See your treating physician regularly. For my long standing VLS patients who are under control I would normally see them on an annual basis. This is to check the skin is not changing and also to make sure there are no skin cancers.
Domination 6
Inspect your skin regularly. Just as you do with the rest of your body, here in Australia, as a part of skin cancer surveillance, you also should check your vulva. This is hard to do due to positioning but a mirror placed on the closed lid of a toilet will do. You then have to put 1 foot on the toilet seat and inspect away! You are looking for a flare of your lichen sclerosus (such as areas of white) or any spots or lumps or bumps. If you see anything of concern then make sure you consult your treating physician promptly.