Treatment for Lichen Sclerosus
In most cases, a very strong cortisone cream or ointment is used to treat lichen sclerosus. However, in cases where non-genital skin is affected, treatment is often not needed. For uncircumcised men, circumcision is the most common treatment for this condition. Your options regarding treatment will be based on the area affected and whether symptoms are present.
Patients with lichen sclerosus that affects non-genital skin often do not need treatment, because the symptoms are generally mild and usually go away over time. The amount of time involved, however, varies from patient to patient.
Treatment for lichen sclerosus should be sought when it affects the genitals, even when it is not causing itching or pain, because it can lead to scarring that may cause the openings in the genital area to narrow and interfere with urination, sexual intercourse, or both. There is also a small chance that skin cancer can develop within the affected areas.
Medications are recommended for:
- Vulvar lichen sclerosus
- Non-genital lichen sclerosus that is causing symptoms
- Lichen sclerosus of the penis that is not cured by circumcision.
The treatment of choice is a highly potent topical corticosteroid (a very strong cortisone cream or ointment). These creams or ointments may be applied daily for several weeks, which will be sufficient to stop the itching.
However, long-term but less frequent applications (sometimes as infrequently as twice a week) will be needed to keep the lesions from reactivating and to help restore the skin's normal texture and strength. This lichen sclerosus treatment does not reverse the scarring that may have already occurred.
Because prolonged use of highly potent corticosteroid creams and ointments can cause thinning and redness of the skin, give rise to stretch marks around the area of application, and predispose women to vulvar yeast infections, periodic follow-up exams by a doctor are necessary.
Young girls may not require lifelong treatment for the condition, since lichen sclerosus can sometimes (but not always) disappear permanently at puberty. Scarring and changes in skin color, however, may remain even after the symptoms have disappeared.
Sometimes, people with lichen sclerosus do not respond to topical corticosteroid creams or ointments. Other factors -- such as low estrogen levels, an infection, irritation, or allergy to the medication -- can keep symptoms of lichen sclerosus from clearing up. Your doctor may need to treat these as well. If you feel that you are not improving as you would expect, talk to your doctor.