One of the primary reasons that we always suggest that you be seen by your gynecologist or doctor if you are having any unusual symptoms is because your symptoms may overlap with multiple conditions. For example, vaginal itching irritation, burning, and even lesions or sores can be common symptoms of very different disorders requiring different treatments. One guess as to the cause of such symptoms is a yeast infection. Many women attempt to self-treat with over the counter medication for yeast infections and many times this is not the culprit. In fact, The National Women’s Health Information Center states that two-thirds of women who buy over the counter yeast infection medications don’t really have a yeast infection. Other women having such symptoms may be frightened that they have genital herpes especially if they see vaginal lesions. There is another possibility as to the cause of all of these symptoms and that is a vulvar skin condition. In this post we are going to talk about genital skin conditions called Lichen Planus and Lichen Sclerosus.
What is Lichen Planus?
Lichen planus is a dermatological condition which can affect the vulva, vagina, and anus. Women are most likely to have this condition but it can also affect male genitalia as well. This skin condition can also develop on other areas of the body such as the inside of the mouth, the wrist, the ankles, and the lower back. Lichen planus is considered to be a chronic auto-immune skin disorder with periods of flare-ups and remission. One important thing to know about Lichen planus is that it is not contagious and you cannot give it or receive it from anyone. This skin condition develops most commonly in middle aged women who are nearing menopause or who are post-menopausal. According to Harvard Health Newsletter there are some medications which can trigger Lichen planus symptoms. Some of these medications include: diuretics, beta blockers, ACE inhibitors, certain antibiotics, or antimalarial drugs. If you suspect that you have this condition you should tell your doctor about all the current medications you are taking.
What are the symptoms of Vulvar Lichen Planus?
"¢ Bumps and patches on the skin that itch.
"¢ Soreness, burning, and tenderness
"¢ Blisters and open sores can develop making sexual intercourse painful or impossible. They can also make urination painful.
"¢ The vulva can appear pale or have a white lacy pattern.
"¢ Lichen planus can cause a yellowish discharge.
"¢ The vaginal skin may be fragile and thin which sometimes causes cracking and bleeding.
"¢ If left untreated this skin condition can erode the vaginal skin tissues, especially the labia minora.
It is not difficult to understand how some women may mistake these symptoms for either some sort of an infection (itching, burning, and soreness) or even genital herpes (the presence of painful lesions).
What is Lichen Sclerosus?
Lichen Sclerosus is another inflammatory chronic skin disease affecting the genital region which can mimic the symptoms of an infection or genital herpes. Lichen sclerosus can be a co-condition to lichen planus or can develop from erosive lichen planus (where the labia minora can shrink and fuse to the labia majora. The predominant symptoms are itching and soreness. There may be white shiny patches on the vaginal skin. There is a chance for bruising, bleeding, and ulcers to appear. Lichen sclerosus can be extremely painful, making sexual intercourse a source of physical distress. The skin can be thin and easily broken, causing cracking and fissures.
Women who have psoriasis may be more susceptible to being diagnosed with lichen sclerosus. In addition, this is a skin condition primarily affecting post-menopausal women. According to the Harvard Health Newsletter one in 30 older women may have lichen sclerosus. The problem is that many women do not realize they have this condition and mistake it for other gynecological problems. If left untreated both lichen planus and lichen sclerosus can progress and cause tissue damage and scarring to the vulvar area. In some rare cases lichen sclerosus is associated with an increased chance of vulvar cancer. Anyone with these vulvar skin conditions needs to be checked regularly by their gynecologist to make sure that the disease does not progress to something more serious.
What to do if you have any of these symptoms:
If you are experiencing itching, burning, soreness, bleeding, fissures, white thickened patches of skin or if you are developing ulcers or blisters in the vulvar area, you need to be seen by your gynecologist. Most doctors will be able to diagnose these conditions by doing a vulvar skin biopsy. Don’t try to guess at what these symptoms mean or try to self-diagnose. Many women suffer needlessly from lichen planus and lichen sclerosus because they think it is some sort of recurring yeast infection. Although both of these genital skin conditions can be chronic and without a definitive cure, there is treatment which is extremely effective. An early diagnosis and treatment can prevent pain, scarring, and damage to the vulvar skin and tissues.
The Worldwide Lichen Sclerosus Support website has much information on how this skin condition is diagnosed and how to treat it. The literature is fairly consistent in recommending the use of a potent steroid, clobetasol propionate, on the affected areas. In one study, the use of clobetasol propionate cream resulted in a 77% chance of complete remission of symptoms for lichen sclerosus patients. If you are diagnosed with this skin condition, your doctor will provide guidance as to how often to use your steroid cream.