What is lichen sclerosis and what does it look like?

Lichen sclerosis (LS) is a skin condition that makes the vulva look white, slightly shiny, and smooth. The skin's surface becomes thin and delicate so that it tears easily. This can cause bleeding under the skin. In severe cases of lichen sclerosis of the genital area, scarring can occur. This causes the inner lips of the vulva to get smaller. The clitoris can become covered in scar tissue.

What causes lichen sclerosis?

We do not know the exact cause of lichen sclerosis. Scientists have different theories to try to explain the cause. Some scientists think that an overactive immune system may play a role in causing the disease. Some people may also develop lichen sclerosis due to their genes or to changes in hormones. Since lichen sclerosis is not caused by an infection, it cannot be spread and is not contagious.

What are the symptoms of lichen sclerosis?

Symptoms of lichen sclerosis may be different from one person to another and can be mild to severe. Girls and young women who have this disease may experience some or all of the following symptoms in the vulva area:

Mild to severe itching in the vulva area

Skin that appears fragile, pale, and/or white

Bruised skin with broken blood vessels or "blood blisters"

Small tears or fissures in the skin

Scar tissue covering the labia or clitoris

Bleeding or tearing of skin when having bowel movements

How is lichen sclerosis diagnosed?

Lichen sclerosis can be a difficult diagnosis to make. It is not unusual for someone to see more than one doctor before the disease is finally diagnosed. Most of the time, doctors who see many patients with lichen sclerosis can often make the diagnosis just by looking at the skin. However in most cases if you are in the early stages of lichen sclerosis, the doctor may have to do a biopsy (removal and examination of a small sample of affected skin) to identify the cause of your symptoms.