What is lichen sclerosus et atrophicus?

Lichen sclerosus et atrophicus is a connective tissue disease that affects the mucous membranes of the external genitalia. The disease can also spread down into the perineum and around the rectum. In rare cases, the disease can also be seen on the skin elsewhere on the body.

Lichen sclerosus et atrophicus is not a venereal disease. It is a disease of the mucous membrane's connective tissue, which breaks down and is replaced by a firmer connective tissue that resembles scar tissue.

At the same time, the mucous membrane becomes thinner (atrophic), whitish and pale. Lichen sclerosus et atrophicus is seen in both adults and children.

More women than men are affected, and there is a tendency for the disease to first appear after menopause. The cause of lichen sclerosus et atrophicus is not known. The disease thus occurs suddenly without known provoking factors. 

What are the symptoms?

• Stinging, burning and pain
• Pain during intercourse
• Bleeding in the mucous membrane/red-blue discoloration
• Whitish discoloration of the mucous membrane of the foreskin and the head of the penis.

In cases where you do not treat in time, the following can occur:

• Shrinkage of the labia
• Narrowing of the vaginal entrance
• Narrowing of the foreskin where the foreskin is tight and cannot be retracted

How is lichen sclerosus et atrophicus diagnosed?

Often the doctor will take a small tissue sample which is sent for microscopic examination, where the disease can be detected with certainty.

How does the treatment take place?

In the vast majority of patients with lichen sclerosus et atrophicus, the disease can be kept at bay by treatment with ointments/creams containing adrenocortical hormone (steroids). One usually uses ointments that contain a strong steroid, e.g. Dermovat.

The treatment is often given as a long-term daily treatment for 6-8 weeks, followed by a maintenance treatment, where the ointment is applied 2-3 times a week.

If the symptoms disappear completely, you can take breaks in the treatment and resume the treatment if the symptoms reappear. Even if the disease subsides, there will often be a paler mucous membrane.

Follow up

For many, the disease will be chronic and therefore long-lasting. You can see that the disease disappears spontaneously, but this is often in children in connection with puberty.

Lichen sclerosus et atrophicus increases the risk of cell changes on the mucous membrane, which can develop into skin cancer (squamous cell carcinoma). It is therefore recommended that you are checked approx. 1-2 times a year to your doctor and otherwise consult if the symptoms do not improve despite treatment, if wounds occur that do not heal, or if nodules form in the area.