Lichen sclerosus

Lichen sclerosus is a skin disease that primarily affects the genital area. Although it can occur in males, it most frequently affects young girls before they enter puberty or women after they’ve experienced menopause. When it affects children, it is called pediatric lichen sclerosus, and with girls, it’s often centered around the skin of the vulva, which is the area around the vagina. 

Lichen sclerouss is often a distressing diagnosis for parents and children who may have never heard of this disease. The cause of lichen sclerosus is thought to involved genetifc and immunologic factors. If may go undiagnosed for years if not seen by a physicain who is able to recognisze it. Because Dr. Trager is an expert at diagnosing and treating pediatric and adolescent vulvar lichen sclerosus, he helps families understand and manage the condition effectively and compassionately.

What are the signs and symptoms of lichen sclerosus?

Some patients do not experience symptoms even if they have the disease, but most often, lichen sclerosus symptoms include:

• Lightening and thinning fo the vulvar skin
• Cuts
• Bruises
• Inflamed, irritated vaginal and anal areas
• Bleeding from the skin
• Painful urination
• Constipation

How is lichen sclerosus diagnosed?

An experienced pediatrician can usually diagnose lichen sclerosus with a careful medical exam that includes the child’s vaginal skin, vulva, and anus. A genital exam is a typical part of a routine pediatric checkup. 

A visual inspection for symptoms is usually enough to diagnose the disease so treatment can begin right away. The exam is external only and does not require or include an internal pelvic exam.

If there is concern that a bacterial, fungal, or viral infection may be present and/or contributing to the uncomfortable symptoms, Dr. Trager may take a culture by gently swabbing the area with a saline moistened swab.

How is lichen sclerosus treated?

Prescription topical corticosteroid creams are one of the most effective treatments for lichen sclerosus.  Topial non-corticosteroid creams may are also used.  Platelet-rich plasma is an emerging treatment for vulvar lichen sclerosus.

Topical treatment can provide dramatic relief from pain and discomfort as the healing process begins. Early treatment makes the disease managable and helps prevent long-term negative effects on a girl’s future gynecologic health and well-being.

If you or your daughter experience any of the symptoms of this condition, or if you would like to speak with an expert in the field of pediatric lichen sclerosus, call Dr. Trager’s office or schedule an appointment online.