SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

Information for Patients

View all Images (46)

Lichen sclerosus - Anogenital in
See also in: Overview,External and Internal Eye
Other Resources UpToDate PubMed

Lichen sclerosus - Anogenital in

See also in: Overview,External and Internal Eye
Contributors: Vivian Wong MD, PhD, Kudakwashe K. Maloney MD, MPhil, Belinda Tan MD, PhD, Susan Burgin MD, David Foster MD, Mary Gail Mercurio MD, Lynne Margesson MD
Other Resources UpToDate PubMed


Lichen sclerosus (LS) is the most common chronic vulvar condition. It is characterized by vulvar hypopigmentation and scarring with loss of normal architecture. Onset is typically at 35-45 years of age, but it can be seen in prepubertal children. Genetic and autoimmune factors are thought to contribute to the pathogenesis of LS.

The main symptom is pruritus, and at times, this can be incapacitating, interfering with daily activity and sleep. Dyspareunia and urinary retention may occur. It can also be asymptomatic, just with scarring and hypopigmentation.

Squamous cell carcinoma (SCC) can occur within LS genital lesions. There is a higher risk of SCC in untreated cases.


L90.0 – Lichen sclerosus et atrophicus

895454001 – Lichen sclerosus

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required


Subscription Required

Last Reviewed:08/12/2020
Last Updated:01/18/2022
Copyright © 2023 VisualDx®. All rights reserved.
Patient Information for Lichen sclerosus - Anogenital in
Print E-Mail Images (46)
Contributors: Medical staff writer


Lichen sclerosus refers to a type of inflammation, bleeding, thinning, scarring, and resultant white plaques of the mucous membrane and skin in the genital area, or possibly elsewhere on the body. Its origin is uncertain. There may be a genetic association among some family members.

Lichen sclerosus lesions may resemble childhood or adult sexual abuse. Your doctor may need to rule out this possibility.

Who’s At Risk

Lichen sclerosus is reported 6 times more often in females than males. In females, it is most often genital and presents either before puberty or after menopause. Lichen sclerosus in males is almost always in uncircumcised boys and men.

Women with genital lichen sclerosus may have a slightly greater risk of skin cancer.

Lichen sclerosus is rarely seen in infants.

Signs & Symptoms

Lichen sclerosus of the anogenital area begins with inflamed, dry, sore, and very itchy areas of genital skin. It may progress to painful, bleeding, red or purple lesions. Female symptoms can include pain during urination, defecation, or intercourse. In males, lesions may occur on the head and shaft of the penis. Other symptoms may include itching and painful urination, defecation, and erection. Impaired sensation of the penis may occur.

Lichen sclerosus of other skin areas may occur without any symptoms, or may appear as dry, itchy skin patches. White, scar-like areas appear on the shoulders, arms, neck, and back. It may appear in tattoos or previously injured skin (surgical scars, trauma, burns).

Rarely does it occur in the mouth.

Self-Care Guidelines

Use only mild cleansers. Follow the directions of your health care provider to alleviate the pain, itch, and discomfort of the condition.

When to Seek Medical Care

When the skin and mucous membranes begin to show signs of aggravated reddening, irritation, itching, and skin plaques, contact your doctor.

If conditions worsen following your medical appointment, contact your doctor for follow-up. Lichen sclerosus, if left untreated, can cause irreversible damage to skin and mucous membranes.


Your health care provider may perform tests to rule out other conditions or infections, or to confirm your diagnosis prior to starting treatment. Your health care provider may perform a biopsy to rule out malignancy and other white plaque conditions. A biopsy is not ordinarily performed on children, except in extreme cases.

Treatment of symptoms, particularly itching, may be the first approach. Topical steroids have been used with great success. A number of other treatments have had mixed results, such as surgery, injections, cryotherapy, phototherapy, and other laser therapy. Circumcision is believed to be helpful for men.
Copyright © 2023 VisualDx®. All rights reserved.
Lichen sclerosus - Anogenital in
See also in: Overview,External and Internal Eye
A medical illustration showing key findings of Lichen sclerosus : Eyelids, Glans of penis, Labia majora, Smooth plaque, White color, Inguinal region, Pruritus, Skin atrophy, Hardened skin
Clinical image of Lichen sclerosus - imageId=174921. Click to open in gallery.  caption: 'A shiny white plaque in the intergluteal fold.'
A shiny white plaque in the intergluteal fold.
Copyright © 2023 VisualDx®. All rights reserved.