Treatments for Lichen sclerosis
Treatment List for Lichen sclerosis
The list of treatments mentioned in various sources
for Lichen sclerosis
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Lichen sclerosis: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Lichen sclerosis may include:
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Latest treatments for Lichen sclerosis:
The following are some of the latest treatments for Lichen sclerosis:
Discussion of treatments for Lichen sclerosis:
Patients with lichen sclerosus of nongenital skin often do
not need treatment because the symptoms are very mild and usually go
away over time. (The amount of time involved varies from patient to
However, lichen sclerosus of the genital skin should be
treated, even when it is not causing itching or pain, because it can
lead to scarring that may narrow openings in the genital area and
interfere with either urination or sexual intercourse or both. There is
also a very small chance that cancer may develop.
In uncircumcised men, circumcision is the most widely used
therapy for lichen sclerosus. This procedure removes the affected skin,
and the disease usually does not recur.
Prescription medications are required to treat vulvar
lichen sclerosus, nongenital lichen sclerosus that is causing symptoms,
and lichen sclerosus of the penis that is not cured by circumcision. The
treatment of choice is an ultrapotent topical corticosteroid. Daily use
of these creams or ointments can stop itching within a few days and
restore the skin's normal texture and strength after several months.
However, treatment does not reverse the scarring that may have already
Because ultrapotent corticosteroid creams and ointments
are very strong, frequent evaluation by a doctor is necessary to check
the skin for side effects when the medication is used every day. Once
the symptoms are gone and the skin has regained its strength, medication
can be used less frequently, although use must continue indefinitely,
several times a week, to keep vulvar lichen sclerosus in remission.
Prescription in the United States
Young girls may not require lifelong treatment, since
lichen sclerosus can sometimes, but not always, disappear permanently at
puberty. Scarring and changes in skin color, however, may remain even
after the symptoms have disappeared.
Because ultrapotent topical corticosteroids are so
effective, other therapies are rarely prescribed. The previous standard
therapy was testosterone ointment or cream, but this has recently been
proven to produce no more benefit than a placebo (inactive) cream.
Another hormone cream, progesterone, was previously used to treat the
disease, but also has little beneficial effect. Retinoids, or vitamin
A-like medications, may be helpful for patients who cannot tolerate or
are not helped by ultrapotent topical corticosteroids.
Patients who need medication should ask their doctor how
it works, what side effects it might have, and why it is the best
treatment for lichen sclerosus.
For women and girls, surgery to remove the affected skin
is not an acceptable option. Surgery may be useful for scarring, but
only after lichen sclerosus is controlled with medication.
Sometimes, people do not respond to the ultrapotent
topical corticosteroid. Other factors, such as low estrogen levels that
cause vaginal dryness and soreness, a skin infection, or irritation or
allergy to the medication, can keep symptoms from clearing up. Your
doctor may need to treat these factors as well. If you feel that you are
not improving as you would expect, talk to your doctor.
Can People With Lichen Sclerosus
Have Sexual Intercourse?
Women with severe lichen sclerosus may not be able to have
sexual intercourse because of pain or scarring that narrows the entrance
to the vagina. However, proper treatment with an ultrapotent topical
corticosteroid should restore normal sexual ability, unless severe
scarring has already narrowed the vaginal opening. In this case, surgery
may be needed to correct the problem, but only after the disease has
been controlled. (Source: excerpt from Questions and Answers About Lichen Sclerosis: NIAMS)
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