Genital Itchiness: What You Need to Know About Lichen Sclerosus

It's probably not something you want to talk about, but have you been itching "down below" lately? Does it get worse at night? Do you sometimes feel a burning sensation? You could have a condition called "lichen sclerosus," or LS.

Lichen sclerosus is a dermatological condition that primarily affects the genital area. Most cases occur in postmenopausal women, but about 7 percent to 14 percent occur in girls who have not yet started menstruating. However, LS can also occur in men (typically on the tip of the penis) and even, rarely, in very young children.

Lichen sclerosus involves the vulva (the external part of the female genitalia) or the perianal area, around your anus. In rare instances, it can also appear on the clitoris or labial folds. Lesions may also appear on your back, chest, neck, armpits, forearms, collarbones, breasts and legs.

When they first appear, the skin lesions are small, white, shiny and smooth. Over time, however, they grow larger, causing cracking and abrasions on the skin. They eventually thin the skin, leaving it crinkly and at risk of tearing and infection.

In very severe cases the lesions produce scarring of the vulva, with narrowing of the opening of the vagina and covering of the clitoris with the shrinking and disappearance of the clitoral lips. It can prevent women (or men) from having sexual intercourse, due to pain or scarring, and can affect urination. Skin scarred by LS is more likely to develop skin cancer than non-scarred skin, although the lesions themselves don't increase the risk of skin cancer.