Skin Articles

What can I wash and moisturise with for LS?

Lichen sclerosus can be made worse by anything that irritates the skin so the general advice is to avoid soaps and shower gels that are detergent-based. If a little of the detergent is left on the skin it can aggravate the problem. My advice is to use a non-perfumed and simple moisturiser instead of soap in the bath or shower - think slimy rather than foamy. Rinse this off well then apply a rich barrier emollient such as Vaseline, Hydromol, Epaderm or 50:50 ointment.

Are lichen sclerosus & urinary problems linked?

Both urinary problems and LS are more common in post-menopausal women and there is no doubt that urinary incontinence and excessive wearing of pads can aggravate LS and cause patients to go into remission. If you are experiencing incontinence you should check for diabetes and ensure weight loss, if your symptoms persist then it would be appropriate to be referred to a uro-gynaecologist for further investigation.

Is there a link between diet/hormones &lichen sclerosus?

As LS can occur in people of all ages, there is not a simple answer to your question regarding hormones and there has been no research that’s found a clear link between the two. Likewise, diet hasn't been shown to influence the presentation or severity of LS. Lack of funding for research is one of the reasons why we haven't looked into these areas more, collaboration between clinicians and patients is continuing to try to formulate such questions.

What is the best practice for diagnosing LS? Should biopsies always be done instead of relying on clinical examination? 

When I first started doing vulval clinics (last century) we thought that every patient should have a biopsy. That was a long time ago and we've come to realise that a biopsy is not necessary if a sound clinical diagnosis can be made. I now reserve biopsies for patients who fail to respond to treatment or are showing signs of other potential diagnoses, like cancer. If a biopsy is taken, a full clinical examination has to take place as well, this allows the pathologist testing it to write a clear report that helps the clinician and patient to move forward.

I have been advised that steroids can be applied twice weekly on either consecutive or non-consecutive days. Is this correct?

First and foremost, I advise the application of emollients twice a day. They keep the acidity and water level of the skin in the normal range. Topical steroids can then be used twice a week to maintain and prevent remission. Steroids gently remind the white blood cells in the skin that trigger LS (lymphocytes) to stop damaging the basal layer of the skin. It's this damage that causes flare-ups. 

Can LS spread to other areas of the body like the Inner thigh and anus? Can you use the same ointments in these areas?

LS can spread to other areas such as the anus and perineum (the area between the anus and the genitals). Spreading to the inner thighs is less common but can happen. If you are using potent steroids on your thighs you should know that, if applied for a long period, they can cause skin thinning. I would suggest getting your GP to examine you again so you can discuss exactly where you need to apply your cream and for how long. 

Do genetics have anything to do with lichen sclerosus?

There is almost certainly a genetic component to the likelihood of being affected by lichen sclerosus. At present no specific gene has been identified that can be tested to know if someone has an increased risk of developing it though. It’s thought that there is a genetic link because LS often develops in more than one family member and it’s more common in families who have existing immune disorders. Saying that some people can develop LS when no one else in their family has it! 

Last year, Clare Baumhauer, a LS and vulval cancer campaigner, hosted a talkhealth webinar. In the interview, she shares her own experience with the condition and how she came to terms with the diagnosis of both LS and cancer. If you want to learn more about the condition, watch the video now! 

If you need more advice for managing lichen sclerosus, you can still visit the clinic here!