If you have unbearable intimate itching, you might have Lichen Sclerosus. This uncommon skin condition is usually a "girl thing," though men and children can get it too.

Lichen sclerosus (LS) causes delicate skin in the genital area to become thin, whitened, wrinkled, and sometimes, unbearably itchy, primarily in postmenopausal women. Estimates vary as to how many people have LS, but it may be as many as 1 in 30 postmenopausal women and between 1 in 300 to 1 in 1000 in the general population.  It can crop up anywhere on the body, but lichen sclerosus appears most frequently on the vulva, labia, clitoris and around the anus.  Uncircumcised men get LS on their foreskin and circumcised men, on the head of their penis. Approximately 15 to 20 percent of affected people develop LS on other skin surfaces too, like their legs, breasts, arms, neck, and mouth.  

It's not clear what causes Lichen Sclerosus, but it isn't contagious and isn't caused by a specific bacteria, virus, or organism. Researchers believe some people have a genetic predisposition to developing LS, especially after they've had some other type of infection, injury, or trauma. Since most LS patients are postmenopausal women, researchers believe there may be a hormonal component. People with LS are at greater risk for developing autoimmune disorders like thyroid disease, anemia, and diabetes so scientists are studying whether the immune system might also be responsible for triggering it.

Many people with LS have no symptoms at all. Some have just the telltale scaly, white patches. Others feel itchy or a dull, painful discomfort. When they scratch or rub the area to relieve the itch, the skin is so fragile it causes abrasions, blisters, skin cracks, bleeding, bruising, and eventually scarring. In severe cases, scarring disfigures the affected area and affects function.  Some patients say the itch is most severe at night and interferes with sleep. Sex can be uncomfortable and if left untreated, eventually becomes impossible because omen who've had repeated cracks and abrasions may develop scarring that narrows the vaginal opening.  Men may experience scarring on their penis and tightening of their foreskin.

LS does not cause skin cancer, but women who have had it are at greater risk for developing skin cancer on their genitals. Women with LS affecting the vulva are at increased risk for developing squamous cell skin cancer in that area.  LS outside the genital area does not appear to increase cancer risk.

When there are no symptoms, LS doesn't require treatment and frequently goes away on its own. If it feels itchy or painful, however, medical treatment is necessary to relieve symptoms and reduce chances for scarring, disfiguring, and dysfunction.

Family physicians, dermatologists, gynecologist,s and urologists are the best doctors to consult. LS is diagnosed by physical exam and/ or biopsy, where a tiny piece of affected skin is examined under the microscope. 

LS is usually treated with corticosteroid ointments applied daily for several weeks then several times per week for months. This eliminates itching immediately and allows skin to heal. Occasionally, doctors also prescribe hormone replacement therapy (estrogen) to prevent vaginal/labial skin from becoming thinner. Ultraviolet light treatments are sometimes used in non-genital areas. 

Uncircumcised men whose LS does not respond to corticosteroids are advised to have their foreskin removed (circumcision) to prevent recurrence, scarring, disfigurement, and pain with intercourse.

 

 

Sources:

National Institute of Arthritis, Musculoskeletal and Skin Diseases
Lichen Sclerosus
http://www.niams.nih.gov/Health_Info/Lichen_Sclerosus/default.asp