If you have patches on the arms or upper body, they usually don't need treatment. The lesions go away over time.
Lichen sclerosus of the genital skin should be treated. Even if it isn't painful or itchy, the affected areas can scar. This can cause problems with urination or sex. There is also a very small chance that skin cancer may develop in the affected skin.
Surgery is normally a good option for men. Circumcision (removing the foreskin on the penis) is the most widely used therapy for men with lichen sclerosus. The disease usually does not come back. Surgery is not a good option for women. When the lichen sclerosus lesions are removed from the genitals of women and girls, they usually come back.
Treatment also includes using very strong prescription-strength steroid cream or ointment on the skin. You put these creams on the spots every day for several months. This stops the itching. Then you use the cream or ointment two times a week for a long time to keep the disease from coming back. Treatment does not fix the scarring that may have already occurred.
You need regular followup by a doctor because using these creams and ointments for a long time can cause:
- Thinning and redness of the skin
- Stretch marks where the cream is applied
- Genital yeast infections.
Sometimes, you don't get better when using the steroid creams. Some things that can keep symptoms from clearing up are:
- Allergy to the medication.
When creams and ointments don't work, your doctor may suggest:
- Retinoids, or vitamin A-like drugs
- Tacrolimus ointment
- Ultraviolet light treatments (not used on skin of the genitals).
If you need medicine, ask your doctor:
- How does the medicine work?
- What are its side effects?
- Why is it the best treatment for my lichen sclerosus?
If a young girl gets lichen sclerosis, she usually does not require lifelong treatment. Lichen sclerosus sometimes goes away at puberty. Scarring and changes in skin color may remain.