Lichen sclerosus is a long-term inflammatory skin condition that most often affects the vulva and the skin around the anus. It is not an infection, it is not caused by poor hygiene, and it cannot be passed to a partner. It can be treated, and it needs to be followed up.
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Lichen sclerosus (LS) makes the skin thin, white and fragile. It can start at any age but is most common in women after menopause, and it also occurs in girls before puberty. The cause is not fully understood; it is associated with autoimmune conditions such as thyroid disease.
It is often mistaken for thrush or for dryness after menopause, which is why many women use antifungal creams for months before it is diagnosed.
Itching, often worse at night, is the most common symptom. Soreness, burning, skin that splits or bruises easily, and pain during sex are also common. Some women have no symptoms and it is found during an examination.
The skin may look white, shiny or crinkled. Over time, untreated inflammation can cause scarring: the inner labia can shrink or fuse, the hood can close over the clitoris, and the vaginal entrance can narrow.
It is usually diagnosed by examining the skin. A small biopsy, taken under local anaesthetic, is advised when the appearance is not typical, when treatment has not helped, or when an area looks different from the rest.
Other skin conditions, infections and thinning after menopause can look similar, and they are treated differently.
The first-line treatment in guidelines is a strong (potent) topical steroid ointment prescribed by the doctor, used daily at first and then less often.
It does not cure LS, which is long-term, and many women continue a maintenance routine to keep the inflammation quiet. Using a soap substitute and a plain moisturiser instead of soap, wipes or scented products is part of the treatment.
How much ointment to use, how often and for how long is set by the doctor and reviewed at follow-up.
Women with vulval lichen sclerosus have a small increased risk of a type of vulval skin cancer (squamous cell carcinoma). Keeping the inflammation controlled and having the skin checked regularly is how this is watched for.
See a doctor promptly for a new lump, a sore or ulcer that does not heal, a thickened area, or bleeding from the vulval skin.
Laser (including MonaLisa Touch), radiofrequency treatment and PRP (platelet-rich plasma) have been studied for lichen sclerosus. The studies are small, their results vary, and none of these replaces the steroid ointment.
They may be considered in selected cases, after diagnosis and alongside first-line treatment — for example when symptoms continue despite correct use of the ointment. Whether one is appropriate is decided after assessment, and no result is promised.
Surgery does not treat lichen sclerosus itself. It may be considered for problems caused by scarring — such as a narrowed vaginal entrance or a hood that has fused over the clitoris — once the inflammation is controlled.
Operations are performed at our partner hospitals, Praram 9 Hospital and Vimut Hospital, not at the clinic.
Care is provided by the clinic's urogynecologists. Female specialists are available — say so when you book. Consultations are conducted in English or Thai.
No. It is not an infection and cannot be passed to a partner.
No. It is an inflammatory skin condition. It carries a small increased risk of vulval skin cancer, which is why follow-up and prompt checking of any new lump or sore matter.
It is a long-term condition. Treatment aims to control the symptoms and the inflammation and to prevent scarring, and many women continue a maintenance routine.
No, although the two can occur together and feel similar. They are treated differently, which is why an examination comes first.
A potent steroid ointment, used as prescribed and reviewed at follow-up, is the standard long-term treatment for vulval lichen sclerosus. The amount and how often it is used are set and adjusted by the doctor.
Message us with what you are noticing. We will tell you whether an examination is worth making and what it involves.
This page is general information to aid understanding. It is not a diagnosis or individual treatment advice. Which option is appropriate is decided individually after examination, and results differ between individuals. Surgery is performed at a partner hospital, not at the clinic. Consultations are conducted in English or Thai. THE FIT CLINIC, 8th Floor, EM Tower, EMSPHERE, 628 Sukhumvit Road, Bangkok 10110. Open daily 10:00–19:00.