Lichen sclerosus (LS)
Lichen sclerosus (LS) is a non-cancerous skin condition. We have information about diagnosis and treatment.
What is lichen sclerosus (LS)?
Lichen sclerosus is a skin condition. LS can affect the skin anywhere on the body. But the most common areas include the:
- vulva – the 2 pairs of skin folds called lips at the opening of the vagina
- penis – most commonly on the foreskin or the tip of the penis
- skin around the anus.
When it affects these areas, it is called anogenital lichen sclerosus.
Rarely, LS can also affect skin in other areas of the body where there may be pressure or rubbing. For example, this may be areas of skin under straps, belts or under the breasts.
Is LS cancer?
LS is not cancer. But over a long time without treatment, the inflammation caused by some types of LS might slightly increase the risk of cancer. This includes LS affecting the vulva, penis and anus. For most people with LS that is under control, this is not a risk.
Symptoms of LS
The symptoms of LS vary from person to person. It may depend on which area is affected. Sometimes, it causes no symptoms and is discovered during tests for other health problems. The affected area of the skin may:
- be very itchy and sore, which may be worse at night
- change colour, becoming paler than usual – it may also develop white patches
- develop small areas of bruising that look like blood blisters
- be more fragile than normal skin and develop small tears.
Other symptoms
LS can sometimes cause difficulty passing urine (peeing). If this happens, tell your doctor. They may refer you to a specialist called a urologist or urogynaecologist. This is a doctor who treats problems with the kidneys, bladder and reproductive system.
In untreated vulval LS, the skin of the vulva may scar and stick together over time. This can cause the opening of the vagina to narrow. This can make having sex or an internal examination painful and difficult. It can also cause shrinkage of the vulva and changes to the clitoris.
LS affecting the penis can also cause pain during sex. This can be caused by a tightened foreskin.
Many people find it embarrassing talking about symptoms like these. But it is always important to get them checked by your GP.
Causes and risk factors of LS
The causes of LS are not known. It can happen at any age.
It is not possible to get LS through sexual contact. It is not a sexually transmitted disease and is not infectious. LS is also not caused by hormonal problems or an allergic reaction.
Sometimes LS runs in families. It is possible that it may be caused by an inherited altered gene. But there is not enough information about this yet.
Some people with LS also have another condition, such as:
- thyroid problems
- alopecia areata – this is hair loss that is usually patchy
- pernicious anaemia – this is when the immune system attacks healthy cells in the stomach, changing how vitamin B12 is absorbed, which can affect your red blood cells
- type 1 diabetes.
Although these conditions can occur together, one disease does not cause the other.
Diagnosing LS
If you have symptoms, you usually start by meeting with your GP. If needed, they will refer you to a dermatologist. This is a doctor who specialises in skin conditions. If LS is affecting the vulva, you may meet with a gynaecologist – a doctor who treats problems with the female reproductive system.
The main test for LS is an examination of the area. The specialist doctor may diagnose LS from how it looks. They may also do a simple procedure to collect a skin sample of any areas that look abnormal. This is called a biopsy.
Your doctor uses a local anaesthetic to numb the area before taking a sample. You can usually have this as an outpatient. It takes about 15 minutes.
It may take 3 to 4 weeks for the results of your biopsy to be ready. Waiting for your results can be difficult. It may help to talk to a relative or close friend.
Related pages
Treating LS
The aim of treatment for LS is to control the condition and any symptoms you have. This reduces the risk of long term problems. For example, this may include scarring or narrowing of the urethra – this is the tube you pass urine through.
Treatment can also reduce the risk of cancer developing.
Steroid ointment
LS is usually treated with a strong steroid ointment that you put on the affected area. Often a steroid called clobetasol propionate (Dermovate® or ClobaDerm®) is used.
Your specialist doctor or nurse will tell you how to use it correctly. This will include how much to use, and which areas to apply it to. The information leaflet with the steroid may warn against using it on the genital area. But this treatment is safe when prescribed by your specialist doctor.
You may need to keep using the ointment to control the LS. People sometimes worry about the side effects of using a steroid on the skin. When they are used correctly, steroid ointments rarely cause any serious side effects and can control LS well. They can also prevent further damage to skin. Your doctor can answer any questions you have.
Surgery
Surgery is rarely used to treat LS. It may be used to improve problems such as difficulty passing urine or a narrowed vaginal opening.
Surgery is more often used with LS where it has caused tightening of the foreskin of the penis. The surgeon may suggest having surgery to remove the foreskin. This is called a circumcision.
Your doctor can give you more information about surgery for LS.
Skin care advice
Your doctor will also give you advice about things you can do to improve your symptoms. This may include the following:
- Avoid using soap, perfumed products, talcum powder or wet wipes on the affected area.
- Avoid scented toilet roll.
- Wash with a moisturising non-soap substitute.
- Wash your hair over the sink or bath to protect the area from shampoo.
- Avoid hot baths – showering is better, where possible.
- Wear loose-fitting cotton underwear or no underwear.
- Try to avoid scratching the area.
- If you use a sanitary towel, use a non-perfumed type and change it regularly.
- Use a moisturising cream or oil on the skin to reduce dryness and itching.
- Use a lubricant to protect the skin during penetrative sex.
Ask your doctor or nurse about products to avoid and products that may be helpful. You may find you are sensitive to some creams or lubricants but others work well for you. Some products may be available on prescription.
If LS has caused narrowing of the vagina, your doctor or nurse may suggest trying vaginal dilators to help. We have more information about these in our information about sex and cancer.
If you are having problems with leaking urine or stool (incontinence), tell your doctor or nurse. They can give you advice and support to help manage this. It is important to keep the affected area of LS clean.
Follow-up for LS
LS is a long term condition that cannot be cured. It is usually possible to control the symptoms, which prevents further damage to the skin.
You will normally have follow-up appointments until the LS is well controlled. Your specialist nurse will give you more information.
A very small number of people with LS may go on to develop cancer. The type of cancer depends on where the LS is.
This is not common. But talk to your specialist doctor as soon as possible if you notice:
- a sudden change in your symptoms
- any ulcers or lumps
- thickened areas of skin that do not improve with topical steroids
- bleeding
- pain in the area getting worse.
Do not wait until your next appointment.
Related pages
Your feelings
It can be difficult to know who to talk to, or how to start a conversation about living with this skin condition. But for many people, talking about it is an important way of coping.
You may find it helpful to talk to family or friends. Or you may prefer help from someone you are not close to, such as a counsellor. There is no right or wrong way to cope, but help is available if you need it.
Further information and support
You may find the following organisations helpful:
- British Association of Dermatologists (BAD)
- Lichen Sclerosus and Vulval Cancer UK Awareness
- Lichen Sclerosus Support Network
- Lichen Sclerosus Guide
- The British Society for the Study of Vulval Disease – offers patient information and useful links to information about vulval conditions.
Macmillan Cancer Support is also here to support you. If you would like to talk, you can:
- call the Macmillan Support Line on 0808 808 00 00
- chat to our specialists online.
Other vulval skin conditions
There are other conditions that can affect the skin of the vulva. We have more information about:
- lichen planus (LP)
- vulval intraepithelial neoplasia (VIN) – this is also called vulval HSIL.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
-
References
Below is a sample of the sources used in our vulval cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Morrison J, Baldwin P, Hanna L, Andreou A, Buckley L, Durrant L, et al. British Gynaecological Cancer Society (BGCS) vulval cancer guidelines: An update on recommendations for practice 2023. European Journal of Obstetrics and Gynaecology and Reproductive Biology. 2024;292: 210–238. Available from: www.doi.org/10.1016/j.ejogrb.2023.11.013 [accessed July 2026].
The Royal College of Radiographers. The Royal College of Radiologists expert panel recommendations for radiotherapy treatment for vulval cancer. 2024. Available from: www.rcr.ac.uk/media/l1zjohkm/rcr-vulval-cancer-treatment-recommendations.pdf [accessed July 2026]
Date reviewed
Our cancer information meets the PIF TICK quality mark.
This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.