Vulvar Lichen Sclerosus: an Uncommon But Serious Issue

When women experience pain and itching on their genitals, a rare skin condition is the furthest thing from their minds. But postmenopausal women should be aware of the signs and risks of an uncommon skin condition whose initial symptoms can be easily confused with many more common vaginal and vulvar health issues.

Vulvar lichen sclerosus is an uncommon, chronic skin condition that creates white patches of thinning skin that can easily bruise, tear and scar. It is typically seen in postmenopausal women over age 50 and is most likely to affect the vulva and anus. Even with treatment, it can last for years and cause permanent scarring and other complications.

Some people have no symptoms, while others may experience itchiness, burning, discomfort, blistering and in severe cases scarring that can affect bodily functions. However, despite causing discomfort or pain during sex, vulvar lichen sclerosus isn't contagious and cannot be spread through sexual intercourse.

Signs and symptoms of vulvar lichen sclerosus affect the genital and anal areas including the vulva, labia, clitoris, perineal area and the perirectal area. Women may also see patches on the skin of the upper body, upper arms and breasts.

Signs of vulvar lichen sclerosus include:

  • Smooth white patches on vulvar skin
  • Blotchy, wrinkled patches on vulvar skin
  • Spots that grow into larger patches
  • Painful sex
  • Redness
  • Blistering or ulcerated sores
  • Itching
  • Pain
  • Skin that easily tears and bruises
  • Skin that easily becomes scarred

Women with mild vulvar lichen sclerosus may have no signs or symptoms.

Associated Risks

Complications of vulvar lichen sclerosus include painful sex, urinary retention and constipation. While lichen sclerosus does not cause skin cancer, the scarring that occurs may leave its sufferers at a higher risk for cancers such as squamous cell carcinoma. It’s important to have your doctor monitor your vulvar lichen sclerosus, so they can detect any changes that may indicate a worsening of your condition or cancer risk. 


The cause of lichen sclerosus is not fully understood. It may be an autoimmune process, in which antibodies mistakenly attack areas of the skin. This is thought to be the case because other autoimmune conditions occur more frequently in people who have lichen sclerosus. Researchers also believe this unusual condition could be tied to genetic factors, hormonal imbalances or damage related to injured skin, trauma and scarring or any combination of these factors.

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Diagnosis and Treatment

Treatment for vulvar lichen sclerosus typically begins with topical steroids or other types of topical creams. Creams may provide immediate relief from itching and irritation, but it can take a long course of treatment for the skin to return to normal. Depending on the severity of the case, physicians may also recommend calcipotriol cream, topical and systemic retinoids, or systemic steroids.

Lichen sclerosus is one area where Coyle Institute is leading research and treatment using the new TULIP® procedure. The TULIP® is a procedure invented by Dr. Coyle and is a continuation of his original research on Lichen Sclerosus combined with the healing benefits of Platelet Rich Plasma or PRP.

With just one TULIP® treatment, women can be relieved of all signs and symptoms of lichen sclerosus. Dr. Coyle has invented this single-treatment protocol to make treatment easier for every woman, but especially to make treatment more accessible to medical travel patients from around the world who can only make one trip to the U.S.

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This patient drove 500 miles to Coyle Institute as a referral from her GYN. She has had severe Lichen Sclerosus for over 7 years and has been using clobetasol steroid cream for over 7 years. Her before picture shows almost a complete closure of her vaginal opening. Her vaginal opening was only the size of a pencil eraser. The black spot is her biopsy site. She was seen on Monday and we did the biopsy. She was then taken to the operating room on Tuesday to separate all of her adhesions and had the TULIP® (patent pending) on Wednesday. When she came in for her 3-month visit she was not having any symptoms of Lichen Sclerous. She started having intercourse with her husband that she has not had in over 7 years. In addition, she is a diabetic. The entire time she was on the steroid cream she was unable to get her Hemoglobin A1C under 7. Since the TULIP® (patent pending) she has been off her steroids, has had to decrease her insulin and she was so happy to report that her Hemoglobin A1C was 6.5. She was extremely happy and thank us for restoring her life.

Before & After

Before & After

Before & After


Before & After

For lichen sclerosus treatment, Dr. Coyle recommends a three-day stay in Pensacola, beginning on either Monday or Wednesday. On the first day, patients have a full exam and evaluation and a biopsy, if needed. Within 24 hours, Dr. Coyle then has the information he needs to customize treatment using the unique adjustable depth features of the ProFractional™ laser. On the third day, the patient is treated and is then cleared to return home.

Dr. Coyle’s patients have reported 100 percent recovery from all lichen sclerosus symptoms following a single TULIP® procedure, including new, healed vulvar skin and tissues. These women can then return to pain-free lives and resume their intimate relationships.

Even if they aren’t painful or itchy, patches on the genital skin should be treated to prevent scarring, which can interfere with normal urination and with sexual intercourse. In cases where deep scarring has already occurred, surgery may be necessary to allow for normal urination and sexual intercourse.

The condition does tend to recur, so long-term follow-up care may be needed. However, lichen sclerosus on the upper body and arms may disappear over time without treatment. Although lichen sclerosus is an uncommon issue, our team at Coyle Institute has experience in successfully treating and managing its symptoms. With vigilance and care, women can get relief from the painful and potentially dangerous symptoms of lichen sclerosus and return to a healthier, happier life.

If you suspect you have lichen sclerosus, early treatment is urgent to help prevent scarring and its associated risks. Call our compassionate, expert team today and schedule your consultation.