Does lichen sclerosus cause vulval pain?

Lichen sclerosus may make the vulval skin sore, burning or tender. Itching can lead to scratching, which creates tiny splits and makes contact with urine, clothing or sanitary products uncomfortable. Pain may also occur during sex when the skin is inflamed or the vaginal opening has become less flexible. Symptoms can affect the skin around the clitoris, labia and entrance to the vagina, while the vagina itself is usually not the main site of the condition.

Vulval pain has other possible causes, including irritation, infection, hormonal changes and other skin conditions. A clinician can examine the area and decide whether testing or a small skin sample is needed.

Arrange an assessment if pain is new, persistent or interfering with walking, sleep, urination or intimacy. Until then, wash gently with lukewarm water or a fragrance-free cleanser, pat dry, and avoid scented products, douching and tight clothing. A plain protective ointment may reduce rubbing. Do not use steroid, antifungal or numbing creams without advice, because the right treatment depends on the cause.

If lichen sclerosus is diagnosed, prescribed anti-inflammatory treatment and regular follow-up can calm inflammation and help protect the skin. Use treatment exactly as directed and mention any continuing pain, tearing or changes in sexual comfort.

Seek prompt medical care for a new ulcer, a lump, bleeding that is not expected, a sore that does not heal, rapidly worsening pain, or difficulty passing urine. These signs need examination and should not be attributed to lichen sclerosus without checking. Arrange routine review even when symptoms improve, because ongoing monitoring helps identify changes early.

Could lichen sclerosus explain the location and pattern of my pain? Do I need an examination, swab or biopsy? What should I apply, how often, and for how long? How can I reduce pain during sex or urination? When should my next review be, and which changes should prompt an earlier visit?