What should you know about lichen planus and sclerosus?

Lichen planus often produces itchy, flat-topped or purple-toned bumps and may affect the mouth, nails or genital skin. Lichen sclerosus more often causes pale, fragile or wrinkled skin, commonly around the vulva or penis and anus. The conditions can resemble each other, particularly in genital areas, and a clinician may recommend a biopsy when the appearance is unclear. A diagnosis is not made from itch alone: [Itchy Skin](/symptoms/itchy-skin/) and [Skin Bumps](/symptoms/skin-bumps/) have many possible causes.

Book a dermatology or specialised genital-skin assessment if symptoms persist, recur, or affect sex, urination, eating or sleep. Bring a list of products and medicines, and mention any mouth lesions or nail changes. Use bland moisturiser and avoid fragranced washes, scrubbing and tight clothing. Treatment may include a prescribed topical corticosteroid, but the strength, site and schedule matter. General information is available on [Lichen Planus](/conditions/lichen-planus/) and [Topical Corticosteroids](/treatments/medical-dermatology/topical-corticosteroids/). Do not borrow treatment intended for another person.

Seek prompt care for a new ulcer, a thickened or bleeding patch, increasing pain, trouble passing urine, or sores that fail to heal. Urgent assessment is appropriate for severe swelling, fever, rapidly worsening skin breakdown, or difficulty swallowing. Regular follow-up may be advised when genital skin is involved, even if symptoms improve.

Ask which condition best fits the examination, whether a biopsy is useful, how to protect delicate skin, how long to use treatment, and what changes should prompt a review.