What are the treatment options for lichen sclerosus?

Lichen sclerosus can cause itching, soreness, fragile pale skin and splits around the vulva or anus. Ongoing inflammation may lead to scarring and changes in vulval tissue. Treatment calms inflammation, reduces symptoms and helps prevent further skin change; it does not replace examination when a new area looks different. The condition may need continuing care even when symptoms settle.

A clinician may prescribe a strong topical corticosteroid with a schedule that starts more frequently and then becomes less frequent. Apply it only as directed to diagnosed areas, using the amount and technique shown. Avoid fragranced washes, harsh soaps, scrubbing and tight clothing; use a bland emollient or barrier product if advised. Topical steroid treatment for vulval skin can be tailored to the skin and symptoms. Follow-up checks assess response and look for scarring or a persistent thickened area.

Contact a clinician if treatment is not controlling itching, cracks, pain or soreness, or if application causes a concerning reaction. Arrange prompt review for a persistent ulcer, lump, thickened patch, bleeding or a sore that does not heal. Seek urgent help for heavy bleeding, severe pain, fever or rapidly spreading redness.

Ask where to apply the steroid, how much to use, when to step down, and what moisturiser or cleanser is suitable. Discuss sexual discomfort, scarring, follow-up timing and whether a biopsy is needed for a persistent change.