What happens if lichen sclerosus is not treated?

Lichen sclerosus commonly affects the skin around the vulva and anus. Persistent inflammation can cause intense itching, soreness, small cracks and pain with touch or sex. Scratching and friction may worsen skin injury. Healing can leave scars that alter the shape of the vulva, cover the clitoris, or narrow the vaginal opening, making urination, washing or penetration difficult.

The condition can also cause white patches or other vulval skin changes. Most changes are inflammatory, but a new lump, persistent sore, ulcer, thickened area or change that does not settle needs examination because lichen sclerosus is linked with a higher risk of vulval skin cancer.

Arrange a clinical examination if you have ongoing vulval itching, pain, white patches, cracks or altered skin texture. Use gentle washing, avoid fragranced products and reduce rubbing from tight clothing. Prescribed topical corticosteroids or topical steroid treatment for vulval skin are commonly used to calm inflammation; follow the exact schedule and attend recommended follow-up. Do not stop or restart treatment based only on how the skin looks on one day.

Seek prompt review for a new lump, ulcer, bleeding spot, thickened patch, persistent open area or a sore that changes. Get urgent help for severe pain with inability to pass urine, rapidly spreading redness, fever or heavy bleeding. These findings require assessment and may not be explained by lichen sclerosus alone.

Ask whether the diagnosis is clear, where to apply treatment, how to protect the skin during flares, and how often your vulval skin should be checked. Ask what specific changes should lead you to return sooner.