When to worry about vulval pain with lichen sclerosus

Lichen sclerosus can make vulval skin fragile, itchy and easily irritated. Dryness, small cracks, scratching and friction can cause soreness or pain during urination or sex. Pain that changes suddenly may signal a flare, infection, or a separate problem. A persistent ulcer, non-healing area, or firm thickened patch should be examined because visual changes can be difficult to judge at home.

Use the treatment prescribed for lichen sclerosus as directed and attend planned reviews, even when symptoms improve. Wash gently with water or a fragrance-free product, pat dry, and avoid perfumed washes, harsh scrubbing and tight clothing. A plain protective ointment may reduce friction if a clinician or pharmacist confirms it suits you. Avoid scratching and pause painful sex until the skin has settled.

Arrange prompt review for a new lump, persistent ulcer or crack, unexplained bleeding, a patch that becomes thicker or changes colour, or pain that does not improve with your prescribed plan. Seek earlier care for pus, spreading redness, fever, or rapidly worsening soreness. Do not wait for a routine appointment if you cannot pass urine or feel acutely unwell.

Ask whether the pain reflects a flare or another condition, whether your treatment technique is correct, whether the changed area needs sampling, how often follow-up is needed, and which skin changes should be reported without delay.