Why does lichen sclerosus cause vulval pain?

Lichen sclerosus affects the skin of the vulva and nearby tissue. Ongoing inflammation makes the area tender, while dryness and small fissures can cause sharp pain or burning. Urine may sting when it touches broken skin. Over time, healing can change the shape and flexibility of the tissue, so walking, tight clothing, wiping, or sexual contact may become uncomfortable. Pain can vary from a surface sting to deeper soreness, and a sudden change should be examined rather than attributed automatically to the condition.

Arrange a clinical review for persistent or unexplained vulval pain. Use any prescribed anti-inflammatory medicine as instructed, protect the skin from friction, and choose loose clothing and unscented products. A bland barrier ointment may help protect against urine or moisture if a clinician recommends it. Do not use antiseptics, fragranced products, or steroid creams borrowed from someone else.

Seek prompt care for a new ulcer, persistent crack, bleeding, lump, colour change, or pain that is worsening. Urgent assessment is appropriate for severe swelling, fever, pus, difficulty passing urine, or pain that prevents normal movement.

Ask whether the pain reflects active inflammation, a skin split, infection, or scarring. Discuss the correct treatment application, protective products, and whether specialist review or follow-up is needed.