By Dr. Brooke Meinema, DPT, FAFS

What is Lichen Sclerosus?

Lichen sclerosus is a rare inflammatory skin condition typically surrounding the anogenital area which can cause the tissue to become thin and frail increasing the risk of tearing and scarring. Visually, the skin becomes thinner, whitened, and wrinkled. This can create discomfort throughout the pelvic region. While it is significantly more common in females, this can also develop in those with male anatomy (typically those who are uncircumcised commonly affecting the foreskin and head of the penis). While some may not have symptoms, others may be prone to symptoms such as:

• Itching
• Burning
• Development of sores/blisters
• Fragile skin (increased risk of bruising and tearing)
• Pain with intercourse
• Changes with urination

Treatments for Lichen Sclerosus

People who are diagnosed with lichen sclerosus are encouraged to monitor their skin and regularly attend doctor’s visits to prevent the condition from progressing. Their providers may prescribe topical creams (often-times steroids and moisturizers) to prevent worsening skin breakdown. You may be encouraged to see a dermatologist to keep the skin healthy. A pelvic health physical therapist may also be able to help keep the tissue flexible, prevent scar tissue and adhesions, reduce secondary muscle pain in surrounding tissue, as well as reduce pain with activities such as intercourse.

What can you do on your own?

First and foremost, good vulvar or penile hygiene is very important (soaps without scents or dyes, no forceful scrubbing, using non-agitating lubricants, etc). Preventing irritation to the tissue can help reduce some issues with tearing, burning, and itching. Females experiencing lichen sclerosus may also benefit from the use of dilators and pelvic wands to keep pelvic floor muscle tension at bay. If you experience discomfort using a dilator (or with insertion of any kind), be mindful that “pushing through the pain” can actually create more issues leading to further discomfort. Our brains are very good and protecting our bodies, so pushing through pain can make our brains sense something is wrong and create muscle spasms. The more we push through pain, the more our body wants to lock things down to protect us. Finding a good lubricant can help reduce some of this discomfort experienced with insertion. Keeping pelvic muscles flexible and reducing tension gently can also be a good place to start.

If you are having a hard time creating a routine for yourself to reduce your symptoms, talk to your provider or see a pelvic health physical therapist!