Lichen sclerosus

  • Lichen sclerosus (like-en scluh-ro-sus) is an uncommon skin condition that causes a distinctive rash, and usually affects the genital skin around the vulva (external female genital area) and anus. It most often looks like white patches on the skin. It can last for years and in some cases, cause permanent scarring of the affected area.

    While lichen sclerosus can affect females and males of any age, it is most common in females, and it usually occurs before puberty or around menopause. 

    If your child has lichen sclerosus, they should avoid using soap, talcum powder, antiseptics and non-prescription creams. The most effective treatment is strong steroid ointment.

    Signs and symptoms of lichen sclerosus

    Lichen sclerosus can occur anywhere on the body, but it usually affects the genital skin around the vulva and anus. It does not affect the inside of the vagina. The general health of a person with lichen sclerosus remains normal. 

    The most common symptoms include:

    • itchiness
    • constipation (due to painful cracks in the skin around the anus)
    • pain when urinating
    • small tears in the skin, which may bleed
    • red and inflamed skin at the beginning, that later looks like white, shiny, wrinkled or thickened patches.

    In males, lichen sclerosus can cause the foreskin of the penis to become tight and difficult to draw back. In some cases, a circumcision is required.

    What causes lichen sclerosus?

    The cause of lichen sclerosus is thought to be an autoimmune disease, although the trigger is unknown. It is not an infection, and it is not contagious (cannot be spread from one person to another).

    There may be a family history of lichen sclerosus or other types of autoimmune disease (where the immune system mistakenly attacks part of its own body), for example, vitiligo (loss of skin pigment), alopecia (loss of scalp or body hair), diabetes, psoriasis or pernicious anaemia. 

    In adult women, lichen sclerosus may be associated with thyroid gland problems and other autoimmune conditions.

    When to see a doctor

    If your child shows signs of lichen sclerosus, see your GP. Lichen sclerosus in children can usually be diagnosed by inspection alone. Sometimes a biopsy (small sample of the affected skin) may be taken to confirm the diagnosis.

    Left unrtreated, lichen sclerosus found on or near the vulva may cause the labia to shrink and the opening to the vagina may become narrow and tight. 

    Treatment for lichen sclerosus

    Your doctor may prescribe steroid ointment, which is the most effective treatment for lichen sclerosus. The ointment should be used once a day initially, usually at night and should only be applied to the affected area. Over time it may be used less often, depending on symptoms. Continued use once or twice per week may be needed for the long term. 

    If the lichen sclerosus causes scarring, surgery may be required. Photographs can help in monitoring activity and treatment.

    Care at home

    Because genital skin is very delicate, it is important to protect it, especially when lichen sclerosus is present. If your child has lichen sclerosus, they should stop using the following items, if they cause irritation:

    • soaps and bubble baths
    • vaginal wash products
    • talcum powder
    • antiseptics or non-prescription creams from the chemist or supermarket

    Alternatives for washing include:

    • soap free wash products 
    • salt-water baths (add two teaspoons of salt per one litre of water).

    If certain activities or clothing worsen your child’s symptoms, they should be avoided. Examples include tight clothing, and activities such as bike riding and horse riding. It is also recommended to apply moisturiser to relieve any dryness or itchiness that your child may experience. 

    Current research suggests that lichen sclerosus around the anal and genital area can get better naturally, before or around the time your child starts having periods. However, the condition can continue past this time in some cases, or it can also be latent (sleeping) and start again at an older age.


    Once the condition is controlled, either by the use of steroid ointment or naturally, it is important to have an annual check-up with your GP, dermatologist or gynaecologist who has experience with this condition. Changes in the vulva architecture, such as shrinking of the labia and narrowing of the vaginal opening can happen without other symptoms. Furthermore, very rarely, a skin cancer can develop when there has been long-standing chronic inflammation of the skin.

    Key points to remember

    • Lichen sclerosus is an uncommon skin condition. It is not contagious and usually affects females.
    • Lichen sclerosus usually affects genital skin around the vulva and anus.
    • Avoid soaps, talcum powder, antiseptics and non-prescription creams.
    • The most successful treatment is steroid ointment, and current research also suggests it usually gets better naturally.
    • An annual check-up is important once the condition has cleared.

    For more information

    Common questions our doctors are asked

    What can I do to relieve the itch in the genital area caused by lichen sclerosus? 

    Steroid ointments are the most common treatment for lichen sclerosus and treating the lesions will reduce the itch. Symptom relief can also be achieved with salt-water baths and barrier creams/ointments. 

    How high is the risk of skin cancer after having lichen sclerosus? 

    Studies have shown that skin that has been affected by lichen sclerosus is slightly more likely to develop skin cancer, later in life. That is why it is important to have a checkup each year, so the doctor can monitor any changes to the skin. The risk of cancer is higher in adults with lichen sclerosus, compared to children with the condition. 

    Developed by The Royal Children's Hospital Dermatology department. We acknowledge the input of RCH consumers and carers.

    Reviewed February 2023.


This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.