The underlying cause of lichen sclerosus is not fully understood. The condition may be due to genetic, hormonal, irritant and/or infectious factors (or a combination of these factors). It is believed to relate to an autoimmune process, in which antibodies mistakenly attack a component of the skin. Other autoimmune conditions are reported to occur more frequently than expected in people with lichen sclerosus. In some cases, lichen sclerosus appears on skin that has been damaged or scarred from previous injury or trauma.

Lichen sclerosus appears:

• Most often in women (usually after menopause).
• Less commonly in men.
• Rarely in children.

Lichen sclerosus is more likely in women, especially after menopause. It is rare in children. You may have inherited an increased risk for lichen sclerosus from your parents.

Usually a doctor will take a small piece of skin and look at it under a microscope to diagnose lichen sclerosus. In more severe cases, doctors can just look at you to diagnose the disease based upon how it has affected your skin.

Strong topical steroid creams or ointments reportedly are very helpful for lichen sclerosus, especially when it affects the genital areas. However, the response to this treatment varies. While itching may be relieved within days, it can take weeks or months for the skin's appearance to return to normal.

Other treatments that may be used instead of steroid creams, or in combination with steroid creams, include calcipotriol cream, topical and systemic retinoids (acitretin), and/or systemic steroids.

If the vaginal opening has narrowed, dilators may be needed. In rare cases, surgery is necessary to allow for sexual intercourse. The condition sometimes causes the vaginal opening to narrow or close again after surgery is initially successful.

Lichen sclerosus is treated by:

• Dermatologists (doctors who treat the skin).
• Gynecologists (doctors who treat the female reproductive system).
• Urologists (doctors who treat the urinary or urogenital tract).
• Primary health care providers.