Lichen Planus: A Guide for Patients
What is Lichen Planus?
- Lichen planus is a chronic inflammatory skin condition that can affect the vulva, vagina, and other mucosal surfaces. It causes redness, irritation, sores, and sometimes scarring, leading to discomfort and pain. While its exact cause is unknown, it is believed to be related to an autoimmune response.
Types of Vulvar Lichen Planus
- Erosive Lichen Planus: Painful sores and raw, inflamed skin, often affecting the vulva and vagina.
- Papulosquamous Lichen Planus: Small, purple, scaly bumps on the vulva.
- Hypertrophic Lichen Planus: Thickened, rough skin, which can cause itching and discomfort.
Symptoms of Lichen Planus
- Redness and irritation in the vulvar or vaginal area
- Pain or burning sensation
- Itching (though less common than in other conditions)
- Painful intercourse (dyspareunia)
- Vaginal discharge, which may be yellow or bloody
- Sores or erosions that may take time to heal
- Scarring and narrowing of the vaginal opening in severe cases
Causes and Risk Factors
- Autoimmune reactions: The immune system mistakenly attacks healthy skin and mucosa.
- Genetic predisposition: Family history of autoimmune conditions may increase risk.
- Triggers: Certain medications, infections, or stress may contribute to flare-ups.
Diagnosis
- Physical examination by a gynecologist
- Biopsy (small tissue sample) to confirm the diagnosis
- pH testing and cultures to rule out infections
Treatment Options
- Topical steroid creams to reduce inflammation and discomfort
- Steroid mouthwashes (if oral lichen planus is present)
- Immunosuppressive medications in severe cases
- Moisturizers and barrier creams to protect the skin
- Vaginal dilators or physical therapy if scarring causes narrowing of the vaginal opening
Complications
- Scarring and fusion of vaginal tissues, leading to discomfort
- Painful intercourse and reduced vaginal elasticity
- Increased risk of secondary infections
- Slightly increased risk of vulvar cancer (though rare)
When to See a Doctor
- If you experience persistent vulvar irritation, pain, sores, or unusual discharge, consult a gynecologist. Early diagnosis and treatment can help prevent complications and improve quality of life.
For more information or to schedule an appointment, contact our office today.