Lichen planus

Lichen planus (said ‘like-en plain-us’) is an inflammatory condition that can cause bumps on your skin and/or sores in moist areas like your mouth and vagina and around your vulva.

It is often painful and sometimes itchy. If it is not treated, lichen planus can cause permanent scarring and possibly cancer.

For most women it is a lifelong condition.

What are the signs of vulvar lichen planus?

Symptoms include:

  • reddish brown patches on the inner part of the vulva
  • pain or burning around the vulva and/or vagina
  • itchiness in the vulvar area.

In severe cases, lichen planus can cause scarring which changes the structure of your vagina and vulva. The labia minora may appear flattened, the clitoris can become buried under its hood, the opening of the vagina may shrink or the sides of the vagina may fuse together.

What causes lichen planus?

It appears that lichen planus may be an auto-immune disorder, where your immune system becomes confused and attacks your skin instead of protecting it.

How is lichen planus diagnosed?

Your doctor can diagnose lichen planus by looking at your vulva. Sometimes they might take a small sample of the vulvar skin (called a biopsy) and send it away to a laboratory for testing.

Lichen planus can sometimes be mistaken for other skin conditions (such as lichen sclerosus) so you might want to see a skin specialist (a dermatologist) or women’s health specialist (a gynaecologist).

How is lichen planus treated?

Unfortunately there is no cure or way to get rid of lichen planus completely. There are ways though to reduce or lessen the symptoms so that you can live comfortably with it.

  • Cortisone cream applied to the vulva and vagina can provide relief and stop lichen planus from getting worse. Strong cortisone is safe to use on inflamed skin and will not cause the skin of your vulva to thin.
  • Medications such as prednisolone or methotrexate may also help. These come in a tablet form.
  • Surgery to remove any cancerous or pre-cancerous skin. Surgery can also remove scarring or adhesions that cover the entrance to your vagina if these are affecting your ability to have or enjoy penetrative sex.

You will also need to have regular checkups with your doctor to monitor your lichen planus. Let them know if you notice any new changes to your vulva and vagina.

Can I have sex if I have lichen planus?

It is safe to have sex. You can’t give someone lichen planus because it’s not a sexually transmitted infection or contagious.

You might find sex painful however, because scarring can make the vulvar skin (and vaginal opening) tight and more likely to split.

Talk to your doctor or a sexual counsellor if sex is painful or you are anxious about trying it again. Dilators that help to open the vagina and exercises that relax the surrounding muscles may help.

Things to remember

  • Lichen planus can affect the vulva and vagina.
  • There are treatments that can help you successfully manage the symptoms.
  • Lichen planus is not contagious and it is okay to have sex.

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Disclaimer

The Women’s does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided on the Website or incorporated into it by reference. The Women’s provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.

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