Complications of Lichen Sclerosus can have far-reaching implications that extend beyond the immediate physical symptoms.
While this long-term skin condition does not spread or usually threaten life, its ongoing effects and location can greatly affect physical comfort, mental health, and sexual health. Many complications of Lichen Sclerosus arise when the condition goes unnoticed or is not treated properly. Knowing the full range of possible problems helps patients get early care and stay well in the long run.
Physical Changes and Skin Damage
The most common problem is scarring and changes to the skin, especially in the genital and anal areas. The skin often looks white, patchy, thin, shiny, or wrinkled. Over time, constant swelling causes the skin to shrink and scar. In women, this can lead to the narrowing of the vaginal opening, fusion of the labia, or covering of the clitoris. These changes may make sex painful or even impossible. In men, the foreskin can tighten (phimosis), making it hard to pull back or causing pain during sex. Often, these problems need surgery and can cause lasting discomfort or reduced movement of the skin.
Another serious issue linked to complications of Lichen Sclerosus is the risk of skin cancer. Long-lasting or untreated cases can raise the chance of getting squamous cell carcinoma (SCC), especially in the vulva or penis. Research shows that about 4–5% of women with untreated vulvar lichen sclerosus may develop SCC. That’s why it’s crucial to check for any changes in the skin’s size, colour, or feel. Doctors often take small skin samples (biopsies) to find cancer early and improve outcomes.
Pain, Infections, and Sexual Difficulties
Ongoing itchiness and pain are also major concerns. Intense itching causes people to scratch, which damages the skin and may lead to infection. Open sores can let in bacteria, making things worse. This adds more pain and slows healing. Repeated infections can also affect mental health and make the disease harder to live with. Besides bacterial infections, yeast infections can also happen—especially in people using steroid creams without antifungal medicine.
Sexual problems are another common result. Women often feel pain during sex (dyspareunia), lose interest in sex, or fear skin tearing. Men may find sex painful or avoid it due to phimosis. These challenges can strain relationships, lower confidence, and cause emotional distress. Treating these issues may require medical care, therapy, and open conversations with partners.
Emotional Impact and Urinary Problems
The emotional toll of lichen sclerosus is often high. When a disease affects private parts, it can lead to shame, sadness, or anxiety. Many people feel embarrassed or frustrated about how the condition looks or feels. If scarring or sexual problems happen, these feelings may grow stronger. Relationships and social life may suffer, and some people avoid getting help out of fear.
Urinary symptoms also occur in some people. In women, changes to the skin around the urethra may cause pain while urinating or make it hard to empty the bladder. In men, phimosis can block the flow of urine or cause pain. Rarely, the disease spreads into the urethra itself. This can lead to a blockage (stricture), which might need surgery. All these problems add to the burden and reduce quality of life.
Complications of Lichen Sclerosus in Reproduction and Diagnosis
Lichen sclerosus may also affect fertility and childbirth. In women, scarring may make pelvic exams or delivery painful or risky. Some women need surgery before childbirth or may need a caesarean section if the vaginal tissue is too damaged. These issues show how important early care is, especially with regular visits to a gynaecologist.
One often missed issue is delayed diagnosis. Since symptoms appear in private areas and the disease is not widely known, many people don’t get the right diagnosis for years. This delay allows the condition to get worse. Without treatment, complications of Lichen Sclerosus like scarring, infection, or even cancer become more likely. Better education for both patients and doctors is key to closing this gap.
Even children can get lichen sclerosus, though it is less common. If not treated early, it can cause lasting harm. Children may show signs like bedwetting, avoiding the toilet, or skipping sports. Without proper care, they may carry scars and complications into adulthood.
Managing the Full Scope of Complications
Dealing with complications of Lichen Sclerosus takes a team. Dermatologists, gynaecologists, urologists, therapists, and sexual health experts often need to work together. While strong steroid creams are the main treatment, patients also need regular check-ups, clear information, and emotional support to cope with all aspects of the disease.
In conclusion, complications of Lichen Sclerosus go beyond skin symptoms. They include scarring, cancer risks, infections, emotional pain, sexual troubles, urinary problems, fertility issues, and delays in diagnosis. A complete care plan focused on early action, regular checks, and treating the person—not just the disease—can reduce these risks. This helps people with lichen sclerosus live more comfortably and confidently.
