Lichen Sclerosus

What's actually happening when you have lichen sclerosus?

Lichen sclerosus is a long-term skin condition, not an infection, that turns vulvar skin white, thin and itchy. It's more common than most people realize, and it's very treatable. Here's what it is, how it's diagnosed, why sticking with treatment matters so much, and how to care for your skin every day.

93%had their symptoms clear when they kept up treatment, in a study of 507 women
0cases of vulvar cancer in the women who kept up treatment
1.7%of patients in a general gynecology practice had it
Healthy skinLichen sclerosus
Color pinkTexture smooth

What is lichen sclerosus?

Lichen sclerosus is a long-term inflammatory skin condition. It most often affects the vulva and the skin around the anus, where it turns the skin white, thin and fragile. It isn't an infection and isn't caught from anyone, including through sex. It seems to involve the immune system: about 1 in 5 women with it also have another autoimmune condition, most often thyroid disease.

It's more common than most people think. In one general gynecology practice, 1.7% of patients had it, and as many as a third of people with it may have no symptoms at all. It's most common after menopause, but it can start at any age, including in childhood.

The good news: it's very treatable. With the right prescription ointment, most women's symptoms clear and stay under control.

What are the symptoms?

Itching

The most common symptom, and it can be severe. Scratching can break the skin and make it sore.

White, shiny, thin patches

Skin that looks pale or crinkled, like tissue paper. Around the vulva and anus it can form a figure-of-eight shape.

Tears or splits

Fragile skin that tears easily, especially after sex.

Pain during sex

Over time the vaginal opening can narrow, and the shape of the vulva can change.

Because the itch can feel like a yeast infection or irritation, lichen sclerosus is easy to mistake for something else. If itching keeps coming back, or antifungal treatment doesn't help, ask your clinician to check for it. Not sure which one it is? Try the symptom sorter.

How is it diagnosed and treated?

A clinician, often a gynecologist or dermatologist, can usually recognize it by looking, and may take a small skin sample (biopsy) to confirm it.

The treatment that works best is a strong steroid ointment, usually clobetasol propionate 0.05%. A typical plan tapers over three months, then continues as a regular maintenance dose your clinician sets. The warning on the tube about not using it on genital skin doesn't apply here: this is exactly where it's meant to go. There's no permanent cure, but symptoms are usually well controlled, and in most girls who are treated it goes away by puberty.

A typical first three months of steroid ointment, from the British Association of Dermatologists' patient leaflet. Follow the plan your own clinician gives you.

Why does keeping up treatment matter so much?

An Australian study followed 507 women with lichen sclerosus for years. The women who kept using their steroid ointment regularly, even after their skin looked normal, did far better than those who used it only now and then.

Women who kept up treatment vs women who used it only sometimes (Lee 2015, 507 women). Untreated lichen sclerosus can scar the vulva and slightly raises the risk of vulvar cancer; steady treatment lowers both.

How do you care for your skin every day?

Alongside your prescription, dermatologists recommend gentle daily care.

Swap soap for a soap substitute

Use an emollient instead of soap, and skip bubble baths, shower gels and anything scented.

Protect skin from urine

Pat dry gently after peeing, and use a barrier ointment to keep urine off the skin.

Use a lubricant for sex

It helps prevent tears. If sex stays painful, ask your clinician about other options.

Check your skin monthly

Use a mirror. See your clinician about any lump, thickened patch or sore that lasts more than two weeks. Not smoking also lowers your risk.

What do customers with lichen sclerosus say?

Some of our customers with lichen sclerosus use the Salve as part of their daily skin care, alongside the treatment their clinician prescribed.

"I've tried many different products for relief from both lichen sclerosis and intertrigo and this one actually works. I have a subscription and I use it every day."

Verified buyer, Soothe & Restore Salve, 2026

"I was a long time user of another popular vulva balm but I may prefer the fragrance and feeling with the Momotaro product."

Verified buyer, Soothe & Restore Salve, 2026

How can Momotaro Apotheca help?

Your prescription comes first. Keep using the steroid ointment exactly as your clinician tells you. Nothing here replaces it.

Then comfort your skin between doses. Our products are made for everyday vulvar comfort.

Soothe & Restore Salve

Calendula and coconut oil with tea tree oil (about 2%), to soothe itchy outer skin. Read about calendula and coconut oil.

See the Salve

Organic Body Oil

Sunflower, argan and sea buckthorn oils to moisturize dry skin, including the outer vulva.

See the Body Oil

Common questions about lichen sclerosus

Is lichen sclerosus contagious or an STI?

No. It isn't an infection and can't be passed on through any contact, including sex.

Can lichen sclerosus be cured?

There's no permanent cure in adults, but a strong steroid ointment controls it well for most women. In most girls who are treated, it goes away by puberty.

Is it safe to use a strong steroid on the vulva long term?

For lichen sclerosus, yes, under a clinician's care. In the study of 507 women, side effects such as steroid rash or skin thinning were uncommon (about 1 to 4%) and reversible.

Can I use the Salve instead of my steroid ointment?

No. The Salve is for comfort, not treatment. Keep using the ointment your clinician prescribed, and use the Salve or Body Oil at a different time of day if you'd like.

Does lichen sclerosus cause cancer?

It slightly raises the risk of vulvar cancer, to less than 5%. Keeping up treatment lowers that risk: in the long-term study, none of the women who used their ointment regularly developed vulvar cancer.

Is it safe to use these products with lichen sclerosus?

Skin with lichen sclerosus can be fragile and easily irritated. Patch test any new product on your inner arm first, and don't apply it to open splits or sores. The Salve contains tea tree oil (about 2%), which can sting sensitive skin; stop if it burns. Oil-based products can weaken latex condoms. None of the ingredient studies on this site were done in people with lichen sclerosus.

These statements have not been evaluated by the Food and Drug Administration. Momotaro Apotheca products are not intended to diagnose, treat, cure or prevent any disease.

Sources

  1. British Association of Dermatologists. Lichen sclerosus in females: patient information leaflet. 2022. skinhealthinfo.org.uk.
  2. Lewis FM et al. British Association of Dermatologists guidelines for the management of lichen sclerosus. 2018. Br J Dermatol 178(4):839.
  3. Lee A, Bradford J, Fischer G. Long-term management of adult vulvar lichen sclerosus: a prospective cohort study of 507 women. 2015. JAMA Dermatol 151(10):1061.
  4. Goldstein AT et al. Prevalence of vulvar lichen sclerosus in a general gynecology practice. 2005. J Reprod Med 50(7):477.
  5. Meyrick Thomas RH et al. Lichen sclerosus et atrophicus and autoimmunity: a study of 350 women. 1988. Br J Dermatol 118(1):41.
  6. O'Connell TX et al. Non-neoplastic epithelial disorders of the vulva. 2008. Am Fam Physician 77(3):321.

Reviewed by the Momotaro Apotheca medical team, including OB-GYNs and naturopathic doctors. Educational information, not medical advice. All ingredient research