The difference between lichen sclerosus and lichen planus

[Guest Posts]

Some years ago now I have been diagnosed with ‘lichen planus type’ problem around my vulva and labia minor. At first my GP thought that it might be lichen sclerosus, but a biopsy came up with the ulterior diagnosis. I understand that is mostly men that suffer from lichen planus. I feel very strange about that!
I was referred to a kind specialist who saw me yearly for quite some time and prescribed mild synalar cream. He told me that I could use it for ever as it was so mild and I applied it thinly once a day. That was changed by my GP to Dermovate 0.05. However I am wondering if I am able to carry on with that cream as before?
Also, what is the difference between lichen sclerosus and lichen planus please. I have a granddaughter who has suffered from it from a very young child and she is now 20 and has seen specialists from time to time. She is somewhat worried about having a sexual relationship and my own experience has been bleeding after sexual intercourse, but now in my mid 70’s that is no longer relevant to me.
I do hope that you choose to answer my query as I find talking to my new GP about my condition a little embarrassing - I also feel it’s slightly unnecessary given other patients more pressing complaints and illnesses.
Thank you.
Lyn

[Dr Nevianna Bordet]

Although lichen planus (LP) and lichen sclerosus (LS) are different conditions, I have seen patients in the Vulval clinic where there seems to be an overlap between the conditions. Lichen planus can affect the vagina internally as well as the outer vulval part of the skin. LP can also affect the mouth or gums, usually with sore areas. On the skin it is usually very itchy whereas in the genital area it is usually painful, although it can also be itchy. The scalp can also be affected by LP and can even lead to scarring hair loss.
LS on the other hand usually only affects the genitals. It does not affect the vagina internally and typically causes itching, although if severe it can lead to pain. It can affect the skin, but much more rarely than LP and usually on the skin it is not very itchy (unlike LP which is one of the most itchy skin conditions). I don't think men get more LP than women and I certainly see a lot more LP in women than in men when it is on genital areas.
I am afraid that I cannot comment on the cream that you should be using without examining you, so you will have to ask your GP or dermatologist. You should never be embarrased to see your doctor. As doctors, we see people naked all the time, all day long. If you have a concern you should make an appointment to see your GP or at least to talk to them on the telephone.