Causes of vulvar lichen sclerosus

Every woman is very concerned about her vulva health, because the female vulva is an area that is vulnerable to bacterial invasion. If the vulva is infected, it will cause more serious gynecological diseases. There is also a very serious vulvar disease called vulvar lichen sclerosus. After this disease occurs, the patient will obviously feel vulvar itching. At this time, patients need to understand the causes of vulvar lichen sclerosus so that they can prescribe the right medicine.

Vulvar lichen sclerosus is a skin disease characterized by atrophy and thinning of the vulva and perianal skin. The lesions mainly invade the clitoris and its foreskin, labia minora, posterior labia joint and perianal area, and are the most common white lesions of the vulva. This disease is characterized by skin atrophy, and dermatologists still call it "lichen sclerosus atrophicus". Clinical manifestations include vulvar itching, dyspareunia, and burning sensation or pain. Treatment is mainly sedatives, sleeping pills, anti-allergic drugs and hormone drugs.

1. General treatment

Keep the vulva clean and dry, do not use irritating drugs or soaps to clean the vulva, avoid wearing synthetic underwear, and do not eat spicy or allergenic foods. For patients with severe itching symptoms leading to insomnia, sedatives, sleeping pills and anti-allergic drugs can be added.

2. Topical medication

The main symptom of this disease is severe itching, and the treatment with glucocorticoids has a definite effect. Commonly used: 1% to 2% hydrocortisone ointment or 0.025% fluocinolone ointment, 3 to 4 times a day. Six weeks after medication, the skin lesions will return to normal. Topical application of testosterone propionate is the standard method for treating lichen sclerosus. The efficacy varies from person to person. Some atrophic skin can return to normal, some lesions can improve, and some have no obvious effect.

3. Subcutaneous Injection

For patients with persistent itching and ineffective topical medications, subcutaneous injection of triamcinolone acetonide suspension can be used. If this method does not achieve the desired effect and the patient still has itching, pure alcohol can be injected subcutaneously under regional anesthesia. Care should be taken not to inject alcohol into the skin, as this will cause skin necrosis. Subcutaneous injection of alcohol can completely relieve itching, but it cannot relieve the burning sensation of the vulvar skin.

4. Surgery

For patients with severe conditions or who are unresponsive to drug treatment, superficial vulvar excision or laser excision can be performed. Laser excision can only remove epidermal lesions but is ineffective for dermal lesions under the epidermis. The recurrence rate of surgical excision is high, not only at the excision edge but even in transplanted skin. The disease has a very small chance of becoming malignant and surgical treatment is rarely used.