Lichen sclerosus is chronic inflammatory disease that affects mainly the genital and the anal area. But it is also seen in the neck, shoulders, breasts and back. It is more common in women and less common in men and children. It is commonly seen in post-menopausal women. It is not a contagious disease. The exact cause of lichen sclerosus (LS) is unknown. There are several theories though, one is it is due to autoimmunity, another is imbalance hormones, skin damage can also precipitate lichen sclerosus, some says that there is a genetic component and its hereditary, infections, environment can precipitate it. So no one exactly knows the reason.
Is Lichen Sclerosus Hereditary?
There are few cases of lichen sclerosus reported in family members. But we don’t know whether it was a hereditary lichen sclerosus or it was from another cause. Although, the exact cause of lichen sclerosus is unknown there are some possible causes and risk factors.
The Causes And Risk Factors of Lichen Sclerosus Are:
Autoimmune Disease: There are several reasons to believe lichen sclerosus is an autoimmune disease
- Autoantibodies against extracellular matrix protein 1 have been to be found in many patients with lichen sclerosus. These can be a result of autoimmunity.
- T-cell mediated autoimmunity seen in lichen sclerosus patients.
- These patients also have other autoimmune disease such as thyroid disorders, type 1 diabetes mellitus.
Because of the above mentioned reason lichen sclerosus is believed to be an autoimmune disease.
Hereditary: Some cases of family members having lichen sclerosus is reported. But no hereditary deformity or gene sequence identified as the cause of the hereditary disease.
Local Irritation and Trauma: This is seen especially in patient who have a genetic predisposition as well. When there is excessive skin irritation and trauma this can precipitate the formation of lichen sclerosus. How to prevent skin irritation and trauma:
- Wash with emollient soap substitute’s instead of regular soap. You can ask your doctor or pharmacist for a suitable product.
- Gently dab your genital dry after passing urine.
- Apply a barrier cream or an ointment on the affected areas.
- Wear cotton or silk underwear.
- Use vaginal lubricants if there is pain during intercourse.
- Do not wear tight undergarments or clothes
- Do not scratch or rub the affected area
- Wash your underwear with water only. Don’t’ use detergents.
Oral Contraceptive Pills In Premenopausal Women: Studies have shown there is 2.5% risk of getting lichen sclerosus in women who have used oral contraceptive pills (OCP) during the premenopausal age. This suggests a hormone imbalance may cause lichen sclerosus. However lichen sclerosus is seen in prepubertal children as well and sometimes it gets cured with the onset of puberty. So even though a hormone imbalance can be the cause what hormones exactly cause it has not been identified.
Associated with Psoriasis – The histopathological findings in psoriasis and lichen sclerosus are similar. Therefore there might be some connection between the two conditions.
Uncircumcised or Partially Circumcised Males: Lichen sclerosis almost exclusively seen in men with uncircumcised or partially circumcised penis. The reason for lichen sclerosus developing in this category of males is unknown.
Conclusion
Lichen sclerosus is chronic inflammatory skin disease commonly seen in the genital and anal areas but also seen in the neck, shoulders, breast and the back. It is seen commonly in postmenopausal women. The exact cause for lichen sclerosus is unknown however there are some reported cases of lichen sclerosus in family members. There might be a possibility that genetic predisposition plays a role in the development of the disease. Other possible causes can be autoimmunity, hormonal imbalance, local irritation and trauma, association with psoriasis and it is seen in men who are uncircumcised or partially circumcised.
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