The Nu Guide: Lichen Sclerosus
(It’s more common than you think—and it’s totally manageable)
Lichen sclerosus (pronounced like-en skluh-roe-sus) is a skin condition that mostly affects the vulva, so usually diagnosed in women or people assigned female at birth.
It often starts with itching. Not just a little bit…. But really itchy, often at night when you’re trying to get to sleep. You might also notice the skin looking pale or white, maybe a bit shiny, and sometimes thin or crinkly like tissue paper. Some people feel burning or soreness, and others might experience small splits in the skin or pain during sex. If you’ve got any of this going on and it’s not going away, it’s definitely worth getting checked out.
What causes lichen sclerosus?
No one’s quite sure what causes lichen sclerosus. It’s not an infection, it’s not contagious, and it’s definitely not your fault. It seems to be related to the immune system and tends to show up more often after menopause, though younger women and even children can get it too. It’s difficult to get accurate numbers but probably one in every 100 women might experience this condition.
What can I do about it?
The good news? It’s treatable. The go-to treatment is a strong steroid cream or ointment that can penetrate into the deeper dermal layers of the skin where inflammation is occurring. This usually works quickly to calm everything down but you need to keep applying it even after symptoms settle. Most people use it daily for a few weeks, then taper down to just a couple of times a week to keep things under control. It might feel weird putting a steroid on your vulva, but used the right way, it’s absolutely safe—and it works.
It’s important to keep up with maintenance therapy and check in with your doctor regularly. Get to know your own body by doing a self check. Use the Nu Guide: How to check your vulva for help here. Left untreated, lichen sclerosus can lead to scarring or narrowing of the vaginal opening. This can affect daily functions like going to the toilet, exercise or having sex. Very rarely, over many years, it can increase the risk of skin cancer in that area—but keeping symptoms under control significantly reduces that risk.
How can I manage it on a daily basis?
Living with lichen sclerosus means learning to be kind to your skin. Skip the scented soaps and bubble baths (they’re not doing you any favours), stick with plain water or gentle, fragrance-free washes, and wear comfy, breathable underwear—cotton is your friend. Get to know the terms for vulval anatomy to help communicate your symptoms or concerns to heath care providers — our Nu Guide to Anatomy 101 is your friend!
Alongside your prescribed steroid treatment, it’s really helpful to use a plain emollient (moisturiser) and barrier cream—something like Nu Butter is ideal. This wonder product helps soothe dryness, protect the skin from friction and irritation, and keep the area feeling comfortable day-to-day. It’s 100% natural and contains no chemicals or preservatives. Think of it like skincare for your vulva. Just remember: emollients are not a replacement for your steroid cream—they work best together. The steroid treats the inflammation, while the emollient supports and protects your skin in between. Most people find using Nu Butter morning and night (and after washing or using the toilet) makes a big difference. Just make sure you put your steroid treatment on first so it gets absorbed into the skin!
Living with lichen sclerosus or other vulval conditions
If you’re feeling worried, you’re not alone. Lots of women feel self-conscious or frustrated dealing with this. But getting a diagnosis and starting treatment can make a world of difference—not just physically, but emotionally too.
So if you are having vulval symptoms or something doesn’t feel right don’t just put up with it. There are a number of conditions that can affect this part of the body. Speak to a health provider at your doctor's surgery or ask for a referral to see a gynaecologist. Lichen sclerosus is more common than you think, and you deserve care that makes you feel comfortable, confident, and in control.
