*Welcome to the OutUK series looking at gay men and their health brought to you in association with the NHS* website.**
	Each week we'll tackle a different topic in our A to Z of Gay Health. We'll have features and advice on everything from relationships, sexual health, mental and physical conditions and how to stay fit. You can follow any of links provided below for more information direct from the NHS website, or see this week's feature L: Laxatives.

Lichen Sclerosus

Lichen sclerosus is a skin condition that causes itchy white patches on the genitals or other parts of the body. There's no cure, but treatment can help relieve the symptoms.

Check if you have lichen sclerosus

Lichen sclerosus affects people of all ages, including children. But it's much more common in women over 50.

People with white, brown or black skin can get lichen sclerosus.

It causes patches on the skin that are usually:

itchy
white
smooth or crinkled
easily damaged - they may bleed or hurt if rubbed or scratched

The patches can appear anywhere, but most often are on the:

area around the opening to the vagina (vulva) and anus
foreskin and end of the penis

Things you can do to help with lichen sclerosus

To help stop your skin becoming irritated or damaged:

Do

wash with an emollient soap substitute instead of regular soap - ask a doctor or pharmacist about suitable products
gently dab your genitals dry after peeing
regularly apply a barrier cream or ointment, such as petroleum jelly, to affected areas
wear cotton or silk underwear
use vaginal lubricant if sex is uncomfortable

Don't

do not scratch or rub the affected skin
do not wear tight or restrictive clothes - it may help to wear stockings rather than tights
do not wash your underwear with detergent - just use water
do not do activities like cycling or horse riding until your symptoms have improved

See a GP if you have:

an itchy white patch on your genitals or skin
been diagnosed with lichen sclerosus and treatment is not helping
been diagnosed with lichen sclerosus and have pain when going to the toilet or having sex

A GP may refer you to a specialist for tests and treatment.

Treatment for lichen sclerosus

Lichen sclerosus cannot be cured, but prescription steroid cream usually helps relieve the symptoms.

Unless your doctor tells you otherwise, follow the directions on the patient information leaflet that comes with the medicine.

You may need to use the cream regularly for a few months to get your symptoms under control.

If your symptoms keep coming back, you may have to keep using it every now and again.

You can get more cream from a GP if you need it.

Problems caused by lichen sclerosus

Although treatment can help, skin affected by lichen sclerosus can sometimes become scarred and tight over time.

The vulva may shrink, with the clitoris and small inner lips (labia minora) around the opening of the vagina often affected.

The scarring and tightness can cause discomfort when peeing, pooing and during sex. Having an erection can be painful.

If lichen sclerosus is severe, you might need a small operation, such as surgery to widen your vagina or remove your foreskin (circumcision).

Cancer and lichen sclerosus

Lichen sclerosus increases your risk of getting cancer on your vulva, penis or anus.

The risk is low, but it's a good idea to check yourself regularly and see a GP if you're worried.

Symptoms to look for include a lump, a change in skin texture, such as thickening, or an ulcer that does not go away.

Read about vulval cancer, penile cancer and anal cancer.

Causes of lichen sclerosus

The cause of lichen sclerosus is unknown.

It might be caused by your immune system, the body's defence against infection, mistakenly attacking and damaging your skin.

Lichen sclerosus is not:

contagious - you cannot spread it to other people
caused by poor personal hygiene

OutUK's A to Z of Gay Health continues and you can read this week's feature L: Laxatives. We have covered many subjects in this series and you can catch up with all of our Previous A to Z Features. If you want to find out more about this particular topic you can visit the Original article on the NHS website. If you are worried by any aspect of your health make sure you go and see your doctor or book an appointment at your local clinic.
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