Vulvar Lichen Simplex

What is Lichen Simplex?

Lichen simplex is a skin condition resulting from a chronic irritation of the vulva. Lichen simplex may cause itching, burning and/or thickened skin.

Symptoms occur when the vulvar skin becomes sensitive and irritated. This may exist for several weeks or months. As a result of constant vulvar scratching, the skin thickens, itches more, and then is scratched again. Many doctors refer to this as an "itch-scratch cycle".

What are the signs and symptoms of Lichen Simplex?

Moisture, scratching, scrubbing, and the use of medications may cause the skin to look different in each person.

Signs and symptoms may include: Chronic vulvar itching and/or burning on vulva. This may be mild to severe. Pink to dusky red or purple-looking skin. Swelling and/or thickened areas of skin. Skin tears caused by scratching. Raw and/or damp feeling - Women tend to think the dampness is caused by a vaginal discharge. Many believe it to be the cause of their symptoms. In reality, the dampness may come from the outer vulvar skin surface. Chronic irritation to the outer vulvar skin can cause it to weep. Women tend to think the dampness is caused by a discharge coming from inside the vagina, and many believe it to be the cause of their symptoms. This dampness if from the outer vulvar skin surface as chronic irritation causes it to weep. How is Lichen Simplex Diagnosed? Your doctor or health care worker will look for common skin changes of the vulva. A sample of your discharge may be checked to rule out infection.

What is the cause of Lichen Simplex?

When the irritation exists long enough so that an itch-scratch cycle develops, Lichen Simplex may occur. It may be caused by many different factors, such as contact irritants.

Contact Irritants

Contact irritants are products that cause irritation of the skin. This is not always an allergic reaction. The difference between an "allergen" and an "irritant" is:

Allergens: Are materials that cause difficulty in breathing or a general skin reaction (rash, hives, and blisters) and itching after contact of only one or two times.

Irritants: Are materials that cause burning or itching at the site where the irritant was in contact with the skin after a number of uses.

The following items may irritate vulvar skin:

• Laundry detergents containing enzymes, whiteners or brighteners.
• Fabric softeners and dryer sheets.
• Bath soaps, gels, lotions.
• Bubble bath, oils, bath salts, skin.
• Feminine hygiene sprays, perfumes, or powders.
• Adult and baby wipes or towelettes.
• Deodorant tampons and pads.
• Douches.
• Contraceptive creams, jellies, foams, and sponges.
• Condoms, prepackaged with lubricant or spermicides.
• Colored, perfumed toilet paper.
• Synthetics such as nylon underwear or panty hose.

The goals of treatment are to relieve itching and break the itch-scratch cycle.

1. Follow the "Guidelines for Vulvar Skin Care". The vulvar area should be kept as clean and as dry as possible. Although the initial irritant may be removed, if the itch-scratch cycle has already developed, the Lichen Simplex process may continue without additional treatment.

2. Apply Topical Steroids
   Use: A thin layer to areas of discomfort.
   Action: Decrease redness, swelling, itching, and burning.
   Caution: Use only as prescribed by your doctor. Overuse may result in worsening of your problems rather than helping it.

3. Baking Soda Soaks: Soak in luke-warm bath water with 4-5 tablespoons of baking soda to help sooth vulvar itching and burning. Soak 2-3 times a day for 10-15 minutes. If you are using a sitz bath, use 1-2 teaspoons of baking soda.

4. Gold Bond or Zeosorb powder may be applied to the vulva and groin areas if chronic dampness / moisture is a problem.

Symptoms should resolve with treatment. If symptoms persist, further follow-up and treatment may be needed.

See related Patient Textbooks about Obstetrics and Gynecology.

See related Patient Topics Gynecology, Obstetrics and Gynecology, Vaginal Diseases or Women's Health.

See related Provider Textbooks about Obstetrics and Gynecology.

See related Provider Topics Gynecology, Obstetrics and Gynecology, Vaginal Diseases or Women's Health.

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