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I developed lichen sclerosus postmenopause. What are the best treatments out there, and are there other ways to manage? |
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Lichen sclerosus is a long-lasting skin condition that most often affects the genital and anal areas, and is common during postmenopause. It’s not contagious and is thought to be related to changes in the immune system and hormones, but the exact cause remains unknown.
It usually appears as smooth, white patches on the skin. These areas may feel thin, fragile, or wrinkled. Common symptoms include itching, burning, and soreness. Sometimes, the skin can crack, bleed, or scar, which may make sex or urination uncomfortable. In some cases, the skin changes can cause narrowing of the vaginal opening or changes in the shape of the labia. Lichen sclerosus can also increase the risk of developing skin cancer in the affected area, so regular check-ups are important.
The main goal of treatment is to relieve symptoms, prevent scarring, and reduce the risk of skin cancer. Treatments include:
- Ultra-potent topical steroid ointment, such as clobetasol propionate 0.05%: This is usually applied once daily for up to 12 weeks, then less often as symptoms improve. Using the ointment exactly as prescribed gives the best results. Most people notice less itching, pain, and skin changes after starting treatment.
- Maintenance therapy: After the initial treatment, ongoing use of a topical steroid is often needed to keep symptoms under control. This may mean using the ointment a few times a week or as needed, depending on symptoms.
- Other options: If symptoms do not improve with steroids or if side effects occur, other treatments may be considered, such as topical calcineurin inhibitors, phototherapy (UV-A1 light) and photodynamic therapy, and surgery (in rare cases).
After treatment, it’s important to:
- Use gentle, fragrance-free cleansers and avoid irritants like harsh soaps, bubble baths, or tight clothing.
- Schedule regular follow-ups with a healthcare professional to monitor for skin cancer and manage symptoms.
- Report any new lumps, sores, or changes in the skin to your doctor.
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| Do you have any questions for our menopause experts? Let us know at menopause@healthline.com, and the answer may be featured in an upcoming edition! |
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| HEALTHY TIP |
| Work with a sex therapist |
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It’s common to experience issues with arousal, orgasm, and physical discomfort during menopause. A qualified sex therapist can help you identify pain points and work toward solutions. You deserve to lead a satisfying sex life for years to come.
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