Lichen Sclerosus Treatment

Lichen sclerosus is a chronic, non-contagious skin condition that mainly affects the vulva and the skin around the anus, causing white, thinning patches, itching, and soreness. At FemRenew in Toronto, Dr. Fay Weisberg diagnoses lichen sclerosus and discusses lichen sclerosus treatment options — from conventional steroid creams to a steroid-free MonaLisa Touch laser approach.

Overview & Causes

Lichen sclerosus is an uncommon skin condition that shows up as small, white, sometimes scaly patches that can be intensely itchy. It isn’t an infection and it isn’t something you can catch or pass on — but left unmanaged it can be genuinely debilitating. The patches make the skin itchy and sore, and over time they can cause the skin to tighten or develop small cracks that bleed. Together, those changes can make intercourse painful, daily activities uncomfortable, and intimacy anxiety-provoking.

The exact cause isn’t fully understood, but it’s often linked to immune and hormonal factors and is most common around and after menopause. Getting the right diagnosis matters more here than with many conditions. Many women treat the itch as a recurring yeast infection, or — more concerning — ignore it altogether, when in fact lichen sclerosus needs ongoing medical management. Because a small number of long-standing, untreated cases can lead to more serious skin changes, seeing a gynecologist early is the safe move. To confirm the diagnosis, your physician may recommend a small biopsy of an affected area before settling on a treatment plan.

Symptoms

• White, patchy, or shiny areas of skin on the vulva or around the anus
• Persistent itching, often worse at night
• Soreness, burning, or stinging
• Thin, fragile, or easily torn skin, sometimes with small cracks that bleed
• Pain or tightness during intercourse
• Skin changes that keep returning despite over-the-counter creams

How FemRenew Approaches Lichen Sclerosus

Once the diagnosis is confirmed, lichen sclerosus is typically managed with a prescription steroid cream, which works well for many patients and is often the first step we discuss. For women who don’t respond fully, prefer to reduce long-term steroid use, or want to explore newer options, Dr. Weisberg can discuss a steroid-free approach using MonaLisa Touch laser, which has been used to settle the patchy areas and relieve the itch in some women.

We’re honest that lichen sclerosus is usually a long-term condition to manage rather than a one-time fix, and the right plan is the one matched to your skin, your symptoms, and your medical history. As one of Canada’s first practices to offer laser treatment for vulvar and vaginal tissue, FemRenew can talk through conventional and non-steroid options side by side so you understand what each involves before choosing.

What to Expect — Your OHIP Consultation

Care starts with an OHIP Consultation. You request it through our site, and we’ll contact you within 24–48 hours to arrange your visit. At the appointment, Dr. Weisberg examines the affected skin, reviews your history, and — when it’s helpful for an accurate diagnosis — may arrange a small biopsy. You’ll leave with a clear explanation of what’s going on and a management plan, whether that’s a steroid cream, a steroid-free option, or a combination, plus a plan for follow-up since lichen sclerosus needs monitoring over time. To get started, call (416) 924-4666 or book your OHIP Consultation online.