Lichen sclerosus is a chronic inflammatory disorder of the skin and mucosa, presenting to genitourinary physicians and dermatologists. It affects both sexes and all age groups. Although the exact etiology is uncertain, genetic predisposition, infections and autoimmune factors have been implicated in its pathogenesis. Symptoms include pruritis and soreness, but asymptomatic presentations are not uncommon. The classical clinical picture is of atrophic white plaques in the anogenital region. Histopathology is specific with basal cell degeneration, upper dermal edema, homogenization of collagen and a chronic inflammatory infiltrate. Short courses of potent topical corticosteroids form the mainstay of treatment. The condition tends to be remitting and relapsing, with spontaneous regressions reported in a few. In men, the term balanitis xerotica obliterans is sometimes used to describe late and severe lichen sclerosus of the penis. Scarring and progression to squamous cell carcinomas can occur in chronic LS, resulting in significant morbidity.

Aloe vera gel for oral lichen planus
See aloe vera for more information regarding the potential benefit of aloe vera for oral lichen planus.

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Steroid Cream Treatment for Lichen Scelosus
Lichen sclerosus is a chronic inflammatory skin condition, which most commonly causes dysuria, pruritus and soreness of the vulval and perianal areas. Potent topical corticosteroids are used for the treatment of lichen sclerosus, but it is well known that they inhibit collagen synthesis and cause skin atrophy as a side effect.

Tacrolimus for Lichen Sclerosus
Topical tacrolimus may be helpful in the management of lichen sclerosus. The effective management of vulval lichen sclerosus currently depends upon the use of topical steroids and emollients. There are concerns with regard to the long-term toxicity of potent steroids and therefore is a need to consider effective alternatives. Immunomodulatory macrolactams offer an alternative to steroids in the management of some other inflammatory skin disorders and it would seem reasonable therefore to assess their activity in lichen sclerosus. A pilot study of 16 histologically confirmed cases of lichen sclerosus suggests that macrolactams have a positive pharmacological effect. A second study done in Italy also showed potential benefit for vulvar lichen sclerosus.

Multicentre, phase II trial on the safety and efficacy of topical tacrolimus ointment for the treatment of lichen sclerosus.
Br J Dermatol. 2006 Nov;155(5):1021-8. Department of Andrology and Venereology, Philipps-University Marburg, Marburg, Germany.
Lichen sclerosus is a chronic inflammatory autoimmune disease causing significant sclerosis, atrophy and pruritus. Treatment remains unsatisfactory, with potent corticosteroids being the most effective therapy. We conducted a multicentre, phase II trial to assess the safety and efficacy of tacrolimus ointment 0.1% for the treatment of lichen sclerosus with a follow-up period of 18 months at 10 university and teaching hospitals in Germany and Austria. Methods Eighty-four patients (49 women, 32 men and three girls) aged between 5 and 85 years with long-standing, active lichen sclerosus (79 with anogenital and five with extragenital localization) were treated with topical tacrolimus ointment 0.1% twice daily for 16 weeks. Results: The primary endpoint (clearance of active lichen sclerosus) was reached by 43% of patients at 24 weeks of treatment. Partial resolution was reached in 34% of patients. Maximal effects occurred between week 10 and 24 of therapy. Tacrolimus reatment led to a significant reduction of the total lesional area and to a significant decline in the total symptom score. Symptoms (e.g. itching) and findings (erythema, erosions and induration) showed significant improvement. No serious tacrolimus side effects were observed. There were three (9%) recurrences during the follow-up period. Conclusions Topical tacrolimus ointment 0.1% was safe and effective for the treatment of long-standing active lichen sclerosus.

Vulvar lichen sclerosus: 11 women treated with tacrolimus 0.1% ointment.
Acta Derm Venereol. 2007;87(1):69-72. Department of Dermatology, Arcispedale S. Anna, University of Ferrara.
Lichen sclerosus is a chronic relapsing disease, usually treated with ultra-potent corticosteroids. As immunological alterations are considered important aetiopathogenetic factors in lichen sclerosus, the new immunomodulating topical agents, such as tacrolimus and pimecrolimus, have been employed sporadically as alternative therapies. The aim of this study was to evaluate the therapeutic effects of tacrolimus 0.1% ointment in lichen sclerosus in 11 patients unresponsive or poorly responsive to previous treatments. Tacrolimus 0.1% ointment was applied twice daily for 6 weeks, then tapered over a further 6 weeks. Symptoms and objective parameters were evaluated and quantified at the start, after 6 weeks, at the end of the topical treatment, and at follow-up visits. Improvement or remission of symptoms was observed in the patients who completed the study, while objective parameters were poorly influenced and often were not related to symptom behaviour. Topical tacrolimus can be considered an alternative treatment for lichen sclerosus.

Topical Pimecrolimus for Lichen Sclerosus
Pimecrolimus Cream 1% in the Treatment of Lichen Sclerosus.
Gynecol Obstet Invest. 2006 Nov 2;63(3):151-154. Department of Obstetrics and Gynaecology, Oulu University Hospital, Lansi-Pohja Central Hospital and Oulaskangas Hospital, Oulu, Finland.
The present pilot study evaluated the efficacy and safety of pimecrolimus cream 1% applied twice daily for up to 6 months in 29 women with severe lichen sclerosus. Of the 26 subjects who completed the follow-up period, 42% were in complete remission with relief from itchiness, pain and inflammation. A 3.5-fold increase in type I collagen synthesis and a 7.5-fold increase in type III collagen synthesis of the affected areas was detected after 2 months of pimecrolimus treatment. There were no systemic adverse reactions, although mild local skin reactions were reported by 50% of the patients. Blood concentrations of pimecrolimus were checked in 10/26 patients (39%) and were undetectable in all cases. Conclusions: Patient-applied 1% pimecrolimus cream is safe and effective for the treatment of lichen sclerosus.

Lichen Sclerosus emails
Q. Do you think serrapeptase enzyme or nattokinase would help in lichen sclerosis?
   A. I have no idea. I have not seen any such studies.

Q. I have seen spellings as lichen sclerosis, is this right or is it spelled as lichen sclerosus?
   A. I have most often seen it spelled as lichen sclerosus.

Q. I am 49 years old from India.. and i am suffering from bullous lichen planus for the past one year. I was treated with steroids but in vain. Though the blisters seem to substantially reduce, i do get new ones very soon even on medication. Presently i am on Descort course. I am really worried that my condition is not getting better. I read the feedbacks in your curcumin supplement official website. Now can i take these curcumin supplements for my condition, if so should i stop my present medication. Can u please advice me on this plot.
   A. We cannot give individual advice, but only provide information that we come across.

Q. I have Lichen Planus. and was put on the Clobetasol Propionate ointment, USP,0.05% mfg by Taro Pharmaceuticals Inc, Brampton, Ontario Canada.. Dist by Taro etc, Hawthorne NY 10532, as prescribed by a doctor at Loma Linda University Dental School, CA.  Clobetasol Propionate ointment totally controls the problem.

Q. I have been attending the dental hospital in Wales U.K. under Prof. Lewis for a Lichenoid infection on my tongue. Dr. Lewis, in desperation, to try and find some relief for my condition which was not responding well to other treatment, had seen your web site on curcumin and asked me to give it a try. I ordered curcumin and I have religiously taken two capsules a day for three months and I am so pleased with the results. Although the condition has not completely gone, it is 100 times better than it was and Prof. Lewis is really enthused with the results, and has said that I may be one of the first to try such curcumin treatment over here in the U.K.!! You can't imagine how much it means to me to be almost free from pain and able to start eating foods which are acidy and spicy, in moderation. I know that the Lichenoid infection condition has no complete cure, but at least there is hope on the horizon for the many sufferers of this unpleasant condition. Thank you so much, I will continue to take the curcumin capsules long term. Regards. PS I don't mind my name being used if you think this is worthy of your website. Judith Pearce.
   A. Thanks! We are glad curcumin may have helped you, please keep us updated. Can you tell us the actual name of the skin condition?
      Q. Thank you so much for taking the time to reply to my email, it was much appreciated, as I know how busy you must be. The medical name for my complaint in Lichen Planus, My tongue is very sore with blisters and lesions which subside at times and other times are very inflamed and extremely sore leaving me virtually unable to eat, or at best a diet of bland sandwiches!! I do find that the curcumin helps very much indeed and I would urge anyone who wants to try it, to do so and persevere over a period of three months to see the best results. I will keep you posted regarding my progress. The other advantage also of the curcumin, is that you can take it long term without having to have a "rest" period once a week. Regards, Judith.
         A. One case history does not prove anything. Curcumin may have been the herb that helped your lichen planus, and we eagerly await other reports from those with lichen planus to see if your response was an isolated case or whether in fact curcumin is helpful for lichen planus. If we do get several reports of such help, then perhaps a dermatologist or researcher may wish to investigate the role of curcumin in this skin condition.

Q.  I was diagnosed with lichen sclerosis about 6 months ago after suffering from severe itching, swelling of the vulva burning. My doctor did a biopsy and assured me that it wasn't cancer. I've been on topical steroid creams that really did nothing but stop the itching and got off them with advice from my three daughters who are all RN's. I have tried Premarin vaginal cream and gradually going to get off that if I can. Do you know of any in-depth research that might be going on about Lichen Sclerosis? All I've heard is that there is no real cure for this, true or not? I sure would appreciate any information you could give me and let me know if there might be some "natural" remedy that might cure this.
   A. We will update the information on our site regarding the natural treatment of lichen sclerosis as we come across more studies.

Q. Hello. I have been reading a lot of the supplement information on your website and find it very informative. I would like to know if you have done any research on lichen sclerosis, and/or do you have any recommendations for possible natural remedies for this devastating illness. Apparently It affects many people, although mainly post-menopausal women, but so far researchers have not been able to determine the cause or find a cure. The recommended treatment is usually highly potent topical steroids, but those who suffer from this condition (per the many online forums) are hoping that someone will soon find the cause and hopefully a cure, or at least a more natural treatment. Thank you sincerely for any advice you can offer.

Q. Lichen planopilaris: Lichen Planopilaris is the specific name given to lichen planus on the scalp that may cause permanent, scarring alopecia. I was diagnosed with the above by a biopsy of my scalp which is bald as a man's. This is very, very embarrassing for a female of 59 years. Later I had Azathioprine for one month. But I experienced severe urinary infections and my liver enzymes escalated.