Vulval irritation is a common complaint, and Lichen Sclerosus is probably the commonest cause. It is a poorly understood condition affecting the vulval skin of females at any age from childhood to old age, but the peak incidence is around the age of 50. It can cause intense irritation and sometimes pain.

The cause of Lichen Sclerosus is unknown, but it is thought to be an auto-immune skin disease. This means that the body produces antibodies that fail to recognise parts of the body as “self”, in this case the vulval skin, and a reaction to this part starts. We do not know what triggers this process. There is quite a strong link between lichen sclerosus and other autoimmune diseases such as thyroid disease, pernicious anaemia and vitiligo. About 25% of Lichen Sclerosus sufferers will have a personal or family history of autoimmune disease.

The main symptom is itching, but there may also be pain, especially with intercourse. The vulva can look white, and there is thinning and scarring with loss of surface folds and features in established cases. The skin, being thinner, is prone to splitting, especially at the back of the vaginal opening during intercourse. The whole vulval skin and skin around the anus  may be involved, or it may be just affecting a small area. If the skin around the anus is involved it may cause discomfort during bowel motions. About 20% of women have white patches elsewhere on the body, which may itch, but often do not. Lichen Sclerosus is a skin condition only, and does not extend into the vagina.

Vulvodynia-This condition is a cause of vulval burning and soreness, usually as a consequence of irritation or hypersensitivity of the nerve fibres in the vulval skin