Lichen Simplex Chronicus
Lichen simplex chronicus is a very common cause of vulvar pain. It is a long-term skin condition resulting from regular rubbing the same area. The vulva and inner thighs are most commonly affected, but lichen simplex chronicus may occur anywhere there is friction on the skin, including the anus, buttocks, breasts, or nipples.
Lichen simplex chronicus, or lichen sclerosus et atrophicus, as it is sometimes known, will typically start with a small patch of dryness and irritation on the skin. Skin cells in that area die off more quickly than usual because of the chronic rubbing, so there is not enough new skin to heal the area quickly. The outermost (oldest) layer of skin normally sheds every three weeks. It takes six months or longer to slough off, leading to redness and itching as the thinned-out skin slowly thickens due to hyper-keratinization and elastosis.
The patches are usually light pink and feel leathery when touched. They can be any size from a few millimeters to several centimeters in diameter and can be either circular or oval. Treatment of lichen simplex chronicus is aimed at reducing excessive itching and preventing further damage to the skin. The most common approach is to apply a corticosteroid cream or ointment three times a day for two weeks, then once daily for another two weeks. This can help to reduce inflammation and relieve symptoms.
