Lichen sclerosus et atrophicus (LSA) is a condition that belongs to the autoimmune diseases. We do not know why it occurs, but it is not uncommon.
There is inflammation in the skin outside the vaginal opening (it can also occur in skin elsewhere on the body). The skin can become thin, irritated, and itchy, and adhesions can develop over time.
Untreated lichen sclerosus et atrophicus also gives a slightly increased risk of developing cell changes in the skin of the genital area.
It is therefore important to follow up the treatment properly, and to keep an eye on things and contact us if you develop thickening of the skin or sores that do not disappear within 2-3 weeks, or if you do not get the expected effect from the treatment.
LSA usually responds very well to treatment. Most often, a strong cortisone cream called Dermovat is used. It can feel alarming to use such a cream in the genital area, but we have both a lot of research and many years of experience with this.
Make sure to reach all the "nooks and crannies", and follow the instructions carefully.
If you do that, the result is usually very good. Most people continue with "maintenance application"; a few eventually only need treatment if symptoms return.
Apply Dermovat every evening for 4 weeks, then every other evening for 4 weeks, then 2 fixed evenings per week for 4 weeks (for example Monday-Thursday), then 1-2 fixed evenings per week depending on what feels best, but at least once weekly.
Wash the genital area with clean water. Avoid all types of soap, but you may wash with oil.
ACO Cleansing Oil, almond oil, or wheat germ oil all work very well and are available at pharmacies. You can also use olive oil, coconut oil, or another pure plant oil.
On the days you do not use Dermovat, apply a fatty cream, such as Warming Critical Care (Vitus pharmacies, Boots), or Locobase Repair 1-2 times daily.
It is also fine to apply fatty cream 30-40 minutes AFTER applying Dermovat, but never use oil washing or fatty cream just before, because then Dermovat will not enter the skin.
Be aware that people with LSA have an increased likelihood of developing an underactive thyroid, so inform your GP that you have been diagnosed with LSA.
You can find information about the condition at vulva.no. Choose "Pasient" ("Patient"), then "Sykdommer og tilstander" ("Diseases and conditions"), then "Hudsykdommer" ("Skin diseases").