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Lichen Simplex, Sclerosis, and Planus

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Lichen Simplex, Sclerosis, and Planus

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Created OnJuly 31, 2020
byPHS Team

Lichen Simplex, Sclerosis, and Planus

What is it?

The word “lichen” refers to a number of medical conditions involving irritation of and changes to the skin. The presenting symptoms, and therefore appropriate treatment, differ depending on the type. The conditions discussed here refer to dermatological conditions of the genital region, though some of these types can occur on other parts of the body as well. 

Types of Lichen


Lichen Simplex

  • Thickening of the skin due to the itch-scratch cycle.

    Symptoms
  • Chronic irritation of the vulva.
  • Causes a cycle of itching, scratching, and thickening of the skin.
  • Vulvar skin may become weepy causing moisture in the area.
  • Disrupted sleep due to itching.
  • Sometimes mistaken for a yeast infection due to the intense itch.

    Medical Treatment
  • Topical steroids applied to the affected area.

Lichen Sclerosis

  • Chronic, progressive, autoimmune skin condition.

    Symptoms
  • Itching or burning.
  • Patchy, white skin.
  • Scars and adhesions on the vulva.
  • Skin is easily bruised or torn when rubbed.
  • Clitoral tissue can adhere.
  • Painful intercourse.
  • Disrupted sleep due to itching.

    Medical Treatment 
  • Prescription strength cortisone cream daily until the itching and irritation settles.
  • Long-term use of cortisone cream.
  • Monitoring of potential malignancy.

 

Lichens Planus 

  • An inflammatory autoimmune disorder involving keratinized and mucosal surfaces.

    Symptoms 

  • Itching or burning.
  • Scars and adhesions.
  • Involves the vulva and/or vagina.
  • Painful intercourse.
  • Disrupted sleep due to pain.
  • Affects other mucosal membranes as well (esophageal, oral – usually occurs first).
  • Significant pain.

    Medical Treatment 
  • Topical or oral corticosteroids (prednisone).

    Physiotherapy Treatment

    Along with the necessary medical interventions, pelvic health physiotherapy can have a huge impact on the successful management of lichen simplex, sclerosis or planus. Areas of treatment in physiotherapy may include:

  • Tips for vulvar care/health:
    Moisturizers
    Underwear
    Feminine hygiene brands
  • Tips for intimacy:
    Lubricants
  • Education on use of dilators/accommodators.
  • External myofascial techniques.
  • Internal myofascial techniques.
  • Mindfulness/meditation:
    Pain
    Anxiety/stress/depression
    Relaxation
  • Breathing techniques.
  • Pain education.
  • Treatment of the nervous system.
  • Pelvic floor muscle training:
    Proprioceptive training
    Lengthening/relaxing muscles
    Pelvic pain
  • Bowel and bladder education.
  • Toileting/evacuation positioning and techniques.
  • Therapeutic exercise:
    Whole body reconditioning

Treatment and management of all three of these epithelial disorders requires a whole-person approach – one that addresses medical, pharmacological, physical, and psychosocial components. By addressing the treatment areas listed above, a patient is sure to regain control and confidence over their symptoms in order to improve their everyday quality of life.

  • For the Patient
    • For The Patient
  • What is Pelvic Floor Health Physiotherapy?
    • What is Pelvic Floor Health Physiotherapy
  • Why Do We Do an Internal Exam?
    • Why Do We Do an Internal Exam?
  • The Biopsychosocial Approach
    • The Biopsychosocial Approach
  • Incontinence – Urinary and Fecal
    • Incontinence: Urinary and Fecal
    • Facts and Myths About Pelvic Floor Dysfunction
    • Pelvic Floor Muscle Weakness
    • Pelvic Floor Muscle Strengthening (Kegels) for Females (Or If You Have a Vulva/Vagina)
    • Pelvic Floor Muscle Strengthening (Kegels) for Males (or if you have a Penis)
    • The Knack
    • Pelvic Floor Muscle Tightness
    • Bladder Irritants
  • Overactive Bladder (OAB)
    • Overactive Bladder
    • Bladder Irritants
    • Nocturia
  • Pelvic Organ Prolapse (POP)
    • What is Pelvic Organ Prolapse (POP)?
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    • The Knack
    • Constipation
    • Pessary
  • Bowel Dysfunction
    • Bowel Dysfunction
    • Pelvic Floor Muscle Weakness
    • Pelvic Floor Muscle Strengthening (Kegels) for Females (Or If You Have a Vulva/Vagina)
    • Pelvic Floor Muscle Strengthening (Kegels) for Males (or if you have a Penis)
    • Pelvic Floor Muscle Tightness
    • Constipation
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
  • Pelvic Floor Muscle Weakness
    • Pelvic Floor Muscle Weakness
    • Pelvic Floor Muscle Strengthening (Kegels) for Females (Or If You Have a Vulva/Vagina)
    • Pelvic Floor Muscle Strengthening (Kegels) for Males (or if you have a Penis)
    • The Knack
  • Pelvic Floor Tightness
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
  • Persistent Pelvic Pain
    • Persistent Pelvic Pain
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Pudendal Nerve Irritation
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
  • Endometriosis
    • Endometriosis
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
  • Dysmenorrhea (Painful Periods)
    • Dysmenorrhea (Painful Periods)
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
  • Vaginismus
    • Vaginismus
    • Accommodators and Dilators
    • Pelvic Floor Muscle Tightness
    • Lubricants and Moisturizers
    • Vulvar Care
    • Pelvic Tissue Dysfunction
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Sleep
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
  • Vulvodynia
    • Vulvodynia
    • Vulvar Care
    • Pelvic Tissue Dysfunction
    • Deep Breathing Exercises
    • Pelvic Floor Muscle Tightness
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
  • Dyspareunia (Painful Penetration)
    • Dyspareunia
    • Vulvar Care
    • Accommodators and Dilators
    • Lubricants and Moisturizers
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
  • Interstitial Cystitis and Bladder Pain Syndrome
    • Interstitial Cystitis (IC) and Bladder Pain Syndrome (BPS)
    • Diet Modification for IC/BPS
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
  • Pudendal Nerve Irritation
    • Pudendal Nerve Irritation
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
  • Pregnancy
    • Pregnancy
    • Postpartum
    • Breastfeeding
  • Rectus Diastasis
    • Diastasis
  • Pelvic Girdle Pain (PGP)
    • Pelvic Girdle Pain
  • Tailbone (Coccyx) Pain
    • Tailbone (Coccyx) Pain
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Sleep
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Pain Education in a Nutshell
    • Catastrophization
  • Persistent Genital Arousal Disorder (PGAD)
    • Persistent Genital Arousal Disorder (PGAD)
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Sleep
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Pain Education in a Nutshell
    • Catastrophization
  • Menopause
    • Menopause
    • Vulvar Care
    • Lubricants and Moisturizers
    • Dyspareunia
  • Lubricants vs Moisturizers
    • Lubricants and Moisturizers
  • Chronic Non-Bacterial Prostatitis
    • Chronic Nonbacterial Prostatitis
    • Bladder Irritants
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
  • Prostatectomy
    • Prostatectomy
  • Paediatrics Pelvic Health
    • Pediatric Pelvic Physiotherapy
  • Transition Related Surgeries
    • Ways a Physiotherapist Can Help With Preparation and Rehabilitation for Transition-Related Surgeries
  • Preparing for Pelvic Surgery
    • Preparing for Pelvic Surgery
  • Post Pelvic Cancer Rehab
    • Post Pelvic Cancer Rehab
  • Post Breast Surgery Rehab
    • Articles coming soon
  • Lichen Simplex, Sclerosis, and Planus
    • Lichen Simplex, Sclerosis, and Planus
    • Accommodators and Dilators
    • Lubricants and Moisturizers
    • Vulvar Care
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Pain Education in a Nutshell
    • Catastrophization
  • Breastfeeding
    • Breastfeeding
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