Lichen sclerosus in children

Relieve instead of endure

Itching and burning in the genital area: Many people do not allow this to be clarified and treated out of misplaced shame. Often the non-infectious skin inflammation lichen sclerosus is the cause, which mostly occurs in women. But even children – mainly boys here – can be affected. The earlier the therapy begins, the faster and more effectively the stressful symptoms can be alleviated.

What is lichen sclerosus?

Scientists suspect that it is an autoimmune disease: lichen sclerosus manifests itself as a chronic inflammatory reaction of the skin, mostly in the genital area.

In adulthood, women are predominantly affected; among children and adolescents, boys are more frequently affected. Symptoms usually start in elementary school or during puberty. However, it is not uncommon for the initial treatment to be incorrect or it does not happen at all.

Disease characteristics

The skin disease manifests itself in boys and girls primarily through itching and burning in the genital and/or anal area. The symptoms often occur in episodes over a long period of time. Lichen sclerosus should also be considered if there is repeated pain when urinating for months or even years, but the urine does not show any bacteria during the examination.

What are the symptoms?

In summary, the typical symptoms are:

  • Itching and burning in the genital and anal areas
  • Scarring of the vagina or penis and consequent narrowing of the foreskin or urethral meatus
  • whitish shiny areas of skin
  • Redness or open sores
  • Anal fissures (painful cracks)

What is known about the causes?

The exact causes are still unclear. Researchers assume that a genetic tendency to the disease plays a role: it tends to run in families. Certain triggers can then cause an (auto) immune reaction over the course of life, which is accompanied by chronic inflammation of the skin. These stimuli include pressure, friction (e.g. from tissue) and small injuries, so-called microtraumas. In boys they affect the foreskin, in girls mostly the external or internal genitals.

How is the medical diagnosis made?

The medical diagnosis is made by visual examination based on the visible symptoms. Children with lichen sclerosus and their families often go through years of discomfort and visits to the doctor before a proper diagnosis and targeted treatment can be made. Because the initially non-specific symptoms occur in many different skin disorders. The disease is often not sufficiently known, or a suspicion is prematurely dismissed. A biopsy is possible, but controversial: the tissue findings are often non-specific in the early stages of children and are then not meaningful.

Treatment & Therapy

Due to the chronic course of the disease, symptoms can reoccur over the course of a lifetime and fuel the disease again. However, simple care The disease cannot be cured and can occur again and again in the course of life. With regular care, however, it can usually be treated well, so that only slight symptoms or no symptoms at all appear for a long time. Especially in boys, the symptoms fade into the background with good and consistent treatment in adulthood.

During acute therapy, the doctor prescribes an ointment containing cortisone with a therapy plan lasting four weeks to three months - depending on the severity. During and after this, a nurturing maintenance treatment is carried out in the intimate area with moisturizing ointments that nourish the dry areas. Itching and burning are relieved. Appropriate preparations with thymus peptides obviously have a regenerating and supportive effect on the upper layers of the skin.

In a clinical observation1, the care cream Thymuskin Sclero discret, which contains a thymus peptide complex, was able to show hopeful results accompanying therapy: in over 71% of the cases of adult sufferers, there was a reduction in itching, burning and sclerosis, flare-free intervals could be extended, side effects did not occur. The cream is also suitable for children from 3 years of age.

Important to know

Care should be regular and should not end when the patient is free of symptoms, otherwise a relapse may occur. Regular medical check-ups should also take place after puberty: women in particular tend to relapse.

If three months of cortisone treatment produces little or no improvement in boys, circumcision is often recommended.

Instructions for everyday life

Mechanical stimuli, the most common trigger, can be effectively reduced with the following measures:

  • Girls should not cycle for too long and always use a soft saddle suitable for them.
  • Underwear should not srub and be made of cotton or cooling silk.
  • Damp bathing suits or sweaty underwear promote inflammation and should therefore be changed promptly.

¹ M. Hagedorn, S. Polley, E. Hasche: Behandlung und Pflege von genitalem Lichen sclerosus, 2008