Recognition and Management of Vulvar Dermatologic Conditions: Lichen Sclerosus, Lichen Planus, and Lichen Simplex Chronicus


  • Katrina Alef Thorstensen CNM, MSN,

  • Debra L. Birenbaum MD

Katrina Alef Thorstensen, CNM, MSN, Dartmouth-Hitchcock Medical Center, Department of Obstetrics and Gynecology, 1 Medical Center Drive, Lebanon, NH, 03756. E-mail:


Lichen sclerosus, lichen planus, and lichen simplex chronicus are dermatologic conditions that can affect the vulva. Symptoms include vulvar itching, irritation, burning, and pain, which may be chronic or recurrent and can lead to significant physical discomfort and emotional distress that can affect mood and sexual relationships. With symptoms similar to common vaginal infections, women often seek care from gynecological providers and may be treated for vaginal infections without relief. Recognition and treatment of these vulvar conditions is important for symptom relief, sexual function, prevention of progressive vulvar scarring, and to provide surveillance for associated vulvar cancer. This article reviews these conditions including signs and symptoms, the process of evaluation, treatment, and follow-up, with attention to education and guidelines for vulvar care and hygiene.