Dermatologist vs Gynecologist for Lichen Sclerosis?

Posted by evar @evar, Feb 18 7:16am

Good-morning-
A few months ago at my full body skin check the derm diagnosed Lichen Sclerosis: "You don't need a biopsy, it's unequivocally LS." She then said Gynecologists treat LS with heavy duty topical steroids, which Dermatologists do not. I consulted with a Gyn who agreed I likely have LS but recommended a biopsy to be certain. She also said Gyn's do in fact recommend daily steroids to reduce inflammation, even if a person is asymptomatic, because the inflammation is believed to be the source of the increased incidences of vulvar cancer in LS patients. I'm essentially symptom-free, but don't want to ignore it. How are others treating their condition? Are you managed by your Derm or Gyn? Taking daily steroids even if asymptomatic? Thanks!

Interested in more discussions like this? Go to the Autoimmune Diseases Support Group.

@evar. This is a good question. Many women have lichen sclerosis and doctors seem to treat all of them differently. This comment, by @colleenyoung , in a discussion about lichen sclerosis will direct you to discussions about treatments
https://connect.mayoclinic.org/comment/806344/
https://connect.mayoclinic.org/comment/183333/
Here is another discussion where you will meet members who have/have had LS. I’m sure they will have good information for you
You said that you are currently asymptomatic. Do the doctors want you to take treatment anyway?

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I have LS. I don’t take steroids, however I apply Clobetasol, an ointment that does contain a steroid that can cause some thinning of the skin where it is applied. This is different from taking a system wide steroid. I have used Clobetasol for over 25 years with no problems. I was using it twice a week for two weeks then none on the third week just Vaseline then back to the Clobetasol routine.

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@willows

I have LS. I don’t take steroids, however I apply Clobetasol, an ointment that does contain a steroid that can cause some thinning of the skin where it is applied. This is different from taking a system wide steroid. I have used Clobetasol for over 25 years with no problems. I was using it twice a week for two weeks then none on the third week just Vaseline then back to the Clobetasol routine.

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I also use topical clobetasol ointment prescribed by my current gynecologist. She also prescribed topical estrogen to combat the skin thinning and mupirocin in the event of infected skin breaks. My LS impacts both the vulvar and perianal regions.

I found my current doctor after moving to a new town by searching on lichen sclerosis, willing to see either a dermatologist or gynecologist. I needed both but I had a flare. The doctor I found happened to be a gynecologist who specialized in both LS and menopausal women.

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I don’t understand at all how a person with LS can be asymptomatic? It’s a horrible condition and if I ignored it, would be even way worse, like it used to be before “finally” being diagnosed. I’ve been on mometasol ointment (2-3x/wk)/Clobetasol cream (daily) /Betamethasone ointment (past). Also estradiol inserted weekly.

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Yes, it is horrible. I find stress makes mine worse. Are you symptom free more or less with this protocol? I’ve hesitated to use drugs for extended periods.

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I also have LS my first biopsy was at 15 years old. I am 75 ys old now, just had biopsy of rectum area. I am negative for cancer.

Is there a support group here. I go to one but am always open to new information and support.

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@helendances

I also use topical clobetasol ointment prescribed by my current gynecologist. She also prescribed topical estrogen to combat the skin thinning and mupirocin in the event of infected skin breaks. My LS impacts both the vulvar and perianal regions.

I found my current doctor after moving to a new town by searching on lichen sclerosis, willing to see either a dermatologist or gynecologist. I needed both but I had a flare. The doctor I found happened to be a gynecologist who specialized in both LS and menopausal women.

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One of the telltale signs of LS is that it does affect both the vulvar and peri anal regions. The classic butterfly shape. If doctors only knew that about it would be a significant advantage in suspecting LS.

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@alikiw

I also have LS my first biopsy was at 15 years old. I am 75 ys old now, just had biopsy of rectum area. I am negative for cancer.

Is there a support group here. I go to one but am always open to new information and support.

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@alikiw You’ve been dealing with LS doe a long time now! You must have lots of good information that you can pass along to others. There are groups on Mayo Clinic Connect that are just like support groups
https://connect.mayoclinic.org/discussion/lichen-schlerosus/. There are others, too. Just enter ‘lichen sclerosis groups’ in the search space at the top of this page. Then, just click on the one that seems interesting.
Try it and see if it works for you and let me know!

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I just sent a reply to one woman. Is there a way for me to introduce my self in this??

What are your guidelines?

I sent this as a reply to a 65 yr old who said she can never have sex..

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I found it. The profile and tips.

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