The predominant symptom of Lichen Sclerosus is itching of the external genitalia in women. This comprises the labia majora, labia minora, the clitoral hood, and vestibule. Then scratching, intercourse and/or exercise can cause paper-cut like fissures that burn and may cause staining. Otherwise the tissues feel dry, tight, and chafed. Visually, the skin appears wrinkly, shiny and feels sticky. Subtle to stark white areas may appear. As the condition progresses, the labia minora or small lips fuse to the labia majora or large lips and gradually disappear. Fusion can occur above and beneath the clitoris thereby changing the sensitivity of the clitoris. The vaginal caliber can stricture causing pain with intercourse.  While the condition is not particularly uncommon, few gynecologists are experienced in the diagnosis and treatment of the condition. Especially if the condition is early and the tissue changes are subtle, the condition may be overlooked by providers. Consider the following comments by two patients:

“The problem started around ten years ago and I was told it was due to menopause and just aging. The itching was terrible and also had pain with intercourse. It was distracting and causing irritability. Saw about 3 doctors for it. One year ago I was diagnosed with Lichen Sclerosus. Then I was referred to Dr. Fowler 4 months ago. Now I'm doing much better, there is no longer any itching or pain, it's wonderful. Even the vulvar rinse is very helpful. The soap is also great. I'd say overall 95% of my previous symptom are gone.  I was so grateful I sent a thank you note the NP that referred me to Dr. Fowler; that was the the best thing that happened to me. It has changed much of my daily life. I am delighted with how quickly relief started after Dr. Fowler's prescribed treatment!” B. SunCity West, AZ

“I had suffered for years with undiagnosed symptoms and had seen a number of doctors back home in Canada; none of who could diagnosis the issue.  With one visit to Dr. Fowler he diagnosed my problem as Lichen Sclerosus.  An issue that I had struggled with for years was diagnosed and treated with one visit and 100% better within 4 months of the medicated treatment protocol.  I was so impressed with Dr Fowler that after I learned that he had retired from the Mayo Clinic (where I had first met him) I searched him up and found him practicing at Fowler Gyn International and have followed him there.” T. Edmonton Alberta, Canada

At Fowler Gyn International (FGI), we find most gynecologists do not know how to recognized especially the early signs of LS. And those gynecologists that are familiar with LS seem to consistently treat the condition by prescribing episodic potent corticosteriods such as Clobetasol. This is NOT a good approach. While this is an appropriate medication to start with in severe cases of LS, it is not appropriate for mild or moderate case or ongoing suppressive treatment. With prolonged use it can cause skin damage, bone demineralization or adrenal gland suppression. Also most providers use it whenever symptoms recur and nothing at other times, this allows the condition to progress between bouts of symptoms. At FGI we use specially formulated low dose corticosteriods on an ongoing basis to prevent recurrence of symptoms. This prevents asymptomatic progression of the condition.