Lichen sclerosus (LS) is an uncomfortable skin condition that mainly affects the skin of the genital area. Many women experience symptoms such as itching and a burning sensation between the labia or pain when the area is touched. Medical treatment is essential, but it is not the whole story. The way the skin is cared for and protected also makes a significant difference to daily comfort.
What is lichen sclerosus?
Lichen sclerosus is a long-term (chronic) inflammatory skin condition that mainly develops around the genitals and sometimes around the anus. Because the condition affects the external skin, the vaginal lining itself is usually not involved in women.
Lichen sclerosus can occur at any age, but it is most common in women before and after menopause. It is less common in men and children, although similar symptoms can occur in these groups.
What causes lichen sclerosus?
The exact cause is unknown, but researchers suspect that autoimmune mechanisms play an important role. Genetic predisposition and hormonal factors may also contribute to the development of the condition.
Symptoms
Research from 2017 confirms that itching of the vulva (around the labia and the vaginal opening) is the most common symptom and also the most troublesome.
This intense itching is often accompanied by a burning or painful sensation and is usually one of the first symptoms to appear.
Symptoms may be constant or worsen due to heat, friction or after washing.
Other possible symptoms include:
These symptoms have a considerable impact on daily life.
Mental wellbeing is also affected
Persistent itching and pain are not only physically distressing, but they can also have a mental impact. Feelings of shame, prolonged stress, reduced sexual desire, fear of pain and sleep problems are frequently reported. The physical and mental impact significantly reduces quality of life.
Itching and burning: why do they keep coming back?
Itching and burning are not only the most common symptoms, they are also recurring. Why?
In lichen sclerosus, the skin remains chronically inflamed. This weakens the skin barrier, causing nerve endings to respond more quickly to stimuli such as heat, friction or even urine.
This hypersensitivity leads to ongoing itching and a burning sensation in the genital area.
An ointment or cream may temporarily relieve symptoms, but they often return over time. The structure and elasticity of the skin are permanently altered.
Repeated scratching or scar formation further increases skin sensitivity, creating a vicious cycle of itching, scratching and renewed irritation, also known as the itch-scratch cycle.
Research from the University of Bologna shows that not only the inflammation itself but also everyday factors such as friction, heat and synthetic clothing can worsen symptoms.
This is why lichen sclerosus requires a broad approach: medical treatment to suppress inflammation, combined with skin-friendly clothing, appropriate skincare and self-care to calm the skin and prevent further irritation.
Combining medical treatment with skin-friendly clothing
Below, we discuss standard treatment (topical steroids) and complementary treatment (medical underwear).
Treatment with topical steroids (corticosteroids)
The standard treatment for lichen sclerosus consists of a potent corticosteroid ointment, usually clobetasol propionate 0.05%. This ointment reduces inflammation, limits scar formation and helps maintain skin flexibility, reducing itching and pain.
The use of corticosteroids should always be tailored to the individual. Always discuss this with a GP or dermatologist.
In addition to medicated ointments, doctors often recommend using a greasy base ointment. These neutral ointments contain no medication but help protect, hydrate and soften the skin. They are used alongside corticosteroid treatment, not as a replacement.
Medical underwear as an addition to medication. The benefits of silk
Although medication helps control inflammation, the skin often remains fragile and sensitive to external stimuli.
This is where skin-friendly clothing can be a valuable addition to medical treatment.
Prolonged friction or wearing synthetic underwear, such as nylon or polyester briefs, can worsen symptoms. These materials allow little airflow and retain moisture, increasing the risk of irritation.
Cotton is often recommended, but it is not always the best option. While it may feel comfortable, cotton absorbs moisture and stays damp, which can actually increase friction and irritation.
Soft, breathable materials regulate moisture far more effectively. Silk is a good example, helping to keep the skin calmer.
For this reason, dermatologists are increasingly studying the effect of medically treated silk as part of daily skin comfort. One of the best-known examples of medical silk underwear is DermaSilk Intimo.
What is DermaSilk and how does it work?
DermaSilk underwear is specifically developed to protect and comfort sensitive skin in the genital area, including in conditions such as lichen sclerosus.
The garments include briefs and shorts made from pure medical silk (100% sericin-free) and have a permanent antibacterial finish that does not wash out. The fabric does not disrupt the natural bacterial balance of the skin.
Key features of DermaSilk include:
Research and case studies
The benefits of medical underwear have been studied, including research by the University of Bologna and several case studies.
A clinical study involving 42 women with lichen sclerosus showed that those who wore medical silk underwear alongside corticosteroid treatment experienced improvement more quickly. After a few weeks, they reported less itching, pain and burning compared to women wearing cotton underwear.
After six months, some participants even achieved complete symptom control.
Additional case studies involving 14 women also reported reduced irritation, itching, pain and burning.
In some cases, women reported needing less medicated ointment while wearing medical silk underwear. It should be noted that these are individual experiences.
The rapid reduction in symptoms observed in these case studies is clearly shown in the graph below.
The graph illustrates the effect of DermaSilk on pain, burning and irritation in vulval symptoms over a four-week period.
It demonstrates that medical underwear can be a valuable addition to treatment. The main reason is that the clothing protects the skin and improves comfort. As the graph shows, noticeable results can be achieved without a long wait.
Conclusion
Itching and a burning sensation in lichen sclerosus are more than just uncomfortable. They can affect daily comfort and self-confidence. Alongside medical treatment with corticosteroid creams to control inflammation, soft, skin-friendly DermaSilk clothing has been shown to significantly reduce symptoms such as itching and irritation.
As the Bologna researchers concluded:
“DermaSilk fabric may represent a simple but effective way to enhance the quality of life in patients with chronic vulvar diseases.”
FAQs
There is no specific diet that cures lichen sclerosus, but certain foods may worsen symptoms. Highly processed foods, sugar, spicy foods, coffee and alcohol can further irritate the skin.
For some people, gluten, dairy products and nightshade vegetables such as tomatoes and peppers may also increase irritation. An anti-inflammatory diet rich in vegetables, fruit, fish and olive oil may help. If in doubt, always consult your GP or dietitian.
No. Bacteria and fungi cannot become resistant to DermaSilk because its action is mechanical rather than chemical.
The AEGIS molecule damages the cell wall of micro-organisms upon contact. Because no substances are released or absorbed, micro-organisms cannot adapt to it. This ensures long-lasting effectiveness, even with prolonged use and repeated washing.
DermaSilk differs from ordinary silk because it is antibacterial. The fibres contain the AEGIS molecule, which inhibits bacteria and fungi without harming healthy skin bacteria.
In addition, sericin, a substance in regular silk that can cause irritation, has been removed from the fibres. This reduces the risk of skin reactions.
Yes. Allow the medicated cream to absorb fully before putting on the underwear. DermaSilk is breathable and does not absorb active ingredients, so it does not affect the effectiveness of medicated ointments.
Many users notice reduced itching and irritation within days to weeks. Research shows that women with lichen sclerosus who wore DermaSilk alongside medical treatment experienced improvement in itching and burning within the first month.
Ladies DermaSilk clothing range
Our specially designed range of women’s garments are made from a single layer of knitted, medical grade silk fabric which, by allowing the free flow of air, helps control body temperature which in turn reduces the itching and scratching so often associated with various forms of eczema and contact dermatitis.