Lichen sclerosus care online, between your yearly exams

Common symptoms

• White, thin, itchy skin on the vulva or around the anus
• Itch or soreness that comes back after treatment (a flare)
• Skin that can scar over time

May fit online care

• Adults 18 and older
• You are 18 or older and in Virginia or West Virginia
• A biopsy confirmed your lichen sclerosus, or a skin doctor, a gynecologist, or a vulvar specialist examined you in person and told you that you have it
• You finished your first treatment
• A clinician examined you in person after that, in the last 12 months
• You have used a steroid ointment on this skin before
• You have none of the warning signs listed below

Look for another care setting

• Trouble breathing, or wheezing (call 911 or go to the ER now).
• Swelling of your lips, tongue, face, or throat, or trouble swallowing (call 911 or go to the ER now).
• No way to pass any urine (call 911 or go to the ER now).
• Bleeding that soaks a pad every hour (call 911 or go to the ER now).
• If any of the signs above start after you use the ointment, stop using it and call 911 or go to the ER now.
• A fever of 100.4 F (38 C) or higher, or shaking chills (see a doctor in person today).
• Skin on your vulva that is red, hot, swollen, very painful, or has pus (see a doctor in person today).
• Painful blisters or small sores that started in the last few days (see a doctor in person today).
• Hives, or an itchy rash all over your body, after you use the ointment (see a doctor in person today).
• If any of the signs just above start after you use the ointment, stop using it first, then see a doctor in person today.
• A new lump or growth (see a doctor in person within 7 days).
• A sore, crack, or raw spot that has not healed in 2 weeks (see a doctor in person within 7 days).
• Skin that is thicker, raised, rough, or like a wart (see a doctor in person within 7 days).
• Bleeding that is not from scratching and is not your period (see a doctor in person within 7 days).
• A new red, purple, or bruised patch (see a doctor in person within 7 days).
• A patch that turns pink, brown, or dark, or a mole that changes (see a doctor in person within 7 days).
• One patch that looks different from the rest, or does not get better with your ointment. That includes one patch that is not better after 14 nights (see a doctor in person within 7 days).
• These can be signs of skin cancer. Finding it early helps.
• Your itch or soreness has not been under control for more than 4 weeks, even with your ointment (see a doctor in person within 14 days).
• Your itch or soreness came back in the last 4 weeks, and you had another flare in the 3 months before (see a doctor in person within 14 days).
• Your itch or soreness gets worse while you use the ointment every night for a flare (see a doctor in person within 14 days).
• Your itch or soreness, as a whole, is not better after you use the ointment every night for 14 nights (see a doctor in person within 14 days).
• You usually need your ointment more than 3 times a week to keep your symptoms down. Do not count a flare step your doctor told you to use (see a doctor in person within 14 days).
• You used more than 30 grams of ointment in the last 6 months. Do not count your first 3-month course (see a doctor in person within 14 days).
• You have new pain when you pass urine, a weaker urine stream, or new pain with sex (see a doctor in person within 14 days).
• You have new discharge from the vagina, a bad smell, or burning inside the vagina (see a doctor in person within 14 days).
• The opening of your vagina feels tighter, or the folds of skin look more stuck together (see a doctor in person within 14 days).
• You have painful bowel movements, or new cracks near the anus (see a doctor in person within 14 days).
• The skin where you use the ointment has gotten thinner since your last in-person exam (see a doctor in person within 14 days).
• While you wait to be seen for a sign in the 7-day or 14-day lists, use your ointment only on the usual schedule your own doctor gave you. Do not add extra nights. If your own doctor did not give you a schedule, ask your own doctor how to use it.
• You were told you have lichen sclerosus, but you did not have a biopsy and did not see a skin doctor, a gynecologist, or a vulvar specialist (see your own doctor).
• No clinician has examined you in person for this, or you are not sure (see your own doctor).
• Your last exam in person for this was more than 12 months ago, or you are not sure when it was (see your own doctor).
• You are still on your first treatment, or you have never used a steroid ointment on this skin (see your own doctor).
• No clinician has examined you in person since you finished your first treatment, or you are not sure (see your own doctor).
• You also have lichen planus, or sores or scars inside the vagina (see your own doctor).
• You have had precancer or cancer of the vulva (see your own doctor).
• A specialist gives you a pill or shots for this, or is changing your plan now (see your own doctor).
• Your lichen sclerosus is only on skin away from the vulva and anus, or on the penis (see your own doctor).
• You are pregnant or might be, you plan to get pregnant in the next 3 months, or you are breastfeeding (see your own doctor).
• Neither of our two ointments is safe for you, for example because of an allergy. We will not send one (see your own doctor).
• You are under 18 (see your own doctor).
• If you are pregnant or breastfeeding, ask your own doctor how to use your ointment.
• If more than one fits, follow the first one.