The medical community does not yet understand the exact nature or cause of lichen sclerosus (LS), although there is some general agreement on what does NOT cause LS.  It is generally thought, for instance, that LS is not caused by a virus, bacteria, or fungus -- but is instead something else entirely.¹

Currently, doctors can only treat the symptoms of LS, rather than provide a cure.  Regardless, professionals seem to agree that the condition is worsened by excessive heat and moisture, and that there is a possibility that some people may be genetically predisposed towards LS (i.e., the predisposition may be inherited, as seen in the few cases where more than one family member has LS).

Also, the medical community does have a few possible causes under consideration.

One such example is autoimmune theory.  The key elements of this theory are that:  (a) in people with LS, the system's own antibodies attack skin and tissue, causing damage, (b) many people have a predisposition toward LS, (c) LS is not brought about randomly, but is instead triggered by something affecting the body, and (d) LS has different triggers in different people.

Research has shown that possible triggers of LS include physical trauma and hormonal changes.  For example, some women experience the "Koebner phenomenon", meaning that they only have LS in areas that were previously damaged or scarred.  In these cases, the damage/scarring helped trigger the LS.  In contrast, other women's LS is hormone-related (rather than trauma-related, etc.), as demonstrated by the fact that the largest population of women with LS is post-menopausal.  Clearly, hormones play a role in triggering LS in these women.  Other evidence for a hormonal connection (in some female sufferers) is that girls with LS sometimes experience remission at puberty, and also that some women experience either relief of symptoms or remission during pregnancy.

One important aspect of autoimmunity is that autoimmune predispositions may be general (rather than condition-specific).  For example, it is possible that -- through genetics -- a mother and her two daughters are predisposed toward autoimmune problems.  Over time, the mother may develop rheumatoid arthritis (an autoimmune condition), one daughter may develop LS (another autoimmune condition), and the other daughter may develop both LS and myasthenia gravis (two separate autoimmune conditions).  The idea here is that, in a certain small percentage of cases, a predisposition toward autoimmunity may be a predisposition toward any number of autoimmune conditions -- not just a single condition.

However, it should be noted that many autoimmune disorders are extremely rare -- so it isn't worthwhile for LS sufferers to spend time worrying about these other disorders.  On the other hand, it is important to remember that, if you are an LS sufferer, there is a slight possibility that your future medical problems may be related to autoimmunity.  Likewise, because of the possible genetic link, there is the small possibility that other members of your family may experience problems that are autoimmune-related.

Other (related?) theories about the causes of LS can be found at Doctor Kate O'Hanlan's vulvar dystrophy site.

Articles on autoimmune theory can be found at:

• MEDLINEplus
• National Women's Health Information Center (NWHIC)
• The New York Times

Footnotes:

¹In research conducted outside the United States, LS has occasionally been linked to a Borrelia infection.  No link has been found between Borrelia and LS in the United States.

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