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Does Trauma cause Lichen Sclerosus?

Does Trauma cause Lichen Sclerosus?

Introduction

A lichen sclerosus diagnosis can be a heavy thing to process. It can bring up a lot of negative emotions, thoughts, and feelings, such as anger, frustration, fear, and more. As folks process their diagnosis, some begin to wonder what caused their LS. In fact, we frequently hear folks express wanting to know what caused this or share their theories on what caused it. Some of those theories involve past trauma as the causal factor behind LS. Today, we will be addressing the question of whether lichen sclerosus is caused by trauma. If this does not feel supportive to you, please feel free to skip this blog and return to it at a time that feels right and safe for you.

Disclaimers

*This post is evidence-based; I draw on the medical literature to share what you need to know about lichen sclerosus and trauma. Importantly, what I share is my interpretation of the science and data.

**The information contained in this blog post is up-to-date at the time of publication. 

***If this post is helpful to you, we’d love your support so we can continue providing important education like this. Make a donation today, volunteer with us, or share our posts in your support groups.

What We Mean by Trauma

We appreciate that trauma can be understood in a multitude of ways. When discussing trauma in the context of lichen sclerosus, we define trauma as including:

  • Damage to the skin from scratching
  • Chronic friction (e.g., caused by wearing tight clothing for extended periods of time)
  • Medical trauma (e.g., being poked and prodded in a room full of doctors talking about you as if you are an object, being medically gaslit, etc.)
  • Surgery (e.g., a hysterectomy)
  • Injury to the pelvis
  • Sexual abuse
  • Traumatic childbirth
  • And more


It’s important to realize that trauma is a broad category. Further, some people will have multiple traumas involving the genito-pelvic area of the body.

Cause versus Risk Factor

A cause is something that directly leads to a particular outcome or result, like lighting a match causing a fire.

On the other hand, a risk factor increases the likelihood of a certain outcome happening but doesn't necessarily guarantee it. For example, smoking is a cause of lung cancer because it directly contributes to developing the condition. However, being exposed to secondhand smoke is a risk factor for lung cancer because it raises the chances of getting the condition, but doesn't always result in it.

Causes make things happen, while risk factors make things more likely to happen.

What does the Science Say about Trauma and Vulvar Lichen Sclerosus?

Graphic design image of a research paper with a pencil on the side representing the research that considers or mentions trauma and lichen sclerosus.

Trauma is often cited as a risk factor for lichen sclerosus; for example, Kirtschig (2016) identifies trauma as a risk factor for lichen sclerosus. De Luca et al. (2023) also identify trauma as a risk factor for developing LS. In their paper, they state, “Hormonal status, frequent trauma, and autoimmune diseases are well-known associations for LS” (emphasis mine).

Higgins and Cruickshank (2012) highlight genital trauma (they do not define this) and the Kobner phenomenon as potential causal factors for LS. For those unfamiliar with the Kobner phenomenon, this essentially means the appearance of new skin lesions that appear after trauma, injury, or surgery on the skin. To quote, “The Koebner phenomenon is known to occur (lichen sclerosus occurs in skin already scarred or damaged), so trauma, injury, and sexual abuse have been suggested as possible triggers of symptoms in genetically predisposed people.” (Powell & Wojnarowska, 1999).

Unfortunately, the majority of papers will either suggest trauma as a potential cause or risk factor but do not offer any more details on the matter. We need a lot more research in this area to better understand the connection between trauma and vulvar lichen sclerosus.

Does Trauma Cause LS

So, back to the question–is lichen sclerosus caused by trauma? The answer is, unfortunately, we do not fully know yet. In all the papers I survey, they all speculate trauma to be a risk factor. However, none outright state it causes LS.

While there certainly seems to be a connection between the two, this connection is not fully understood. For example, what happens at a cellular-molecular level when trauma is experienced that leads to a local, overactive immune response causing high levels of inflammation is unknown. It’s also unclear why some people with trauma develop LS and others with trauma do not.

Indeed, it is possible that different people have different causal factors, especially if it turns out there are certain subtypes/groups of vulvar lichen sclerosus. For some, the cause may be certain medications or infections. For others, it may be trauma–and that can include one or multiple traumas. 

What We See In The Community

The topic of trauma often comes up in our virtual meetups, whether it is someone asking if other people have experienced trauma and think it plays a role in their LS or someone sharing their story (which includes past trauma(s).

Graphic image design of four different people representing the LS community.

We at LSSN see trauma as a common thread uniting many (though not all) people in the LS community.

I (Jaclyn) have connected with other LS patient leaders globally who also report similar findings. That is, overall, it seems that a large percentage of the LS community has a history of trauma. I’m hoping to see more research on this topic in the future. I have a guest blog post on my website on the topic of whether LS and trauma are connected; click here to read this piece.

If you have trauma in your history, you are not alone. You are amongst hundreds of brave warriors out there.

How to Process and Manage Trauma

If you have trauma and think it played a role in developing LS or believe it to be slowing your healing journey, you may want to consider some of the following options to help process and manage trauma.

  • Trauma Releasing Exercises (you can see if there are professionals in this area who can guide you through this, or you can try some exercises on YouTube).
  • Therapy–ideally with a therapist who has a background in trauma
  • EMDR–Eye Movement Desensitization and Reprocessing (look for a therapist trained in this)
  • Art therapy
  • Somatic and body-based practices like dancing and shaking
  • Books on trauma and healing:
  • There are so many good ones, but some of my (Jaclyn) favorites are The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture by Gabor Maté, The Mindful Self Compassion Workbook by Christopher Germer and Dr. Kristin Neff and Getting Past Your Past by Francine Shapiro.
  • Share your favorite books in the comment section below.
  • Listen to the Moving Out of Trauma Podcast
  • Community-based healing events like grief and trauma processing (check your local community center or Facebook group to see if there is anything near you).
  • Other (please share what has helped you in your healing journey with trauma in the comments below.

Want to learn more about trauma, LS, and how to heal? Listen to this podcast I did with Dr. Rebecca Patton (pelvic floor PT) and Kandace (EMDR therapist). It’s definitely worth a listen!

Conclusion on Is Lichen Sclerosus Caused by Trauma

In sum, we do not know enough about the connection between trauma and LS to be able to state that lichen sclerosus is caused by trauma confidently. Trauma is sometimes mentioned as a risk factor in some papers. However, it’s usually just flagged as a potential risk factor or cause, and then the authors move on to another topic. We see a large number of people in the LS community who have trauma, and we would love to see more research on this topic moving forward.

The topic of trauma, in general, can bring a lot of emotions to the surface, even more so when you add LS into the mix. Please be sure to do something nice for yourself, reach out to your support network/community, or talk with your therapist if you need support.

Share your thoughts in the comments if it feels safe and right for you to do.

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Reach Out to Me

Whether you are debating booking a support call with me, have a quick question, or want to share something related to my content, I can be reached via:

Email: Jaclyn@lostlabia.com

DM: @thelostlabiachronicles on Instagram, Facebook, and TikTok.

Support Resources

FREE Lichen Sclerosus Virtual Meetup hosted by myself and Kathy of Lichen Sclerosus Podcast – sign up here.

Feel free to book a 1:1 call with me if you struggle with grief and emotions. Simply click this link to learn more about lichen sclerosus peer support calls.

Image of a person with dark brown skin and dark hair wearing a yellow shirt sitting at a desk on a call. The title text reads, "1:1 LS Peer Support Calls, book now".

LSSN Membership – sign up here.

For a more detailed list of free and paid support resources, check out my LS resources page here.

References

1.Higgins CA, Cruickshank ME. A population-based case–control study of aetiological factors associated with vulval lichen sclerosus. Journal of Obstetrics and Gynaecology. 2012;32(3):271-275. doi:https://doi.org/10.3109/01443615.2011.649320

2.De Luca DA, Papara C, Vorobyev A, et al. Lichen sclerosus: The 2023 update. Frontiers in Medicine. 2023;10:1106318. doi:https://doi.org/10.3389/fmed.2023.1106318

3.Kirtschig G. Lichen Sclerosus—Presentation, Diagnosis and Management. Deutsches Aerzteblatt Online. Published online May 13, 2016. doi:https://doi.org/10.3238/arztebl.2016.0337

4.Sideri M, Fabio Parazzini, Maria Teresa Rognoni, et al. Risk factors for vulvar lichen sclerosus. American Journal of Obstetrics and Gynecology. 1989;161(1):38-42. doi:https://doi.org/10.1016/0002-9378(89)90228-7

6 Comments

  • Ronni

    Hi Jaclyn,

    Thank you for the article and your ongoing support to bring credible information LS sufferers! It really did give me a support when I was going out of my mind when first diagnosed. Of most difficulty, was the lack of knowledge and support through professionals. So your information helped me be proactive. And I have finally found a brilliant doctor too!

    In regards to this article about trauma, I was just wondering, under the heading ‘What we mean by trauma’, I note there is a list of items that are regarding direct physical trauma (presumably to the vulval area?) However, under medical trauma you elude to psychological trauma but do not explicitly state this. Based on the content of the article, I assume it means psychological trauma as well? And could trauma also mean not necessarily related to the vulval area? Eg. Any kind of trauma that could trigger some sort of illness and disease?
    Thanks!
    Ronni

    • Jaclyn Lanthier

      Hi, Ronni. Yes, the list was not-exhaustive, because what falls under ‘trauma’ can be quite lengthy. But yes, I personally would include psychological trauma to the vulvar area, yes. Thanks for your comment! With love,

  • Brenda L

    I thought I’d share what happened to me. I needed an emergency marsupialisation surgery for a left side Bartholin cyst. The Bartholin glands secrete fluid that help lubricate your vagina. I had never heard of Bartholin glands/cysts before prior to this. The surgery didn’t feel right to me before I even left the hospital. I wouldn’t be surprised if LS resulted from the surgery trauma mingled with autoimmune issues. It was a botched surgery (I am leaving out a lot of info). Despite this I found it odd that my labia majora (both sides) looked like bread dough that needed to be punched back down the more I walked or sat (so much swelling & pinching sensations). That was just the beginning of symptoms and I was baffled. I felt relieved to know I had LS some years later. Thank you for a great write-up.

    • Jaclyn Lanthier

      Oh, wow! Brenda, thank you so much for this brave share! That sounds very traumatic indeed; I’m so sorry this happened to you. Yup, I remember feeling relieved to have a diagnosis too. Thanks for your comment <3 With love,

  • Anne

    Jacklyn: Your comments in this post really resonated with me. I’d never considered the cumulative effects of the traumas and injury to my genito-pelvic area. Over my 70 years, I’ve experienced a traumatic childbirth, a high profile sexual assault which required years of therapy, uterine cancer which resulted in a complete abdominal hysterectomy including removal of the vagina, and very invasive painful and humiliating brachia-therapy treatments. My diagnosis of LS last year was another kick, but I approached it like I have all the other traumas in my life. LS is not life threatening and this new information gives me some “peace” if I can call it that. I often wondered what I did in a past life to deserve all this, but now I can see that LS is a badge of honour for having survived and beat my past traumas. I have a strong personality and not even this will bring me down. I was meant to be alive for a reason and all my accomplishments and joy I have in my life far outweigh this latest diagnosis. I pray others find hope, joy and meaning in their lives too.

    • Jaclyn Lanthier

      Wow, Anne! Thank you so much for such a vulnerable share; you are an incredibly brave soul. You have been through so, so much – *hugs* So glad you have done a lot of healing work and have joy and value in your life!

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