Underwear and lichen sclerosus is a topic we get asked a lot about at Lichen Sclerosus Support Network. Folks have questions like: “What should I look for in underwear,” “Are there certain kinds of underwear that aggravate lichen sclerosus symptoms” and “What is the best kind of underwear for lichen sclerosus?” These are lifestyle questions seldom addressed at the doctor's office, so today, we will chat about underwear and lichen sclerosus.
In today's post, I will discuss how underwear can sometimes make lichen sclerosus worse, answer the question “What is the best type of underwear for lichen sclerosus,” and then review different underwear options for you to explore.
*I have no affiliate links in this post. Any brand I mention is either just one I like or one I have heard others recommend. I get no commission if you purchase from any of these links.
How Underwear Can *Sometimes* Make Lichen Sclerosus Worse
Lichen sclerosus can cause symptoms like vulvar itch, pain, soreness, and irritation. This can mean that external factors like fabric can increase and worsen those symptoms for some folks.
Think about it like this.
Most of us have experienced a sunburn before. When you have a sunburn, the touch of your clothing and bedsheets can feel incredibly painful. It is as if your body suddenly has heightened pain sensitivity.
This is because when the body is experiencing pain or discomfort, materials can make those sensations feel worse.
Same for the vulva with lichen sclerosus. If you are symptomatic, the materials of your underwear may cause more discomfort.
To be clear, underwear does not *cause* lichen sclerosus, but it can cause irritation, especially if you have symptomatic.
What are the Best Underwear for Lichen Sclerosus
You may be wondering, “If underwear can irritate my LS symptoms, what is the best type of underwear for LS?”
The best kind of underwear for lichen sclerosus is the kind that feels best for you and your body. ‘Best' is subjective to each individual. Some folks love bamboo underwear; others hate them. No one universally agreed upon type or brand works for everyone, and that is OK.
Similarly, it would help if you avoided underwear that increases your symptoms and does not work for your body.
Cotton Underwear and Lichen Sclerosus
Cotton underwear can be a good choice as it is very breathable and does not retain moisture. Some folks find excess moisture to be irritating. Further, folks with lichen sclerosus tend to prefer breathable materials around their vulva.
Cotton underwear come in many different styles.
- Classic brief
- High cut
- And more
When you are symptomatic, you may want to avoid styles like bikinis, tangas, and thongs, which are often very tight and cause a lot of friction, rubbing, and irritation of the vulva.
When it comes to underwear, my go-to is cotton, classic briefs.
Pro-tip: Order them a size or two larger than you usually would so they are baggier, and the gusset – the extra layer of fabric sewn into the crotch portion of the underwear – is not sitting and rubbing directly on the vulva.
As for brands, you can buy whatever is most affordable for you. I usually buy a bulk pack of white cotton briefs from Fruit of the Loom because it is my cheapest option.
Boxers are another option folks in the LS community like. Boxers are often made of cotton and can be purchased in bulk.
It is nice that these do not have material that sits directly on the vulvar skin. Instead, there is a nice amount of ‘free space' between the vulva and the boxers. It is almost like going commando, but you know you are still covered.
Bamboo Underwear and Lichen Sclerosus
Lately, we have heard a lot of good feedback about bamboo underwear. These underwear are made with bamboo, which is a woody plant with a hollow stem (pandas like to munch on it), instead of cotton or other materials.
Here is a quote on the benefits of bamboo underwear from Sustainability Tracker.com
“Bamboo contains an anti-bacterial and anti-fungal bio-agent which is retained through the process of fabrication and after washing. This property also makes Boody garments odour-resistant. This is so important because the structure of the bamboo fibres contains micro-gaps, which provide ventilation and evaporates moisture that causes bacteria to multiply.
Not only is organic bamboo underwear breathable, but the fabric is also more naturally moisture wicking and absorbent than other materials— which leaves you feeling fresh and dry throughout the day. Fun fact: Bamboo fibre is naturally absorbent and speedily wicks away moisture – up to four times faster than cotton.”
The downside is that these underwear are substantially more expensive than standard cotton. However, it may be worth it if they relieve symptoms.
There are different styles of bamboo underwear, such as the classic brief, high rise, bikini, boxers, thongs, and more.
Here is one popular site I have heard a lot about. I cannot personally vouch for them; I wear regular cotton underwear or commando.
Silk Underwear and Lichen Sclerosus
Another popular option in the LS community is silk underwear.
I do not personally wear silk underwear. I have heard others in the community say that while they are soothing and gentle, they are terrible at wicking away moisture and have to change their underwear multiple times a day because of excess sweat. However, others swear by them. Try getting one pair and testing out how you like them before buying a ton.
DermaSilk is a popular brand in the UK. They are often at medical conferences. Their clothing and underwear are designed for folks with dermatological conditions, including but not limited to eczema, psoriasis, lichen sclerosus, lichen simplex chronicus, etc.
They ran a double-blind, randomized control trial with one group wearing cotton underwear and the other wearing silk underwear in folks with lichen simplex chronicus.
They state: “The results of the present study provide evidence that silk fabric underwear may be a useful tool for VLSC management by diminishing external sources of irritation and by synergizing with the anti-inflammatory action of topical corticosteroids.” – From their leaflet, I picked up at the British Society for the Study of Vulval Diseases, March 2023.
VLSC = Vulvar Lichen Simplex Chronicus
DermaSilk markets its underwear as a class I medical device that can preserve the optimal temperature and humidity around the general area. Its antimicrobial properties allegedly remove excessive bacteria and fungi. I cannot corroborate these claims.
Learn more about DermaSilk and Lichen Sclerosus on their page. (They seem to ship internationally).
Silk underwear tends to be very expensive, so buy one pair to see if you like them before buying many different pairs.
Ditching the Underwear and Embracing the Commando Life
Another popular option is to ditch the underwear and go commando. If you are unfamiliar with that phrase, it means wearing no underwear. Many folks opt to do this as they find it less irritating.
It is also the cheapest option because you do not have to buy anything.
I go commando most days (including when I go to the gym), but I stick with plain ol' cotton when I wear underwear.
Should You Throw Out Those Sexy, Lacy Thongs?
If you follow my journey, you know I threw out all of my lingerie and sexy, lacy thongs after my diagnosis.
Truthfully, I regret that now.
When you are symptomatic, you may need to be more mindful of your underwear choice and temporarily place those lacy thongs on a time-out. However, that does not mean you can never wear them again.
Now that I am in remission, I can wear thongs again without irritation or flares. I rarely do, but I just got used to and prefer going commando, but it is nice to know that I can if I want to.
So if you have sexy underwear, you can always keep them for when you feel better. Alternatively, one tip my gynecologist gave me ages ago was to stick to commando or cotton briefs during the day. When you know you may be intimate with your partner, put them on before so you can feel that sexy feeling, and then back to briefs after.
In sum, underwear and lichen sclerosus can be tricky. The best underwear for lichen sclerosus are the ones that fit your lifestyle and work best for your body. I reviewed different materials and styles you may want to explore. Finally, I addressed the question, “Do I need to throw out all my sexy, lacy underwear.”
In the comment section, let us know what types of underwear you prefer for lichen sclerosus.
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