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Skin conditions
Lichen sclerosus – what are the signs and the symptoms of Lichen sclerosus?
Lichen sclerosus
Lichen sclerosus is a long-term skin condition that mainly affects the skin of the genitals. It usually causes itching and white patches to appear on the affected skin.
Other areas of the body are also occasionally affected, including the upper arms, back, breasts and shoulders.
Lichen sclerosus is most common in women who have been through the menopause, although men and children are also sometimes affected.
It’s not clear what causes lichen sclerosus, but it’s thought to be related to overactivity of the immune system. It’s not an infection and can’t be spread to your partner or other people.
Lichen sclerosus can be uncomfortable and distressing, but it’s usually possible in most cases to control the symptoms with simple treatments.
Symptoms in women and girls
In women and girls, lichen sclerosus tends to affect the vulva (the skin around the entrance to the vagina) and the skin around the anus (back passage).
Symptoms include:
small white areas that may increase in size and join together to form larger patches – these patches may become cracked and sore
itchiness, which tends to be worse at night and may disturb sleep
the skin becoming fragile and thin, or wrinkly and thickened
red or purple blood blisters
pain when having sex and/or passing stools
Without treatment, the vulva may gradually scar and shrink. This can make the entrance to the vagina narrower, which makes sex even more difficult and painful.
Symptoms in men and boys
In men and boys, lichen sclerosus tends to develop on the foreskin and end of the penis. The skin around the anus is rarely affected.
Symptoms can include:
sore or sometimes itchy white patches on the penis, particularly around the tip, but sometimes on the shaft
the skin at the tip of the penis becoming firm and white
difficulty pulling the foreskin back, which can make peeing difficult and lead to painful erections if left untreated
For both men and women, it’s often easy for a doctor to diagnose lichen sclerosus by asking about your symptoms and examining your skin. However, in some cases, a very simple procedure known as a biopsy, where a skin sample is taken for analysis, may be needed to help make the diagnosis.
How long does lichen sclerosus last?
For most people, lichen sclerosus is a long-term condition that lasts many years and may flare up and down over time.
There’s currently no cure, but symptoms can normally be controlled with steroid medication applied directly to the affected skin (see below).
Occasionally, lichen sclerosus goes away on its own and doesn’t come back, but this usually only occurs when children with the condition reach puberty.
Treatments for lichen sclerosus
Steroid creams and ointments
The main treatment for lichen sclerosus is steroid ointment or cream, which helps to control symptoms.
It should be applied regularly, but relatively sparingly, to the affected areas of skin. Your doctor will advise you on how much to use, how frequently, and for how long. Generally, a 30g tube should last around three months.
When used appropriately, the risk of side effects such as thinning of the skin is very low. Read more about the side effects of steroid creams.
Symptoms tend to ease after a few weeks of treatment, but it may be a few months before your symptoms are fully under control.
After three or four months of regular treatment, you might only need to use the cream once or twice a week, or sometimes even less, to stop symptoms returning.
Steroid creams and ointments are very effective in most cases. However, if they don’t help, other treatments may be suggested by a specialist.
Surgery
In a few cases, surgery may be needed to treat problems caused by lichen sclerosus.
For example, if the condition causes a woman’s vaginal opening to become very narrow, affecting sex, an operation to widen it may be suggested.
Men or boys may need surgery to remove the foreskin (circumcision) if steroid ointments or creams don’t help and the foreskin becomes severely affected. This can result in the condition settling fully.
Self-help for lichen sclerosus
In addition to the above treatments, the following measures can often help keep your symptoms under control:
avoid washing with soap or bubble bath – use plain water or an emollient wash instead, such as aqueous cream (but avoid leaving aqueous cream on the skin after washing)
avoid rubbing or scratching the area
gently dab your genitals dry after peeing, to stop your urine irritating the skin
apply a barrier cream or ointment, such as petroleum jelly, to affected areas after washing and before and after urinating
avoid wearing tight or restrictive clothes and wear underwear made from natural materials such as cotton or silk – women may find it helps to wear stockings rather than tights
For women who find sex painful, it may help to use a lubricant or a vaginal dilator.
Epidermolysis bullosa – what are the signs and symptoms of Epidermolysis bullosa?
Symptoms of epidermolysis bullosa
The main symptoms of all types of EB include:
skin that blisters easily
blisters inside the mouth
blisters on the hands and soles of the feet
scarred skin, sometimes with small white spots called milia
thickened skin and nails
Types of epidermolysis bullosa
The 3 main types of EB are:
epidermolysis bullosa simplex (EBS) – the most common type, which tends to be milder with a low risk of serious complications
dystrophic epidermolysis bullosa (DEB) – which can range from mild to severe
junctional epidermolysis bullosa (JEB) – the rarest and most severe type
The type reflects where on the body the blistering takes place and which layer of skin is affected.
There are also many variants of these 3 main types of EB, each with slightly different symptoms.
Read more about symptoms of different types of epidermolysis bullosa.
Diagnosing EB
EB is usually diagnosed in babies and children by your neonatal team, as the symptoms are often obvious from birth. But some milder types of EB may not be diagnosed until adulthood.
If it’s suspected your child has the condition, they’ll be referred to a skin specialist (dermatologist).
The specialist will carry out tests to determine the type of EB and help come up with a treatment plan. They may take a small sample of skin (biopsy) to send for testing.
Prenatal testing
In some cases it’s possible to test an unborn baby for EB at about 11 weeks into pregnancy.
This may be offered if you or your partner are known to be a carrier of the faulty gene associated with EB and there’s a risk of having a child with a severe type of EB.
If the test confirms your child will have EB, you’ll be offered counselling and advice to help you make an informed decision about how you wish to proceed with the pregnancy.
Prenatal tests include amniocentesis and chorionic villus sampling.
Causes of epidermolysis bullosa
EB is caused by a faulty gene (gene mutation) that makes skin more fragile.
Usually, a child with EB will have inherited the faulty gene from a parent who also has EB.
It’s also possible for a child with EB to have inherited the faulty gene from both parents who are just “carriers” but don’t have EB themselves.
Treatment for epidermolysis bullosa
There’s currently no cure for EB, so treatment aims to relieve symptoms and prevent complications developing, such as infection.
A team of medical specialists will help you decide what treatment is best for your child and offer advice about living with the condition.
You can manage EB at home by:
popping blisters with a sterile needle
applying protective dressings
avoiding things that make the condition worse
Medicines can be used to treat infection or to reduce pain. Surgery may be needed if EB causes narrowing of the food pipe or problems with the hands.
Read more about treating epidermolysis bullosa.
Epidermolysis bullosa acquisita
Epidermolysis bullosa acquisita (EBA) is an acquired form of EB with similar symptoms.
Like EB, EBA causes the skin to blister easily. It can also affect the mouth, throat and digestive tract.
But EBA isn’t inherited, and symptoms don’t usually appear until later life.
It’s an autoimmune disease, which means your immune system starts to attack healthy body tissue. It’s not known exactly what causes this.
EBA is a very rare condition that tends to affect people over the age of 40.
Charities and support groups
If your child is diagnosed with EB, it can be a frightening and overwhelming experience. You’ll probably want to find out as much as possible about the condition and available treatments.
DEBRA is a national charity that provides help, advice and support for people in the UK living with EB.
DEBRA International is a worldwide network of national groups working on behalf of people affected by EB.
Support for carers
It’s important not to neglect your own health and wellbeing when caring for a child with a complex and demanding condition such as EB.
Read about carers’ breaks and respite care and get tips on caring for a disabled child.
Molluscum Contagiosum – How To Get Rid Of Molluscum Contagiosum at Home
Molluscum contagiosum is an infectious disease caused by a DNA poxvirus called molluscum contagiosum virus. Most commonly children and sexually active adults or other individual having a low immune system tend to affect by this disease. Use following effective home remedies for molluscum contagiosum to get rid of your problem at home.
1. Baking Soda.
Exfoliate damaged and dead cells can accelerate your treatment process of healing lesions as well. For this, a simple mixture can be useful – make a paste by mixing a half cup of baking soda with water. Use just before shower; rub this paste and rinse it off with water. Use this until bump disappears.
2. Tea Tree Oil.
Tea tree oil is one of the common and available home remedies for molluscum contagiosum. It contains useful properties like antibacterial and antiseptic which is very essential to cure molluscum. It has powerful astringent that can help to reduce the growth of lesions. You can use tea tree oil directly to the infected area or use it with bath water.
3. Duct Tape.
This one is very commonly used home remedy for treating warts and skin bumps. You can apply a small piece of duck tape on the skin bumped area for overnight and remove in the morning. Use it daily until the bumps are gone. It helps to remove the dead skin from warts and protects the virus infection.
4. Apple Cider Vinegar.
Apple Cider Vinegar is very well known for natural bacteria fighting ingredient. It is also one of the useful home remedies for molluscum contagaiosum. Dip a cotton ball in ACV and apply directly on top of the bump and the bandage over to it. This is useful for the baby and suggested to apply before bedtime.
5. Garlic.
Use some garlic paste on the infected area and put a bandage to cover it. Remove bandage before bath and wash it carefully. You can also take garlic capsule or organic one as well.
6. Sea Salt Scrub.
Mix olive oil and honey with sea salt and massage it into lesions 2-3 minutes before taking shower. Wash off with clean water and dry your skin. Use often during treating following same instructions.
Hidradenitis suppurativa – what are the signs, symptoms and treatments for Hidradenitis suppurativa?
Hidradenitis suppurativa (HS) is a painful, long-term skin condition that causes abscesses and scarring on the skin.
The exact cause of hidradenitis suppurativa is unknown, but it occurs near hair follicles where there are sweat glands, usually around the groin, buttocks, breasts and armpits.
For reasons that are unclear, more women than men have the condition. It’s thought to affect about 1% of the population.
Symptoms
The symptoms of hidradenitis suppurativa range from mild to severe.
It causes a mixture of red boil-like lumps, blackheads, cysts, scarring and channels in the skin that leak pus.
The condition tends to start with a firm pea-sized lesion that develops in one place. This will either disappear or rupture and ooze pus after a few hours or days.
New lumps will then often develop in an area nearby. If these aren’t controlled with medication, larger lumps may develop and spread. Narrow channels called sinus tracts also form under the skin that break out on the surface and leak pus.
Hidradenitis suppurativa is very painful. The lumps develop on the skin in the following areas:
around the groin and genitals
in the armpits
on the buttocks and around the anus (back passage)
below the breasts
The abscesses may also spread to the nape of the neck, waistband and inner thighs. Other isolated areas that have been known to be affected include the front or back of the legs, the sides, the back area and even the face.
Some of the lumps may become infected with bacteria, causing a secondary infection that will 
need to be treated with antibiotics (see below).
Many people with hidradenitis suppurativa also develop a pilonidal sinus, which is a small hole or “tunnel” in the skin.
What causes hidradenitis suppurativa?
The exact cause of hidradenitis suppurativa is unclear, but the lumps develop as a result of blocked hair follicles.
Smoking and obesity are both strongly associated with hidradenitis suppurativa, and if you’re obese and/or smoke it’s likely to make your symptoms worse.
Hidradenitis suppurativa usually starts around puberty, but it can occur at any age. It’s less common before puberty and after the menopause, which may suggest that the sex hormones play a part. Many people with the condition also have acne and hirsutism (excessive hair growth).
In rare cases, hidradenitis suppurativa may be linked to Crohn’s disease, particularly if it develops around the groin area and the skin near the anus. Crohn’s disease is a long-term condition that causes the lining of the digestive system to become inflamed.
Hidradenitis suppurativa runs in families in about a third of all cases. It’s not infectious and isn’t linked to poor hygiene.
Diagnosing hidradenitis suppurativa
There’s no definitive test to help diagnose hidradenitis suppurativa.
Your GP will examine the affected areas of skin, and they may take a swab of an infected area. This can be helpful in making a diagnosis because the condition isn’t usually associated with the presence of bacteria that cause skin infections.
Hidradenitis suppurativa could potentially be mistaken for acne or folliculitis (inflammation of the hair follicles).
Treating hidradenitis suppurativa
Hidradenitis suppurativa is a lifelong, recurring condition that requires constant management and is often difficult to manage.
It’s important to try to recognise and diagnose the condition in its early stages and prevent it getting worse.
Treatment for hidradenitis suppurativa will be tailored to the individual. In the early stages, it may be controlled with medication. Surgery may be required in severe or persistent cases. The treatments are outlined below.
Surgery
Surgery may be considered in cases where hidradenitis suppurativa can’t be controlled with medication.
Lifestyle advice
If you have hidradenitis suppurativa you should:
stop smoking, if you smoke
use an antiseptic skin wash or antiseptic soap – this may be prescribed alongside other treatment (see above)
hold a warm flannel on the lumps to encourage the pus to drain
wear loose-fitting clothes
avoid shaving affected skin and avoid wearing perfume or perfumed deodorants in the affected areas
Outlook
Although hidradenitis suppurativa can persist for many years, if it’s diagnosed early the symptoms can be improved with treatment.
However, the condition can have a significant impact on a person’s everyday life. Having to regularly change dressings and constantly live with the pain, discomfort and embarrassment of the symptoms can affect your quality of life and lead to depression.
Speak to your GP if you’re having problems coping. Charities, such as The Hidradenitis Suppurativa Trust, can also provide help support.