---
title: "Lichen Sclerosus vs Dryness: Vulvar Changes"
description: "Learn the vulvar signs that suggest lichen sclerosus vs menopause dryness, including white patches, fissures, itching, and skin changes."
url: "https://www.myalloy.com/knowledge-base/lichen-sclerosus-vs-dryness-vulvar-changes"
---

# Lichen Sclerosus vs Dryness: Vulvar Changes

> Learn the vulvar signs that suggest lichen sclerosus vs menopause dryness, including white patches, fissures, itching, and skin changes.

## What vulvar changes are most suggestive of lichen sclerosus rather than simple dryness?

Lichen sclerosus can look a lot like simple menopausal dryness, but there are a few changes that really point more strongly toward lichen sclerosus rather than just low estrogen.

Here at Alloy, we describe lichen sclerosus as causing **thin white patches and fissures** on the vulvar skin, along with **cracking and bleeding**, especially around the vulva and the perianal area. The itching is often intense and can be worse at night. These aren’t typical features of simple dryness.

From the medical experts featured in our videos, a few other red flags come up often. You might see **pale, papery looking skin**, sometimes with **loss of the labia minora**, and in some cases the clitoral hood can tighten or hide the clitoris under thicker skin. Those structural changes are not part of genitourinary syndrome of menopause, which is the dryness and thinning caused by low estrogen. Dr. Corinne Menn explains this really clearly in the chapter on recognizing persistent vulvar itching in this video: [Lichen sclerosus vs GSM](https://www.youtube.com/watch?v=vRUrIfaA8_U&t=2587s).


[Watch video](https://www.youtube.com/watch?v=vRUrIfaA8_U&t=2587s)

If dryness from menopause is the issue, symptoms usually improve with local estrogen therapy for the vulva and vagina. When itching persists even with correct use of vaginal estrogen, it’s a sign to get a careful vulvar exam to rule out lichen sclerosus. Diagnosis usually requires a biopsy, and treatment is different. Lichen sclerosus needs a high potency prescription steroid to control inflammation, sometimes along with local estrogen for overall tissue health.

If you want to learn more about dryness and itching from menopause, you can take a look at our article on vaginal itching here: [Vaginal Itching and Menopause](https://www.myalloy.com/blog/vaginal-itching-and-menopause).

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This answer was created using the following resources:

- [Optimizing Vaginal Health Through Menopause | Dr. Rachel Rubin - Lichen Sclerosus & Vulvar Conditions](https://www.youtube.com/watch?v=32G9lNBSvrA)
- [Lichen Sclerosis: An Underdiagnosed Condition in Women of Color | Dr. Sameena Rahman - What is Lichen Sclerosus?](https://www.youtube.com/watch?v=y2m4PHD4IG0)
- [Menopause & Sexual Health | Dr. Rachel Rubin - Lichen Sclerosus: Risks and Treatment](https://www.youtube.com/watch?v=9RE9AhaA3OA)
- [Is This Perimenopause? What You Need To Know | Dr. Corinne Menn - Lichen Sclerosus vs. GSM: Recognizing Persistent Vulvar Itching](https://www.youtube.com/watch?v=vRUrIfaA8_U)
- [Treating Lichen Sclerosis and Hormonal Changes | Dr. Rachel Rubin - Understanding Lichen Sclerosus](https://www.youtube.com/watch?v=ZFqs33WFg7E)
- [Your Menopause Questions Answered | Dr. Sharon Malone - Lichen Sclerosus and Estrogen](https://www.youtube.com/watch?v=4PRXWN3UbNw)
- [Vaginal Itching & Menopause | Menopause Treatment | Alloy](https://www.myalloy.com/blog/vaginal-itching-and-menopause)
- [How to Prevent Vaginal Dryness During Menopause | Alloy](https://www.myalloy.com/blog/how-to-prevent-vaginal-dryness-during-menopause)
- [Lesser-Known Menopause Symptoms & How To Treat Them](https://www.myalloy.com/blog/lesser-known-menopause-symptoms)
- [Are Your Menopause Symptoms Worse than You Expected? What You Can Do](https://www.myalloy.com/blog/are-your-menopause-symptoms-worse-than-expected)
- [Signs & Symptoms of Menopause: What You Need to Know](https://www.myalloy.com/blog/signs-and-symptoms-of-menopause-everything-you-need-to-know)
- [How to Have Better Sex After Menopause](https://www.myalloy.com/blog/sex-after-menopause)
- [Thyroid Issues vs. Menopause: Key Differences to Watch For](https://www.myalloy.com/blog/thyroid-issues-and-menopause)
- [What Can You Do About Frequent UTIs During Menopause?](https://www.myalloy.com/blog/frequent-utis-and-menopause-what-can-you-do)

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