[4][5] LS in adult age women is normally incurable, although treatment can lessen its effects, and it often gets progressively worse if not treated properly.

Most males with mild or intermediate disease, restricted to foreskin or glans, can be cured by either medical or surgical treatment.

In women, the condition most commonly occurs on the vulva and around the anus with ivory-white elevations that may be flat and glistening.

[citation needed] On the non-genital skin, the disease may manifest as porcelain-white spots with small visible plugs inside the orifices of hair follicles or sweat glands on the surface.

[7] Distress due to the discomfort and pain of lichen sclerosus is normal, as are concerns with self-esteem and sex.

[citation needed] According to the US National Vulvodynia Association, which also supports women with lichen sclerosus, vulvo-vaginal conditions can cause feelings of isolation, hopelessness, low self-image, and much more.

[8][9] Depression, anxiety, and even anger are all normal responses to the ongoing pain LS sufferers experience.

[10] Several risk factors have been proposed, including exposure to the irritant effects of urine, autoimmune diseases, infections and genetic predisposition.

[13] There is a growing body of evidence suggesting that prolonged exposure of susceptible tissues to the irritant effects of urine may contribute to the development of lichen sclerosus.

[16] Several observations support the "urine occlusion hypothesis," including: Lichen sclerosus may have a genetic component.

A disease that is similar to LS, acrodermatitis chronica atrophicans is caused by the spirochete Borrelia burgdorferi.

A link with Lyme disease is shown by the presence of Borrelia burgdorferi in LSA biopsy tissue.

[35] It has been noted that clinical diagnosis of balanitis xerotica obliterans can be "almost unmistakable," though there are other dermatologic conditions such as lichen planus, localized scleroderma, leukoplakia, vitiligo, and the cutaneous rash of Lyme disease can have a similar appearance.

[39][40] Corticosteroids applied topically to the LS-affected skin are the first-line treatment for lichen sclerosus in both women and men, with strong evidence showing that they are "safe and effective" when appropriately applied, even over long courses of treatment, rarely causing serious adverse effects.

[48][49] Based on limited evidence, a 2011 Cochrane review concluded that clobetasol propionate, mometasone furoate, and pimecrolimus (calcineurin inhibitor) all are effective therapies in treating genital lichen sclerosus.

[50] Continuous use of appropriate doses of topical corticosteroids is required to ensure symptoms remain relieved over the patient's life time.

[citation needed] Continuous, abundant usage of emollients topically applied to the LS-affected skin is recommended to improve symptoms.

With genital LS, appropriate lubrication should always be used before and during sex in order to avoid pain and the worsening the disease.

[citation needed] In males, it has been reported that circumcision can have positive effects, but does not necessarily prevent further flare-ups of the disease[54] and does not protect against the possibility of cancer.

[3] Carbon dioxide laser treatment is safe and effective, and improves symptoms over the long term,[56] but it does not lower cancer risks.

[66][67] A study in men noted that: "the reported incidence of penile carcinoma in patients with balanitis xerotica obliterans is 2.6–5.8%".

The International Society for Study of Vulvar Disease classification system established that "kraurosis" and "leukoplakia" were no longer to be used.