Lichen sclerosus often presents as itch, soreness or splitting, and women may not mention it unless asked. Pallor, a figure-of-eight pattern around the vulva and anus, loss of the labia minora or a narrowed introitus are the signs to look for. A diagnosis known in advance lets the team plan a controlled delivery of the head and a careful post-delivery examination. Ultrapotent topical steroids remain the standard treatment and can be used in pregnancy.
- Ask about vulvar itch, splitting and pain at booking.
- Look for pallor, a figure-of-eight pattern or labial loss on examination.
- Record the diagnosis on the labour plan.
- Treat active disease with topical steroids as usual.
Why it matters
Labour wards cannot plan for a condition nobody has written down.
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