Although there are no robust prevalence data for lichen sclerosus (LS), prevalence is estimated to be between 0.1% and 3% in the general population, with some studies suggesting that prevalence may be as high as 1 in 30 in older adult women.[12]Melnick LE, Steuer AB, Bieber AK, et al. Lichen sclerosus among women in the United States. Int J Womens Dermatol. 2020 Sep;6(4):260-2.
https://www.doi.org/10.1016/j.ijwd.2020.05.001
http://www.ncbi.nlm.nih.gov/pubmed/33015282?tool=bestpractice.com
[13]Goldstein AT, Marinoff SC, Christopher K, et al. Prevalence of vulvar lichen sclerosus in a general gynecology practice. J Reprod Med. 2005 Jul;50(7):477-80.
http://www.ncbi.nlm.nih.gov/pubmed/16130842?tool=bestpractice.com
LS affects both sexes but is more common in women than in men, with studies reporting a male-to-female ratio of between 1:3 and 1:10.[14]Kirtschig G. Lichen sclerosus: presentation, diagnosis and management. Dtsch Arztebl Int. 2016 May 13;113(19):337-43.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4904529
http://www.ncbi.nlm.nih.gov/pubmed/27232363?tool=bestpractice.com
[15]Virgili A, Borghi A, Cazzaniga S, et al. New insights into potential risk factors and associations in genital lichen sclerosus: data from a multicentre Italian study on 729 consecutive cases. J Eur Acad Dermatol Venereol. 2017 Apr;31(4):699-704.
http://www.ncbi.nlm.nih.gov/pubmed/27515901?tool=bestpractice.com
Some data suggest incidence is increasing but it is unknown whether this is related to a true increase in cases or increased recognition and awareness of the diagnosis.[16]Bleeker MC, Visser PJ, Overbeek LI, et al. Lichen sclerosus: incidence and risk of vulvar squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev. 2016 Aug;25(8):1224-30.
https://www.doi.org/10.1158/1055-9965.EPI-16-0019
http://www.ncbi.nlm.nih.gov/pubmed/27257093?tool=bestpractice.com
One study of women in the Netherlands diagnosed with vulvar pathology found that the incidence rate of LS increased from 7.4 per 100,000 woman-years in 1991 to 14.6 per 100,000 woman-years in 2011.[16]Bleeker MC, Visser PJ, Overbeek LI, et al. Lichen sclerosus: incidence and risk of vulvar squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev. 2016 Aug;25(8):1224-30.
https://www.doi.org/10.1158/1055-9965.EPI-16-0019
http://www.ncbi.nlm.nih.gov/pubmed/27257093?tool=bestpractice.com
LS occurs in people of all ages.[14]Kirtschig G. Lichen sclerosus: presentation, diagnosis and management. Dtsch Arztebl Int. 2016 May 13;113(19):337-43.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4904529
http://www.ncbi.nlm.nih.gov/pubmed/27232363?tool=bestpractice.com
Although it used to be considered a condition of primarily prepubertal and postmenopausal people, contemporary data recognize a greater prevalence in the reproductive-age population, with one study finding that 20% of women develop LS during their reproductive years.[17]Kolitz E, Gammon L, Mauskar M. Vulvar lichen sclerosus in women of reproductive age. Proc (Bayl Univ Med Cent). 2021 Feb 22;34(3):349-51.
http://www.ncbi.nlm.nih.gov/pubmed/33953458?tool=bestpractice.com
[18]Trokoudes D, Lewis FM. Lichen sclerosus - the course during pregnancy and effect on delivery. J Eur Acad Dermatol Venereol. 2019 Dec;33(12):e466-8.
http://www.ncbi.nlm.nih.gov/pubmed/31283048?tool=bestpractice.com