Obstetrics - Question about possible Lichen Sclerosus?:Health care

What is "Obstetrics " ?

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Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field.

My experience over Obstetrics "Question about possible Lichen Sclerosus?"

(Photos below) Hello. I am a 27yo Female. I have been to the doctor a couple of times about small tears in my perineum area. First I got tested for HSV - came back negative. Most recently I took photos of them to show my GP and she prescribed me a strong steroid cream (Elecon where I live, clob in the US). She told me to put it on twice a day for 4 weeks as the skin appeared to be thickened. I have been researching this issue for a little while and suspected I may have LS - she didn’t tell me directly that I have LS but put it on the list of my medical conditions on a referral to a dermatologist (not for LS for a completely different reason). So I seem to have LS. I have noticed it has become progressively worse over the last month since using the steroid cream. Which I don’t want to blame on the cream because there are other factors - I have rheumatoid arthritis and have been weaned off oral prednisone for the first time in 7 years because I’m now on a biologic med. I also have been eating gluten again as it no longer flares my RA thanks to the biologic medication. I also had covid a few months ago (I did have LS symptoms here and there before this). It’s just getting worse and I have noticed a white line from my perineum up to the top of my anus. I have also noticed some reddening between my outer and inner labia and it seems like my inner labia are like, for lack of better word, deflated. The tears just keep coming. I guess I’m just confused as to how this has happened all of a sudden. I know I have an autoimmune condition already but I’m not sure how the LS has flared up so badly (to me, not comparatively) all of a sudden. Could it have something to do with tapering off oral prednisone? Or eating gluten since it’s an inflammatory food?

I just feel so defeated and upset because I have a sexual trauma history and can’t even bring myself to show my doctor my bits in person. I had to take photos to show her the tears because I have panic attacks. I don’t know how I am going to cope with LS if it gets worse and worse and having to show my vulva to my doctor or a gyno. Just the thought of it makes me cry so much. I’m so scared. I’m also a lesbian and am really scared about how LS may affect my sex life after I’ve reprocessed the trauma and can finally be in an intimate relationship. It feels so defeating 😞

Does it definitely look like LS? I know a biopsy would confirm but as I said I physically and mentally cannot do it. So please don’t tell me to because I know. I’m trying to build myself up to it.

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