One of the main symptoms of vulvar lichen sclerosus is severe vulvar itching, which may result in noticeable skin lesions, usually caused by a vicious cycle of repeated scratching. In the early stages of the disease, the skin appears dark red or pink. As the condition worsens, the lesions may appear white, and later stages include thickening of the skin, hyperpigmentation, pronounced skin texture resembling lichenoid changes, and may also present with scratches, fissures, and ulcers. If vulvar hygiene is neglected, vulvitis is likely to develop, which can easily lead to vulvar adhesions.