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Forty-five cases of lichen sclerosus (LS) were retrospectively found between 2000 and 2008 among those attending an associate university teaching hospital sexually transmitted infection (STI) clinic (genitourinary [GU] medicine clinic) and 26 responders of the 45, to a questionnaire about psychological morbidity and psychiatric morbidity, were evaluated. Sixteen percent of the patients were worried about the possibility of infecting their partners with the condition, despite counselling to the contrary. Twenty-seven percent felt that the condition's cosmetic appearance adversely affected libido. There was moderate to severe anxiety at one time or another in 58% while 27% experienced depression at one time or another; 19% admitted to insomnia as a result of the condition; 23% were stressed while 11.5% were worried about starting a new relationship. LS has a profound effect on mental health. Selected patients with LS may benefit from routine referral to a clinical psychologist, within the sexually transmitted disease setting to elaborate and institute coping strategies.