Materiały źródłowe

• #1 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. The aim of this review is to focus on first-line, second-line, and maintenance therapies as well as follow-up of women with VLS. […] Effective treatments such as high-potency topical steroids are now the standard of care and first-line treatment. Follow-up may be done every three to six months for the first two years and then at least yearly to ensure adequacy of treatment and encourage compliance. Long-term follow-up in specialist clinics is recommended for women who have persistent complaints, thickened skin, or history of neoplastic lesion. Monitoring young patients yearly is recommended as there are chances of recurrence. […] The gold standard treatment for VLS consists of high-potency topical corticosteroids (TCS), such as clobetasol dipropionate. Clobetasol propionate cream (0.05%) significantly reduces symptoms and improves skin characteristics.

• #2 Lichen sclerosus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/diagnosis-treatment/drc-20374452

  With treatment, symptoms often improve or go away. Treatment for lichen sclerosus depends on how severe your symptoms are and where it is on your body. Treatment can help ease itching, improve how your skin looks and decrease the risk of scarring. Even with successful treatment, the symptoms often come back. […] Steroid ointment clobetasol is commonly prescribed for lichen sclerosus. At first you’ll need to apply the ointment to the affected skin twice a day. After several weeks, your health care provider will likely suggest that you use it only twice a week to prevent symptoms from returning. […] In addition, your health care provider may recommend a calcineurin inhibitor, such as tacrolimus ointment (Protopic). […] Long-term treatment is needed to control itching and irritation and prevent serious complications.

• #3 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Lichen sclerosus is a chronic inflammatory skin disease. It is thought to be underdiagnosed and undertreated. If it is not treated, lichen sclerosus is associated with a greater degree of scarring and an elevated risk of cancer in the genital area. The treatment of first choice is the local application of high-potency corticosteroids as early as possible (1/A). For boys and men in whom the condition does not remit after steroid treatment, circumcision is indicated (3/D). Anogenital itching and clinical features such as erythema, white skin changes (such as hyperkeratosis and sclerosis), and fissures should arouse suspicion of lichen sclerosus. The diagnosis should be confirmed with a skin biopsy, and early, thorough treatment should be initiated. In this way, a mutilating disease course can be averted, and the risk of cancer can be lessened. The recommended initial treatment of lichen sclerosus is a three-month application of potent to ultrapotent topical corticosteroids (level of evidence 1+/grade of recommendation A) (3, e12) (eTable 1, eTable 2). Randomized studies show that application of potent to ultrapotent topical corticosteroids significantly improves lichen sclerosus in 75 to 90% of patients, compared to roughly 10% in placebo groups (3, e12). If the initial three-month treatment with topical steroids does not lead to the desired full remission in male patients with genital lichen sclerosus, a complete circumcision should be recommended, especially in uncomplicated cases in early stages (without involvement of meatus and urethra) (level of evidence 3/grade of recommendation D) (10). This procedure is reported to lead to permanent, lifelong remission (recovery) in 90 to 100% of cases. For many patients, especially for women and girls, a long-term treatment lasting for years or even decades is reasonable (often necessary), even if there are few complaints. It has been shown that individually adapted long-term treatment with corticosteroid applications, e.g. twice a week, resulted in the suppression of symptoms in 93.3% of compliant patients versus 58% of partially compliant patients and prevention of scarring (adhesions/scarring occurred in 3.4% of compliant patients versus 40% of partially compliant patients) in female patients evaluated after an average follow-up time of 4.7 years (range, 2.0 to 6.8 years) (women: level of evidence 1+/grade of recommendation A; men and girls 3/D; boys 2+ to 1+/B) (2, 30). Calcineurin inhibitors (tacrolimus and pimecrolimus) are second choice treatment options. The effects are inferior to those of topical corticosteroids (women: level of evidence 1+/grade of recommendation BA; men 2+/C; boys and girls 3/D) (3).

• #4 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  An evidence-based treatment guideline for lichen sclerosus (LS) was published by the British Association of Dermatologists (BAD) in 2010; this guideline was updated in 2018, and a further update was under way as of November 2024. […] In 2015, an evidence-based guideline for anogenital LS was published by the European Academy of Dermatology and Venereology (EADV). […] First-line therapy includes patient education and superpotent topical corticosteroids (eg, clobetasol propionate). […] Second-line therapies include the calcineurin inhibitors tacrolimus and pimecrolimus, which can be a helpful adjunct to topical corticosteroids for maintenance. […] Third-line therapies that could be considered for treatment-resistant genital LS include topical or oral retinoids, steroid injections, cyclosporine, methotrexate, and hydroxyurea.

• #5 Lichen Sclerosus: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16564-lichen-sclerosus

  Lichen sclerosus is a chronic inflammatory condition that affects skin on your genitals. Treatment may involve medications that you apply directly to your genitals, light therapy, immunosuppressants or circumcision. […] Without treatment, it can lead to scarring, making it difficult or painful to have sexual intercourse (dyspareunia), urinate (pee) or have a bowel movement (poop). […] There isnt a cure for lichen sclerosus, though treatment can help manage your symptoms. […] Yes, healthcare providers can treat lichen sclerosus without circumcision. Circumcision can sometimes treat lichen sclerosus, but there are other options. […] Your healthcare provider may recommend the following lichen sclerosus treatments: Topical corticosteroid creams. Topical steroid creams are medicines that you apply directly to the affected areas. Providers commonly prescribe clobetasol. Phototherapy (light therapy). Phototherapy uses ultraviolet light, usually ultraviolet B (UVB), from special lamps which may reduce inflammation and minimize itchiness. Immunosuppressants. Immunosuppressants help stop your immune system from attacking your healthy cells. Providers commonly prescribe tacrolimus ointment. Surgery. A healthcare provider may recommend surgery depending on which part of your body lichen sclerosus affects. Surgeries may include circumcision if lichen sclerosus affects your foreskin or a urethroplasty if lichen sclerosus causes urethral strictures.

• #6 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. The aim of this review is to focus on first-line, second-line, and maintenance therapies as well as follow-up of women with VLS. […] Effective treatments such as high-potency topical steroids are now the standard of care and first-line treatment. Follow-up may be done every three to six months for the first two years and then at least yearly to ensure adequacy of treatment and encourage compliance. Long-term follow-up in specialist clinics is recommended for women who have persistent complaints, thickened skin, or history of neoplastic lesion. Monitoring young patients yearly is recommended as there are chances of recurrence. […] The gold standard treatment for VLS consists of high-potency topical corticosteroids (TCS), such as clobetasol dipropionate. Clobetasol propionate cream (0.05%) significantly reduces symptoms and improves skin characteristics.

• #7 Lichen sclerosus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/diagnosis-treatment/drc-20374452

  With treatment, symptoms often improve or go away. Treatment for lichen sclerosus depends on how severe your symptoms are and where it is on your body. Treatment can help ease itching, improve how your skin looks and decrease the risk of scarring. Even with successful treatment, the symptoms often come back. […] Steroid ointment clobetasol is commonly prescribed for lichen sclerosus. At first you’ll need to apply the ointment to the affected skin twice a day. After several weeks, your health care provider will likely suggest that you use it only twice a week to prevent symptoms from returning. […] In addition, your health care provider may recommend a calcineurin inhibitor, such as tacrolimus ointment (Protopic). […] Long-term treatment is needed to control itching and irritation and prevent serious complications.

• #8 Treatment Modalities for Genital Lichen Sclerosus: A Systematic Review

  https://www.mdpi.com/2673-6179/4/4/14

  While both sexes can be affected, the prevalence is thought to be a lot higher in females with upwards of a 10:1 female to male ratio. […] Topical corticosteroids, the mainstay of therapy for LS, were discussed throughout the literature, and proved to be more efficient than topical calcineurin inhibitors, topical hormonal therapy, topical vitamin E oil and cold cream. […] However, other treatment modalities proved to be more efficient than topical corticosteroids, including CO2 and Nd:YAG laser therapies, and the addition of polydeoxyribonucleotide intradermal injections, to steroid therapy. […] Overall, high potency topical corticosteroids recurrently proved to be effective in the symptomatic and physical management of LS in both males and females, and should remain the gold standard of therapy for genital LS therapy.

• #9 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  No standardized regimen has been established for treating LS with topical corticosteroids, though most providers divide treatment into an initiation phase and a maintenance phase. […] The addition of a topical calcineurin inhibitor (eg, tacrolimus or pimecrolimus) as a second agent for maintenance is a recommended option if daily treatment is needed. […] An RCT found oral acitretin to be effective in comparison with placebo. […] In an RCT comparing the efficacy of home-administered medium-dose ultraviolet (UV)-A1 phototherapy with that of once-daily application of clobetasol ointment, both groups showed significant improvement. […] The efficacy of systemic corticosteroids plus methotrexate was supported by a retrospective study of 10 patients with extragenital LS. […] Genital LS may respond well to ultrapotent topical corticosteroids, though patients should be warned that the clinical appearance is not always reversed, even if symptoms are relieved.

• #10 Lichen sclerosus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/diagnosis-treatment/drc-20374452

  With treatment, symptoms often improve or go away. Treatment for lichen sclerosus depends on how severe your symptoms are and where it is on your body. Treatment can help ease itching, improve how your skin looks and decrease the risk of scarring. Even with successful treatment, the symptoms often come back. […] Steroid ointment clobetasol is commonly prescribed for lichen sclerosus. At first you’ll need to apply the ointment to the affected skin twice a day. After several weeks, your health care provider will likely suggest that you use it only twice a week to prevent symptoms from returning. […] In addition, your health care provider may recommend a calcineurin inhibitor, such as tacrolimus ointment (Protopic). […] Long-term treatment is needed to control itching and irritation and prevent serious complications.

• #11 Patient education: Vulvar lichen sclerosus (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/vulvar-lichen-sclerosus-beyond-the-basics

  Steroid ointments reduce inflammation and itching. They are the treatment of choice for genital LS. Strong steroid ointments (eg, clobetasol propionate) are the mainstay of treatment for vulvar LS and are effective in most patients. […] Initial treatment usually requires daily application of the steroid ointment for a few months to resolve the symptoms and reduce inflammation. After the initial course, most patients require „maintenance” therapy with less frequent application of a steroid ointment. […] Steroid injections are sometimes helpful when steroid ointments are not effective. […] Another class of topical medications are the calcineurin inhibitors (eg, tacrolimus or pimecrolimus), which are sometimes prescribed for patients who respond poorly to steroids or cannot tolerate steroid treatment.

• #12 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  About 60%-70% of patients experience complete remission of their symptoms. […] The less-potent steroids like mometasone furoate (0.1%) and triamcinolone are also found to be effective. However, current recommendations favor the initial use of highly potent steroids as first line of therapy with the less-potent steroids used for maintenance. […] Intra-lesional injection of triamcinolone acetonide has been proposed as an alternative treatment to topical treatment of LS. […] The promising effect of calcineurin inhibitors (CIs) on immunomodulation and in blocking the release of inflammatory cytokines has been used to treat VLS widely. Tacrolimis and pimecrolimus are very effective when it comes to treat anogenital LS topically. […] Randomized controlled trials have tested and compared testosterone propionate cream (2%), dihydrotestosterone (DHT) cream (2%), and progesterone cream with placebo.

• #13 Treatment of vulval LS | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/treatment/

  Topical steroids are the main treatment for vulval lichen sclerosus (LS), and they play the most important part in reducing flare-ups and soothing symptoms. […] When you have LS, its important to use a very strong or strong topical steroid to keep your symptoms calm and under control. […] Most vulval specialists recommend starting treatment with a very strong steroid (usually clobetasol propionate ointment 0.05%). […] Topical steroids for vulval LS are available as ointments or creams. […] Ointments are generally seen as the most effective and soothing topical steroid option for the vulva. […] Its not unusual for people to worry about using topical steroids. […] But research shows that topical steroids are safe and effective if you have vulval LS, and theyre also safely used to treat a range of other vulval skin conditions.

• #14 Lichen Sclerosus – after diagnosis and initial treatment | CUH

  https://www.cuh.nhs.uk/patient-information/lichen-sclerosus-after-diagnosis-and-initial-treatment/

  It is not necessarily better to avoid using a steroid, as uncontrolled inflammation of the skin can lead to increased skin damage. […] Steroid creams and ointments put on the skin can have several side effects. They can thin the skin and make it look more pink. This is a tricky balance when treating lichen sclerosus, as the inflammation of the condition can also thin the skin if not controlled. Steroid creams used in the vulval area can also make you more susceptible to infection with thrush. […] If lichen sclerosus has been present for many years, cancer of the vulva may be more likely to occur than in normal skin. […] If the symptoms of lichen sclerosus are giving you more bother or are not helped by the treatment, further advice from the doctor should help.

• #15 Lichen Sclerosus – after diagnosis and initial treatment | CUH

  https://www.cuh.nhs.uk/patient-information/lichen-sclerosus-after-diagnosis-and-initial-treatment/

  It is not necessarily better to avoid using a steroid, as uncontrolled inflammation of the skin can lead to increased skin damage. […] Steroid creams and ointments put on the skin can have several side effects. They can thin the skin and make it look more pink. This is a tricky balance when treating lichen sclerosus, as the inflammation of the condition can also thin the skin if not controlled. Steroid creams used in the vulval area can also make you more susceptible to infection with thrush. […] If lichen sclerosus has been present for many years, cancer of the vulva may be more likely to occur than in normal skin. […] If the symptoms of lichen sclerosus are giving you more bother or are not helped by the treatment, further advice from the doctor should help.

• #16 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  An evidence-based treatment guideline for lichen sclerosus (LS) was published by the British Association of Dermatologists (BAD) in 2010; this guideline was updated in 2018, and a further update was under way as of November 2024. […] In 2015, an evidence-based guideline for anogenital LS was published by the European Academy of Dermatology and Venereology (EADV). […] First-line therapy includes patient education and superpotent topical corticosteroids (eg, clobetasol propionate). […] Second-line therapies include the calcineurin inhibitors tacrolimus and pimecrolimus, which can be a helpful adjunct to topical corticosteroids for maintenance. […] Third-line therapies that could be considered for treatment-resistant genital LS include topical or oral retinoids, steroid injections, cyclosporine, methotrexate, and hydroxyurea.

• #17 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  About 60%-70% of patients experience complete remission of their symptoms. […] The less-potent steroids like mometasone furoate (0.1%) and triamcinolone are also found to be effective. However, current recommendations favor the initial use of highly potent steroids as first line of therapy with the less-potent steroids used for maintenance. […] Intra-lesional injection of triamcinolone acetonide has been proposed as an alternative treatment to topical treatment of LS. […] The promising effect of calcineurin inhibitors (CIs) on immunomodulation and in blocking the release of inflammatory cytokines has been used to treat VLS widely. Tacrolimis and pimecrolimus are very effective when it comes to treat anogenital LS topically. […] Randomized controlled trials have tested and compared testosterone propionate cream (2%), dihydrotestosterone (DHT) cream (2%), and progesterone cream with placebo.

• #18 Patient education: Vulvar lichen sclerosus (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/vulvar-lichen-sclerosus-beyond-the-basics

  Steroid ointments reduce inflammation and itching. They are the treatment of choice for genital LS. Strong steroid ointments (eg, clobetasol propionate) are the mainstay of treatment for vulvar LS and are effective in most patients. […] Initial treatment usually requires daily application of the steroid ointment for a few months to resolve the symptoms and reduce inflammation. After the initial course, most patients require „maintenance” therapy with less frequent application of a steroid ointment. […] Steroid injections are sometimes helpful when steroid ointments are not effective. […] Another class of topical medications are the calcineurin inhibitors (eg, tacrolimus or pimecrolimus), which are sometimes prescribed for patients who respond poorly to steroids or cannot tolerate steroid treatment.

• #19 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  No standardized regimen has been established for treating LS with topical corticosteroids, though most providers divide treatment into an initiation phase and a maintenance phase. […] The addition of a topical calcineurin inhibitor (eg, tacrolimus or pimecrolimus) as a second agent for maintenance is a recommended option if daily treatment is needed. […] An RCT found oral acitretin to be effective in comparison with placebo. […] In an RCT comparing the efficacy of home-administered medium-dose ultraviolet (UV)-A1 phototherapy with that of once-daily application of clobetasol ointment, both groups showed significant improvement. […] The efficacy of systemic corticosteroids plus methotrexate was supported by a retrospective study of 10 patients with extragenital LS. […] Genital LS may respond well to ultrapotent topical corticosteroids, though patients should be warned that the clinical appearance is not always reversed, even if symptoms are relieved.

• #20 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Lichen sclerosus is a chronic inflammatory skin disease. It is thought to be underdiagnosed and undertreated. If it is not treated, lichen sclerosus is associated with a greater degree of scarring and an elevated risk of cancer in the genital area. The treatment of first choice is the local application of high-potency corticosteroids as early as possible (1/A). For boys and men in whom the condition does not remit after steroid treatment, circumcision is indicated (3/D). Anogenital itching and clinical features such as erythema, white skin changes (such as hyperkeratosis and sclerosis), and fissures should arouse suspicion of lichen sclerosus. The diagnosis should be confirmed with a skin biopsy, and early, thorough treatment should be initiated. In this way, a mutilating disease course can be averted, and the risk of cancer can be lessened. The recommended initial treatment of lichen sclerosus is a three-month application of potent to ultrapotent topical corticosteroids (level of evidence 1+/grade of recommendation A) (3, e12) (eTable 1, eTable 2). Randomized studies show that application of potent to ultrapotent topical corticosteroids significantly improves lichen sclerosus in 75 to 90% of patients, compared to roughly 10% in placebo groups (3, e12). If the initial three-month treatment with topical steroids does not lead to the desired full remission in male patients with genital lichen sclerosus, a complete circumcision should be recommended, especially in uncomplicated cases in early stages (without involvement of meatus and urethra) (level of evidence 3/grade of recommendation D) (10). This procedure is reported to lead to permanent, lifelong remission (recovery) in 90 to 100% of cases. For many patients, especially for women and girls, a long-term treatment lasting for years or even decades is reasonable (often necessary), even if there are few complaints. It has been shown that individually adapted long-term treatment with corticosteroid applications, e.g. twice a week, resulted in the suppression of symptoms in 93.3% of compliant patients versus 58% of partially compliant patients and prevention of scarring (adhesions/scarring occurred in 3.4% of compliant patients versus 40% of partially compliant patients) in female patients evaluated after an average follow-up time of 4.7 years (range, 2.0 to 6.8 years) (women: level of evidence 1+/grade of recommendation A; men and girls 3/D; boys 2+ to 1+/B) (2, 30). Calcineurin inhibitors (tacrolimus and pimecrolimus) are second choice treatment options. The effects are inferior to those of topical corticosteroids (women: level of evidence 1+/grade of recommendation BA; men 2+/C; boys and girls 3/D) (3).

• #21 Lichen Sclerosus Treatment – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-treatment/

  A double-blind, randomized study by Goldstein et al. 2011 compared the before and after biopsies of folks with vulvar lichen sclerosus. […] When comparing the two groups, they found that clobetasol and pimecrolimus effectively reduced inflammation. However, they noted that clobetasol performed slightly better in reducing inflammation. […] The primary documented side effects of calcineurin inhibitors are stinging and burning. […] Topical corticosteroids and topical calcineurin inhibitors are the two main approved treatments insofar as evidence-based medicine is concerned. […] However, some more experimental/adjunct therapies are out there, such as laser, platelet-rich plasma, and phototherapy. […] Unfortunately, our current studies are limited and have yet to demonstrate a significant reduction in inflammation that many doctors look for when they counsel patients on primary treatments.

• #22 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  Retinoids have anti-inflammatory properties and reduce hyperkeratinization. […] Emollients or moisturizers should be an integral part of treatment of VLS. […] Laser therapy has been used in a few small studies for the treatment of VLS refractory to TCS. […] Photodynamic therapy (PDT) with the use of topical 10% 5-ALA cream (5-aminolaevulinic acid) has been found to be useful in treating VLS. […] Cryotherapy has been used as a treatment modality for VLS refractory to medical management. […] Fat grafting may be considered a supportive or second-line therapy. […] Adipose-derived stem cells, now considered as stem cell transplant, are purported to be able to restore and regenerate damaged tissue as in VLS. […] If pruritus persists after corticosteroid and other local therapies, hydroxyzine or doxepin may be given to stop nighttime pruritus.

• #23 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  No standardized regimen has been established for treating LS with topical corticosteroids, though most providers divide treatment into an initiation phase and a maintenance phase. […] The addition of a topical calcineurin inhibitor (eg, tacrolimus or pimecrolimus) as a second agent for maintenance is a recommended option if daily treatment is needed. […] An RCT found oral acitretin to be effective in comparison with placebo. […] In an RCT comparing the efficacy of home-administered medium-dose ultraviolet (UV)-A1 phototherapy with that of once-daily application of clobetasol ointment, both groups showed significant improvement. […] The efficacy of systemic corticosteroids plus methotrexate was supported by a retrospective study of 10 patients with extragenital LS. […] Genital LS may respond well to ultrapotent topical corticosteroids, though patients should be warned that the clinical appearance is not always reversed, even if symptoms are relieved.

• #24 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  The author has used hydroxychloroquine with good results as a systemic maintenance drug for both genital and extragenital lichen sclerosus. […] Topical testosterone, topical estrogen, topical progesterone, and hormone replacement therapy should not be used. […] A small study examined the use of topical avocado and soybean extracts as alternative treatments for mild-to-moderate vulvar LS in patients wishing to avoid corticosteroids. […] There is a lack of RCTs evaluating the efficacy of treatment for extragenital LS; recommendations are based on case reports and small uncontrolled studies. […] If localized lesion treatment is desired, topical treatment with potent or ultrapotent topical corticosteroids is first-line therapy. […] If patients have extensive involvement, rapid progression, or a goal of preventing new lesions, phototherapy or systemic therapy should be offered.

• #25 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  No standardized regimen has been established for treating LS with topical corticosteroids, though most providers divide treatment into an initiation phase and a maintenance phase. […] The addition of a topical calcineurin inhibitor (eg, tacrolimus or pimecrolimus) as a second agent for maintenance is a recommended option if daily treatment is needed. […] An RCT found oral acitretin to be effective in comparison with placebo. […] In an RCT comparing the efficacy of home-administered medium-dose ultraviolet (UV)-A1 phototherapy with that of once-daily application of clobetasol ointment, both groups showed significant improvement. […] The efficacy of systemic corticosteroids plus methotrexate was supported by a retrospective study of 10 patients with extragenital LS. […] Genital LS may respond well to ultrapotent topical corticosteroids, though patients should be warned that the clinical appearance is not always reversed, even if symptoms are relieved.

• #26 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  About 60%-70% of patients experience complete remission of their symptoms. […] The less-potent steroids like mometasone furoate (0.1%) and triamcinolone are also found to be effective. However, current recommendations favor the initial use of highly potent steroids as first line of therapy with the less-potent steroids used for maintenance. […] Intra-lesional injection of triamcinolone acetonide has been proposed as an alternative treatment to topical treatment of LS. […] The promising effect of calcineurin inhibitors (CIs) on immunomodulation and in blocking the release of inflammatory cytokines has been used to treat VLS widely. Tacrolimis and pimecrolimus are very effective when it comes to treat anogenital LS topically. […] Randomized controlled trials have tested and compared testosterone propionate cream (2%), dihydrotestosterone (DHT) cream (2%), and progesterone cream with placebo.

• #27 Genital Lichen Sclerosus Treatment: From Ointments to Self-Care

  https://www.verywellhealth.com/lichen-sclerosus-treatment-7494850

  The most common treatment regimen for lichen sclerosus involves topical clobetasol propionate (0.05%) applied over the affected area twice daily for 12 weeks. Research indicates that up to 75% of people using clobetasol for lichen sclerosus achieve relief of symptoms. It may be continued past 12 weeks, as directed, for flares, maintenance therapy, and remission. […] In some cases of difficult-to-treat lichen sclerosus, one may benefit from an intra-lesional (delivered directly into a skin lesion) steroid injection using Kenalog (triamcinolone acetonide) 2.55 milligrams per milliliter (mg/mL). […] Topical calcineurin inhibitors are sometimes used as an off-label treatment if your lichen sclerosus is intolerant or unresponsive to a topical steroid. […] Topical retinoids may provide a useful alternative to steroids in treating lichen sclerosus.

• #28 Lichen sclerosus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/diagnosis-treatment/drc-20374452

  Your health care provider might recommend removing the penis foreskin (circumcision) if the opening for urine flow has been narrowed by lichen sclerosus. […] Some basic questions to ask your health care provider about possible lichen sclerosus include: What treatment approach do you suggest, if any? […] If the first treatment doesn’t work, what will you suggest next? […] How much do you expect my symptoms will improve with treatment and how soon? […] Will I need treatment for this condition for the rest of my life?

• #29 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Lichen sclerosus is a chronic inflammatory skin disease. It is thought to be underdiagnosed and undertreated. If it is not treated, lichen sclerosus is associated with a greater degree of scarring and an elevated risk of cancer in the genital area. The treatment of first choice is the local application of high-potency corticosteroids as early as possible (1/A). For boys and men in whom the condition does not remit after steroid treatment, circumcision is indicated (3/D). Anogenital itching and clinical features such as erythema, white skin changes (such as hyperkeratosis and sclerosis), and fissures should arouse suspicion of lichen sclerosus. The diagnosis should be confirmed with a skin biopsy, and early, thorough treatment should be initiated. In this way, a mutilating disease course can be averted, and the risk of cancer can be lessened. The recommended initial treatment of lichen sclerosus is a three-month application of potent to ultrapotent topical corticosteroids (level of evidence 1+/grade of recommendation A) (3, e12) (eTable 1, eTable 2). Randomized studies show that application of potent to ultrapotent topical corticosteroids significantly improves lichen sclerosus in 75 to 90% of patients, compared to roughly 10% in placebo groups (3, e12). If the initial three-month treatment with topical steroids does not lead to the desired full remission in male patients with genital lichen sclerosus, a complete circumcision should be recommended, especially in uncomplicated cases in early stages (without involvement of meatus and urethra) (level of evidence 3/grade of recommendation D) (10). This procedure is reported to lead to permanent, lifelong remission (recovery) in 90 to 100% of cases. For many patients, especially for women and girls, a long-term treatment lasting for years or even decades is reasonable (often necessary), even if there are few complaints. It has been shown that individually adapted long-term treatment with corticosteroid applications, e.g. twice a week, resulted in the suppression of symptoms in 93.3% of compliant patients versus 58% of partially compliant patients and prevention of scarring (adhesions/scarring occurred in 3.4% of compliant patients versus 40% of partially compliant patients) in female patients evaluated after an average follow-up time of 4.7 years (range, 2.0 to 6.8 years) (women: level of evidence 1+/grade of recommendation A; men and girls 3/D; boys 2+ to 1+/B) (2, 30). Calcineurin inhibitors (tacrolimus and pimecrolimus) are second choice treatment options. The effects are inferior to those of topical corticosteroids (women: level of evidence 1+/grade of recommendation BA; men 2+/C; boys and girls 3/D) (3).

• #30 Lichen Sclerosus: Causes, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/skin-problems-and-treatments/lichen-sclerosis

  Surgery to treat lichen sclerosus that’s on your penis can be a good option. Doctors often do a circumcision, which is removing the foreskin–the tissue that covers the head of the penis. After that, the condition probably won’t come back. […] Talk to your doctor if you have itching or skin changes in your genital area. Lichen sclerosus needs to be treated so you don’t have serious complications. Steroid medications you put on your skin and other treatments usually work well.

• #31 Patient education: Vulvar lichen sclerosus (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/vulvar-lichen-sclerosus-beyond-the-basics/print

  Some people with vulvar LS may develop abnormal fusion of the labia and/or scarring. Vaginal dilators can be used in this situation to stretch the skin to help restore normal function. Surgery may also be used in this situation. It is important to continue medical treatment (with steroid ointments) and dilators after surgery to prevent the recurrence of scarring. […] The good news for patients who have been diagnosed with vulvar lichen sclerosus (LS) is that treatments such as topical steroid ointments are very effective. Thus, early treatment of vulvar LS with topical steroids can prevent scarring. Follow-up is important throughout the patient’s lifetime.

• #32 Lichen Sclerosus > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/lichen-sclerosus

  Surgery may be recommended as a treatment for some people. Treatment for uncircumcised men with lichen sclerosus, for instance, may include circumcision. Surgery may also benefit a woman whose vulva has become scarred. […] Fortunately, treatment generally reduces and, in some cases, eliminates symptoms, though relapses still tend to occur periodically. […] A long-term maintenance treatment regimen is very important, and not just to prevent or treat symptom recurrence. Treatment to maintain normal skin color and texture reduces scarring and may prevent progression to skin cancer. […] We start with potent topical steroids and educate the patient on the importance of continued treatment. Even if they dont have symptoms, preventing severe scarring or cancer is a priority.

• #33 Lichen sclerosus: Causes, Diagnosis, and Images – DermNet

  https://dermnetnz.org/topics/lichen-sclerosus

  The doctor should reassess the treated area after a few weeks, as a response to treatment is quite variable. […] Other topical treatments used in patients with lichen sclerosus include: Intravaginal oestrogen cream or pessaries in postmenopausal women. […] When lichen sclerosus is severe, acute, and not responding to topical therapy, systemic treatment may rarely be prescribed. Options include: Intralesional or systemic corticosteroids, Oral retinoids: acitretin, isotretinoin, Methotrexate, Ciclosporin. […] Surgery is essential for high-grade squamous intraepithelial lesions or cancer. […] In males, circumcision is effective in lichen sclerosus affecting prepuce and glans of the penis. […] In females, the release of vulval and vaginal adhesions and scarring from vulval lichen sclerosus may occasionally be performed to reduce urination difficulties and allow intercourse if dilators have not proved effective. […] Other reported treatments for lichen sclerosus are considered experimental at this time.

• #34 Lichen Sclerosus > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/lichen-sclerosus

  Treatments include topical medications and phototherapy […] While there is no cure for lichen sclerosus, various treatments are available: […] Prescription topical steroid ointments that are applied to the affected skin can reduce inflammation and itching. These are usually the first treatment option for lichen sclerosus. The most commonly prescribed topical steroid is cobetasol propionate. […] By suppressing the response of the immune system, these creams and ointments can reduce skin inflammation. […] A class of medications derived from vitamin A called retinoids are sometimes used to treat lichen sclerosus. […] Exposure of affected areas of skin to certain wavelengths of ultraviolet light can reduce inflammation and itching. […] This class of medications, which includes methotrexate and mycophenolate mofteil, suppress the immune system and reduce inflammation.

• #35 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  No standardized regimen has been established for treating LS with topical corticosteroids, though most providers divide treatment into an initiation phase and a maintenance phase. […] The addition of a topical calcineurin inhibitor (eg, tacrolimus or pimecrolimus) as a second agent for maintenance is a recommended option if daily treatment is needed. […] An RCT found oral acitretin to be effective in comparison with placebo. […] In an RCT comparing the efficacy of home-administered medium-dose ultraviolet (UV)-A1 phototherapy with that of once-daily application of clobetasol ointment, both groups showed significant improvement. […] The efficacy of systemic corticosteroids plus methotrexate was supported by a retrospective study of 10 patients with extragenital LS. […] Genital LS may respond well to ultrapotent topical corticosteroids, though patients should be warned that the clinical appearance is not always reversed, even if symptoms are relieved.

• #36 Treatment Modalities for Genital Lichen Sclerosus: A Systematic Review

  https://www.mdpi.com/2673-6179/4/4/14

  An additional three studies (two female studies, one male study) discussed the use of topical corticosteroids, however these studies attempted to use steroid therapy in conjunction with adjunct agents. […] Overall, while topical corticosteroids continuously prove to be efficacious in the management of LS, certain adjunct therapies have also proven to improve patient outcomes, and should be utilized in the clinical setting. […] While certain steroid-sparing topical agents may prove to be effective in the management of genital LS, they are suboptimal in comparison to topical corticosteroids, and should thus not be used as a first-line treatment. […] The efficacy of PRP in the management of LS would require further investigation given the variability of data currently available in the literature among only two randomized controlled trials, while adipose tissue-derived stromal vascular fractions as either monotherapy or in conjunction with PRP have the potential to provide early stage LS patients with symptomatic relief.

• #37 Treatment Modalities for Genital Lichen Sclerosus: A Systematic Review

  https://www.mdpi.com/2673-6179/4/4/14

  Generally, CO2 laser was often effective in comparison to other laser types and high potency topical corticosteroids, serving as an adjunct in the genital LS treatment armamentarium. […] In summary, while certain steroid-sparing topical agents may prove to be effective in the management of genital LS, they are suboptimal in comparison to topical corticosteroids, and should thus not be used as a first-line treatment.

• #38 Lichen Sclerosus | Services | Peninsula Women’s Care

  https://peninsulawomenscare.com/services/lichen-sclerosus/

  The standard treatment for lichen sclerosus has included a 3-month application of potent topical corticosteroids, which have been shown to prevent malignant transformation but can produce side effects and ultimately lead to damage of the anogenital epithelium. […] Recently, practitioners and researchers have started evaluating the effectiveness of using a fractional micro-ablative CO2 laser called the Mona Lisa to treat lichen sclerosus. Recent studies have shown CO2 laser therapy results in symptom resolution, return to normal skin texture and color, and reduced risk of vulvar cancer. In addition, when compared to the standard corticosteroid treatment, the CO2 laser resulted in greater improvement in symptoms and better patient satisfaction. […] The MonaLisa Touch is a laser treatment that promotes the production of collagen and elastic fibers to help restore epithelial structure and vascularization. The MonaLisa Touch is used to treat lichen sclerosus, as well as to treat breast cancer patients and post-menopausal women with a diagnosis of vaginal atrophy. It is an effective, non-invasive, and hormone-free treatment for the symptoms of lichen sclerosus and vaginal atrophy.

• #39 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  Retinoids have anti-inflammatory properties and reduce hyperkeratinization. […] Emollients or moisturizers should be an integral part of treatment of VLS. […] Laser therapy has been used in a few small studies for the treatment of VLS refractory to TCS. […] Photodynamic therapy (PDT) with the use of topical 10% 5-ALA cream (5-aminolaevulinic acid) has been found to be useful in treating VLS. […] Cryotherapy has been used as a treatment modality for VLS refractory to medical management. […] Fat grafting may be considered a supportive or second-line therapy. […] Adipose-derived stem cells, now considered as stem cell transplant, are purported to be able to restore and regenerate damaged tissue as in VLS. […] If pruritus persists after corticosteroid and other local therapies, hydroxyzine or doxepin may be given to stop nighttime pruritus.

• #40 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  Retinoids have anti-inflammatory properties and reduce hyperkeratinization. […] Emollients or moisturizers should be an integral part of treatment of VLS. […] Laser therapy has been used in a few small studies for the treatment of VLS refractory to TCS. […] Photodynamic therapy (PDT) with the use of topical 10% 5-ALA cream (5-aminolaevulinic acid) has been found to be useful in treating VLS. […] Cryotherapy has been used as a treatment modality for VLS refractory to medical management. […] Fat grafting may be considered a supportive or second-line therapy. […] Adipose-derived stem cells, now considered as stem cell transplant, are purported to be able to restore and regenerate damaged tissue as in VLS. […] If pruritus persists after corticosteroid and other local therapies, hydroxyzine or doxepin may be given to stop nighttime pruritus.

• #41 Lichen Sclerosus Treatment – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-treatment/

  A double-blind, randomized study by Goldstein et al. 2011 compared the before and after biopsies of folks with vulvar lichen sclerosus. […] When comparing the two groups, they found that clobetasol and pimecrolimus effectively reduced inflammation. However, they noted that clobetasol performed slightly better in reducing inflammation. […] The primary documented side effects of calcineurin inhibitors are stinging and burning. […] Topical corticosteroids and topical calcineurin inhibitors are the two main approved treatments insofar as evidence-based medicine is concerned. […] However, some more experimental/adjunct therapies are out there, such as laser, platelet-rich plasma, and phototherapy. […] Unfortunately, our current studies are limited and have yet to demonstrate a significant reduction in inflammation that many doctors look for when they counsel patients on primary treatments.

• #42 Patient education: Vulvar lichen sclerosus (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/vulvar-lichen-sclerosus-beyond-the-basics

  Lichen sclerosus (LS) is a skin disorder that causes the skin to become thin, whitened, and wrinkled and can cause itching or pain. […] The goals of treatment of vulvar lichen sclerosus (LS) are to relieve bothersome symptoms and to prevent the condition from worsening. A clinician may recommend medication for the physical symptoms and may refer the patient for support and therapy for other issues associated with the condition, such as problems with sex. […] All patients with vulvar LS, even those without noticeable symptoms, need to use medication on a regular and ongoing basis. Patients also should see a health care provider for re-evaluation of the disease at least once or twice yearly. […] Depending on the severity of the condition, a health care provider may recommend one or more of the following treatments for vulvar LS.

• #43 Treatment of vulval LS | Lichen Sclerosus Guide

  https://www.lichensclerosusguide.org.uk/treatment/

  Topical steroids are the main treatment for vulval lichen sclerosus (LS), and they play the most important part in reducing flare-ups and soothing symptoms. […] When you have LS, its important to use a very strong or strong topical steroid to keep your symptoms calm and under control. […] Most vulval specialists recommend starting treatment with a very strong steroid (usually clobetasol propionate ointment 0.05%). […] Topical steroids for vulval LS are available as ointments or creams. […] Ointments are generally seen as the most effective and soothing topical steroid option for the vulva. […] Its not unusual for people to worry about using topical steroids. […] But research shows that topical steroids are safe and effective if you have vulval LS, and theyre also safely used to treat a range of other vulval skin conditions.

• #44 Lichen sclerosus fact sheet – Melbourne Sexual Health Centre (MSHC)

  https://www.mshc.org.au/sexual-health/sexual-health-fact-sheets/lichen-sclerosus-fact-sheet

  The best treatment is strong steroid ointment or cream. Your doctor can prescribe this. You must use enough to prevent all symptoms (such as itch or soreness) and suppress active disease. Where there have never been symptoms, treatment is still necessary. […] Strong steroid ointment or cream can: control inflammation, help smooth out the roughened skin, prevent or halt scarring. […] Once active lichen sclerosus is stabilised, most people are prescribed maintenance therapy to reduce or prevent the skin inflammation coming back. The minimum recommended frequency of maintenance treatment is once per week. Ointments are preferred to creams in most cases. […] Surgery is not a substitute for ongoing steroid medication. […] With or without symptoms, a level of ongoing, lifelong treatment is usually recommended and an annual check-up is needed. We encourage people to self-check their genital skin.

• #45 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  Once the VLS lesion has responded to treatment, maintenance therapy is often required as a preventive measure. […] Topical steroids are the mainstay of treatment, just like their adult counterpart. Potent or very potent topical steroids, applied once or twice a day for six to 12 weeks, with progressive weaning, are the treatment of choice. […] Regular follow-up is necessary as there is an increased risk of developing SCC. However, there is no consensus between frequency and duration of follow-up. Follow-up may be done every three to six months for the first two years and then at least yearly to ensure adequacy of treatment and encourage compliance. […] Highly potent topical corticosteroids are the first-line treatment. However, their long-term use includes skin thinning.

• #46 Lichen sclerosus fact sheet – Melbourne Sexual Health Centre (MSHC)

  https://www.mshc.org.au/sexual-health/sexual-health-fact-sheets/lichen-sclerosus-fact-sheet

  The best treatment is strong steroid ointment or cream. Your doctor can prescribe this. You must use enough to prevent all symptoms (such as itch or soreness) and suppress active disease. Where there have never been symptoms, treatment is still necessary. […] Strong steroid ointment or cream can: control inflammation, help smooth out the roughened skin, prevent or halt scarring. […] Once active lichen sclerosus is stabilised, most people are prescribed maintenance therapy to reduce or prevent the skin inflammation coming back. The minimum recommended frequency of maintenance treatment is once per week. Ointments are preferred to creams in most cases. […] Surgery is not a substitute for ongoing steroid medication. […] With or without symptoms, a level of ongoing, lifelong treatment is usually recommended and an annual check-up is needed. We encourage people to self-check their genital skin.

• #47 Lichen Sclerosus – after diagnosis and initial treatment | CUH

  https://www.cuh.nhs.uk/patient-information/lichen-sclerosus-after-diagnosis-and-initial-treatment/

  It is not necessarily better to avoid using a steroid, as uncontrolled inflammation of the skin can lead to increased skin damage. […] Steroid creams and ointments put on the skin can have several side effects. They can thin the skin and make it look more pink. This is a tricky balance when treating lichen sclerosus, as the inflammation of the condition can also thin the skin if not controlled. Steroid creams used in the vulval area can also make you more susceptible to infection with thrush. […] If lichen sclerosus has been present for many years, cancer of the vulva may be more likely to occur than in normal skin. […] If the symptoms of lichen sclerosus are giving you more bother or are not helped by the treatment, further advice from the doctor should help.

• #48 Lichen Sclerosus And Cancer: Is There A Link?

  https://www.healthline.com/health/cancer/lichen-sclerosus-cancer

  Lichen sclerosus is a skin condition that can increase your risk of cancer. Its not a type of cancer on its own, but treating this condition can help you prevent vulvar cancer. […] Treatment for the condition typically involves strong corticosteroids. […] Getting effective medical care and treatment of lichen sclerosus is believed to help to reduce the risk of developing vulvar cancer. […] Lichen sclerosus is treated with prescription corticosteroid creams. Treatment is meant to help manage your symptoms, prevent scarring, and reduce the risk of cancer. […] Because lichen sclerosus is often associated with inflammation of the skin, first-line treatment typically includes the use of prescription corticosteroid creams to help restore the integrity of the tissue. […] Treating lichen sclerosus often helps prevent vulvar cancer from developing. […] Treating lichen sclerosus can help prevent the development of this type of cancer.

• #49 Vulval lichen sclerosus (LS) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/worried-about-cancer/pre-cancerous-and-genetic-conditions/lichen-sclerosus-vulva

  Your doctor will also give you advice about things you can do to improve your symptoms, such as: avoid using soap, perfumes, talc or wet wipes on the vulva, wash with an emollient soap substitute, wash your hair over the sink or bath to protect the vulval skin from shampoo, avoid hot baths wear loose fitting or no underwear, if you use a sanitary towel, use a non-perfumed type and change it regularly, use a plain emollient on the vulval skin, such as coconut oil, use a lubricant to protect the skin during penetrative sex. […] Vulval LS is a long-term condition that cannot be cured. It is usually possible to control the symptoms, and this prevents further damage to the skin.

• #50 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  Retinoids have anti-inflammatory properties and reduce hyperkeratinization. […] Emollients or moisturizers should be an integral part of treatment of VLS. […] Laser therapy has been used in a few small studies for the treatment of VLS refractory to TCS. […] Photodynamic therapy (PDT) with the use of topical 10% 5-ALA cream (5-aminolaevulinic acid) has been found to be useful in treating VLS. […] Cryotherapy has been used as a treatment modality for VLS refractory to medical management. […] Fat grafting may be considered a supportive or second-line therapy. […] Adipose-derived stem cells, now considered as stem cell transplant, are purported to be able to restore and regenerate damaged tissue as in VLS. […] If pruritus persists after corticosteroid and other local therapies, hydroxyzine or doxepin may be given to stop nighttime pruritus.

• #51 Vulval lichen sclerosus (LS) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/worried-about-cancer/pre-cancerous-and-genetic-conditions/lichen-sclerosus-vulva

  Your doctor will also give you advice about things you can do to improve your symptoms, such as: avoid using soap, perfumes, talc or wet wipes on the vulva, wash with an emollient soap substitute, wash your hair over the sink or bath to protect the vulval skin from shampoo, avoid hot baths wear loose fitting or no underwear, if you use a sanitary towel, use a non-perfumed type and change it regularly, use a plain emollient on the vulval skin, such as coconut oil, use a lubricant to protect the skin during penetrative sex. […] Vulval LS is a long-term condition that cannot be cured. It is usually possible to control the symptoms, and this prevents further damage to the skin.

• #52 What is the Best Treatment for Lichen Sclerosus?

  https://drbrighten.com/what-is-the-best-treatment-for-lichen-sclerosus/

  Curcumin is the active part of turmeric. There have been studies showing the benefits of turmeric in inflammatory skin conditions. […] If your body is enduring a state of chronic inflammation due to a hidden infection, food allergies, endometriosis, other autoimmune conditions, or leaky gut, its important to address those as part of your lichen sclerosus treatment plan. […] Some of my most important recommendations for treating lichen sclerosus involve developing good habits. […] Just be careful what lube you choose, whats in commercial lubricants can be irritants or endocrine disruptors. […] Cotton helps your vulva to breathe and cuts down on sweat. […] Now is not the time to rock your tightest fitting jeans. […] Wiping front to back helps prevent the spread of bacteria and is a habit that helps prevent urinary tract infections.

• #53 Lichen Sclerosus Long Island, NY | Itchy Labia Treatment Near Me

  https://tidelinehealth.net/vaginal-health/lichen-sclerosus/

  There are some steps individuals can take to help keep their symptoms at bay. These include: Taking oral antihistamines before bed to control itching, Taking sitz baths or using cool compresses on the area, Gently washing and patting dry the affected area, Applying occlusive such as petroleum jelly to the affected area. […] Platelet Rich Plasma (PRP) can be a very effective treatment for lichen sclerosus. When applied to the affected area topically or directly into the skin, PRP has been shown to reduce scarring and improve the health of the vulvar tissue, alleviating itching, inflammation, and pain. PRP can be combined with MonaLisa Touch or ThermiVa to further enhance efficacy. […] In a recent study, 90% of women diagnosed with lichen sclerosus and treated with PRP showed improvement in inflammation and their lichen sclerosus symptoms after their treatment.

• #54 Vulvar Lichen Sclerosus Specialist Melbourne | Dr Len Kliman

  https://drlenkliman.com.au/services/vulval-and-vaginal-skin-disorders/vulvar-lichen-sclerosus/

  There is no total cure for LS but the symptoms can be controlled extremely well by the use of strong steroid ointments. The most effective treatment for LS is a very strong topical steroid ointment such as Clobetasol. This is safe to use in the genital area for this condition. Dr Kliman will advise you how much to use and how often to continue the treatment. Treatment should not be stopped unless advised by Dr Kliman, as LS can recur. […] Many patients find that simple moisturisers such as Vaseline can be helpful in addition to the strong cortisone/steroid ointments. […] All skin irritation should be avoided as far as possible, as irritation may increase the symptoms of LS. Any infections from yeast to bacteria must be treated. […] If intercourse is painful this can be helped with natural gentle oil based lubricants. If dryness is a problem and you are approaching the menopause, or are menopausal, Dr Kliman will discuss the use of vaginal oestrogen. Painful sexual penetration should be avoided.

• #55 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  Once the VLS lesion has responded to treatment, maintenance therapy is often required as a preventive measure. […] Topical steroids are the mainstay of treatment, just like their adult counterpart. Potent or very potent topical steroids, applied once or twice a day for six to 12 weeks, with progressive weaning, are the treatment of choice. […] Regular follow-up is necessary as there is an increased risk of developing SCC. However, there is no consensus between frequency and duration of follow-up. Follow-up may be done every three to six months for the first two years and then at least yearly to ensure adequacy of treatment and encourage compliance. […] Highly potent topical corticosteroids are the first-line treatment. However, their long-term use includes skin thinning.

• #56 More information about Pediatric Vulvar Lichen Sclerosus – Great Neck, NY: Adolescent Young Adult Medicine of Great Neck

  https://www.tragermd.com/contents/services/lichen-sclerosus/pediatric-vulvar-lichen-s

  Lichen sclerosus is fairly easy to diagnose by clinicians familiar with the disease and good treatment is available. […] The most effective treatment for lichen sclerosus in young girls is the topical application of one of the prescription steroid creams. […] The medication is typically applied twice a day for 6-12 weeks; then, based on how the girl is doing, the medication is reduced to a few times a week. […] Signs that the disease is under good control are: Decreased vulvar itching, Decreased vulvar soreness, A more normal appearing vulva with little or no bruising or fissures. […] Non-steroid topical medications are being studied for the treatment of lichen sclerosus and may hold promise as a way of treating lichen sclerosus without the potential side effects of topical steroids.

• #57 Lichen Sclerosus et Atrophicus – Iowa Dermatology Consultants

  https://iowadermatologyconsultants.com/medical-services/lichen-sclerosus-et-atrophicus/

  Lichen sclerosus is treated with high potency topical steroids applied to the affected area daily. You should apply a small amount of ointment and gently rub into the area for 90 seconds. Soaking in a bath tub prior to application is very helpful. Typically, after about 1 month, the condition will improve and your doctor may taper the topical steroid to using it less frequently (1-3x per week). Ointments work better than creams for treatment. The treatment is meant to improve the symptoms and prevent progression of the condition. […] Patients also may find it useful to use barrier ointments like Vaseline Petroleum Jelly, A&D ointment, zinc paste or Cerave Healing Ointment to the affected area to soothe the symptoms once the condition is under control. Unfortunately there is not a “cure” but this condition can be managed. In young girls, about 60% will notice the condition goes away at puberty. However, sometimes it can reoccur or persist into adulthood. In advanced cases where there is significant scarring, sometimes surgery can be helpful.

• #58 More information about Pediatric Vulvar Lichen Sclerosus – Great Neck, NY: Adolescent Young Adult Medicine of Great Neck

  https://www.tragermd.com/contents/services/lichen-sclerosus/pediatric-vulvar-lichen-s

  In addition to using medicines for lichen sclerosus, good vulvar hygiene is important to keeping your daughter comfortable. […] The prognosis of pediatric lichen sclerosus is usually very good. Most girls will improve significantly with treatment. […] To minimize these scarring complications, it is important to start treatment early, before scarring has occurred, and to treat any flare-ups right away. […] Since treatment is so effective, young girls with lichen sclerosus who do not have significant scarring can be expected to have normal sexual functioning. […] Girls with lichen sclerosus may need a great deal of emotional support and encouragement to deal with their disease.

• #59 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  The author has used hydroxychloroquine with good results as a systemic maintenance drug for both genital and extragenital lichen sclerosus. […] Topical testosterone, topical estrogen, topical progesterone, and hormone replacement therapy should not be used. […] A small study examined the use of topical avocado and soybean extracts as alternative treatments for mild-to-moderate vulvar LS in patients wishing to avoid corticosteroids. […] There is a lack of RCTs evaluating the efficacy of treatment for extragenital LS; recommendations are based on case reports and small uncontrolled studies. […] If localized lesion treatment is desired, topical treatment with potent or ultrapotent topical corticosteroids is first-line therapy. […] If patients have extensive involvement, rapid progression, or a goal of preventing new lesions, phototherapy or systemic therapy should be offered.

• #60 Lichen sclerosus (syn. lichen sclerosus et atrophicus)

  https://www.pcds.org.uk/clinical-guidance/lichen-sclerosis

  LS can develop after an injury to the affected area (the Koebner phenomenon) […] Topical treatments are generally much less effective than when used to treat genital LS. A number of treatments have been used including Dermovate cream/ointment (Clobetasol proprionate), calcipotriol cream (Dovonex), and tacrolimus (Protopic) 0.1% ointment […] Most adults with uncomplicated lichen sclerosus can be managed in Primary Care, but if the diagnosis is in doubt the patient should be referred to Secondary Care. Children should be referred to Secondary Care from the onset […] The mainstay of treatment is that of Dermovate cream / ointment (Clobetasol proprionate) […] Such a regime not only improves symptoms in the majority of patients, but also stops scarring […] Other treatments sometimes used include the topical calcineurin inhibitors – tacrolimus 0.1% ointment (Protopic) and pimecrolimus cream (Elidel) […] Long-term follow-up in Secondary Care is appropriate for patients with genital LS associated with troublesome symptoms, localised skin thickening (associated with a higher risk of malignant change), or VIN.

• #61 Frontiers | Lichen sclerosus: The 2023 update

  https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1106318/full

  UVA1 phototherapy is a potential first-line therapy for eLS, with an evidence level 1+ and recommendation grade B. […] Systemic therapy is sporadically indicated and only recommended in widespread eLS or LS refractory to the standard topical treatment. […] There is no surgical first-line therapy for adult MGLS and recommendations are based on expert opinion or non-analytical studies. […] Laser therapy is an emerging therapeutic in gLS, despite the poor evidence and the lack of long-term data to support it. […] The regenerative therapies could be considered as a therapeutic option for complications such as atrophy and scarring, when the first-line therapy is unresponsive.

• #62 Frontiers | Lichen sclerosus: The 2023 update

  https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1106318/full

  UVA1 phototherapy is a potential first-line therapy for eLS, with an evidence level 1+ and recommendation grade B. […] Systemic therapy is sporadically indicated and only recommended in widespread eLS or LS refractory to the standard topical treatment. […] There is no surgical first-line therapy for adult MGLS and recommendations are based on expert opinion or non-analytical studies. […] Laser therapy is an emerging therapeutic in gLS, despite the poor evidence and the lack of long-term data to support it. […] The regenerative therapies could be considered as a therapeutic option for complications such as atrophy and scarring, when the first-line therapy is unresponsive.

• #63 Lichen sclerosus: Causes, Diagnosis, and Images – DermNet

  https://dermnetnz.org/topics/lichen-sclerosus

  The doctor should reassess the treated area after a few weeks, as a response to treatment is quite variable. […] Other topical treatments used in patients with lichen sclerosus include: Intravaginal oestrogen cream or pessaries in postmenopausal women. […] When lichen sclerosus is severe, acute, and not responding to topical therapy, systemic treatment may rarely be prescribed. Options include: Intralesional or systemic corticosteroids, Oral retinoids: acitretin, isotretinoin, Methotrexate, Ciclosporin. […] Surgery is essential for high-grade squamous intraepithelial lesions or cancer. […] In males, circumcision is effective in lichen sclerosus affecting prepuce and glans of the penis. […] In females, the release of vulval and vaginal adhesions and scarring from vulval lichen sclerosus may occasionally be performed to reduce urination difficulties and allow intercourse if dilators have not proved effective. […] Other reported treatments for lichen sclerosus are considered experimental at this time.

• #64 More information about Pediatric Vulvar Lichen Sclerosus – Great Neck, NY: Adolescent Young Adult Medicine of Great Neck

  https://www.tragermd.com/contents/services/lichen-sclerosus/pediatric-vulvar-lichen-s

  Lichen sclerosus is fairly easy to diagnose by clinicians familiar with the disease and good treatment is available. […] The most effective treatment for lichen sclerosus in young girls is the topical application of one of the prescription steroid creams. […] The medication is typically applied twice a day for 6-12 weeks; then, based on how the girl is doing, the medication is reduced to a few times a week. […] Signs that the disease is under good control are: Decreased vulvar itching, Decreased vulvar soreness, A more normal appearing vulva with little or no bruising or fissures. […] Non-steroid topical medications are being studied for the treatment of lichen sclerosus and may hold promise as a way of treating lichen sclerosus without the potential side effects of topical steroids.

• #65 Lichen Sclerosus | Doctor

  https://patient.info/doctor/lichen-sclerosus-pro

  If the treatment has been successful, the hyperkeratosis, ecchymoses, fissuring and erosions should have resolved but the atrophy and colour change remain. […] Maintenance treatment may be required with as-required use of very potent steroids. […] Although some studies have demonstrated some benefit of (unlicensed) topical tacrolimus and pimecrolimus, long-term safety of these drugs is not established and there are concerns about an increased risk of malignancy with their use in this condition, which already has a premalignant potential. Therefore, these medications should not be used as first-line treatment. […] Use ultra-potent topical steroids (clobetasol propionate 0.05%) applied once-daily until remission, then gradually reduced. […] Referral for consideration of circumcision is recommended if there is phimosis and there has been no response to steroid treatment after 1-3 months. […] Options used include potent topical steroids, acitretin, methotrexate and UVA-1 phototherapy. […] Treatment is recommended if patients have features of active disease – eg, ecchymosis, hyperkeratosis or progressive atrophy.

• #66 Lichen Sclerosus | Doctor

  https://patient.info/doctor/lichen-sclerosus-pro

  If the treatment has been successful, the hyperkeratosis, ecchymoses, fissuring and erosions should have resolved but the atrophy and colour change remain. […] Maintenance treatment may be required with as-required use of very potent steroids. […] Although some studies have demonstrated some benefit of (unlicensed) topical tacrolimus and pimecrolimus, long-term safety of these drugs is not established and there are concerns about an increased risk of malignancy with their use in this condition, which already has a premalignant potential. Therefore, these medications should not be used as first-line treatment. […] Use ultra-potent topical steroids (clobetasol propionate 0.05%) applied once-daily until remission, then gradually reduced. […] Referral for consideration of circumcision is recommended if there is phimosis and there has been no response to steroid treatment after 1-3 months. […] Options used include potent topical steroids, acitretin, methotrexate and UVA-1 phototherapy. […] Treatment is recommended if patients have features of active disease – eg, ecchymosis, hyperkeratosis or progressive atrophy.

• #67 Lichen Sclerosus | Doctor

  https://patient.info/doctor/lichen-sclerosus-pro

  If the treatment has been successful, the hyperkeratosis, ecchymoses, fissuring and erosions should have resolved but the atrophy and colour change remain. […] Maintenance treatment may be required with as-required use of very potent steroids. […] Although some studies have demonstrated some benefit of (unlicensed) topical tacrolimus and pimecrolimus, long-term safety of these drugs is not established and there are concerns about an increased risk of malignancy with their use in this condition, which already has a premalignant potential. Therefore, these medications should not be used as first-line treatment. […] Use ultra-potent topical steroids (clobetasol propionate 0.05%) applied once-daily until remission, then gradually reduced. […] Referral for consideration of circumcision is recommended if there is phimosis and there has been no response to steroid treatment after 1-3 months. […] Options used include potent topical steroids, acitretin, methotrexate and UVA-1 phototherapy. […] Treatment is recommended if patients have features of active disease – eg, ecchymosis, hyperkeratosis or progressive atrophy.

• #68 Genital Lichen Sclerosus Treatment: From Ointments to Self-Care

  https://www.verywellhealth.com/lichen-sclerosus-treatment-7494850

  Treatment can reduce and potentially eliminate symptoms, though periodic flares are always possible. […] The first-line treatment involves the use of a very potent steroid ointment. Lifelong follow-up and care are needed since flares can occur even after you control symptoms. When scarring occurs, surgery may be advised. […] Early treatment of this disease can help prevent problems like scarring. Lifetime care and follow-up are needed to reduce your risk of flares.

• #69 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  An evidence-based treatment guideline for lichen sclerosus (LS) was published by the British Association of Dermatologists (BAD) in 2010; this guideline was updated in 2018, and a further update was under way as of November 2024. […] In 2015, an evidence-based guideline for anogenital LS was published by the European Academy of Dermatology and Venereology (EADV). […] First-line therapy includes patient education and superpotent topical corticosteroids (eg, clobetasol propionate). […] Second-line therapies include the calcineurin inhibitors tacrolimus and pimecrolimus, which can be a helpful adjunct to topical corticosteroids for maintenance. […] Third-line therapies that could be considered for treatment-resistant genital LS include topical or oral retinoids, steroid injections, cyclosporine, methotrexate, and hydroxyurea.

• #70 Treatment Modalities for Genital Lichen Sclerosus: A Systematic Review

  https://www.mdpi.com/2673-6179/4/4/14

  While both sexes can be affected, the prevalence is thought to be a lot higher in females with upwards of a 10:1 female to male ratio. […] Topical corticosteroids, the mainstay of therapy for LS, were discussed throughout the literature, and proved to be more efficient than topical calcineurin inhibitors, topical hormonal therapy, topical vitamin E oil and cold cream. […] However, other treatment modalities proved to be more efficient than topical corticosteroids, including CO2 and Nd:YAG laser therapies, and the addition of polydeoxyribonucleotide intradermal injections, to steroid therapy. […] Overall, high potency topical corticosteroids recurrently proved to be effective in the symptomatic and physical management of LS in both males and females, and should remain the gold standard of therapy for genital LS therapy.

• #71 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  An evidence-based treatment guideline for lichen sclerosus (LS) was published by the British Association of Dermatologists (BAD) in 2010; this guideline was updated in 2018, and a further update was under way as of November 2024. […] In 2015, an evidence-based guideline for anogenital LS was published by the European Academy of Dermatology and Venereology (EADV). […] First-line therapy includes patient education and superpotent topical corticosteroids (eg, clobetasol propionate). […] Second-line therapies include the calcineurin inhibitors tacrolimus and pimecrolimus, which can be a helpful adjunct to topical corticosteroids for maintenance. […] Third-line therapies that could be considered for treatment-resistant genital LS include topical or oral retinoids, steroid injections, cyclosporine, methotrexate, and hydroxyurea.

• #72 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  An evidence-based treatment guideline for lichen sclerosus (LS) was published by the British Association of Dermatologists (BAD) in 2010; this guideline was updated in 2018, and a further update was under way as of November 2024. […] In 2015, an evidence-based guideline for anogenital LS was published by the European Academy of Dermatology and Venereology (EADV). […] First-line therapy includes patient education and superpotent topical corticosteroids (eg, clobetasol propionate). […] Second-line therapies include the calcineurin inhibitors tacrolimus and pimecrolimus, which can be a helpful adjunct to topical corticosteroids for maintenance. […] Third-line therapies that could be considered for treatment-resistant genital LS include topical or oral retinoids, steroid injections, cyclosporine, methotrexate, and hydroxyurea.

• #73 Lichen Sclerosus Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1123316-treatment

  No standardized regimen has been established for treating LS with topical corticosteroids, though most providers divide treatment into an initiation phase and a maintenance phase. […] The addition of a topical calcineurin inhibitor (eg, tacrolimus or pimecrolimus) as a second agent for maintenance is a recommended option if daily treatment is needed. […] An RCT found oral acitretin to be effective in comparison with placebo. […] In an RCT comparing the efficacy of home-administered medium-dose ultraviolet (UV)-A1 phototherapy with that of once-daily application of clobetasol ointment, both groups showed significant improvement. […] The efficacy of systemic corticosteroids plus methotrexate was supported by a retrospective study of 10 patients with extragenital LS. […] Genital LS may respond well to ultrapotent topical corticosteroids, though patients should be warned that the clinical appearance is not always reversed, even if symptoms are relieved.

• #74 Lichen sclerosus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/diagnosis-treatment/drc-20374452

  Your health care provider might recommend removing the penis foreskin (circumcision) if the opening for urine flow has been narrowed by lichen sclerosus. […] Some basic questions to ask your health care provider about possible lichen sclerosus include: What treatment approach do you suggest, if any? […] If the first treatment doesn’t work, what will you suggest next? […] How much do you expect my symptoms will improve with treatment and how soon? […] Will I need treatment for this condition for the rest of my life?

• #75 Treatment Options in Vulvar Lichen Sclerosus: A Scoping Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7995233/

  Retinoids have anti-inflammatory properties and reduce hyperkeratinization. […] Emollients or moisturizers should be an integral part of treatment of VLS. […] Laser therapy has been used in a few small studies for the treatment of VLS refractory to TCS. […] Photodynamic therapy (PDT) with the use of topical 10% 5-ALA cream (5-aminolaevulinic acid) has been found to be useful in treating VLS. […] Cryotherapy has been used as a treatment modality for VLS refractory to medical management. […] Fat grafting may be considered a supportive or second-line therapy. […] Adipose-derived stem cells, now considered as stem cell transplant, are purported to be able to restore and regenerate damaged tissue as in VLS. […] If pruritus persists after corticosteroid and other local therapies, hydroxyzine or doxepin may be given to stop nighttime pruritus.

• #76 Lichen Sclerosus—Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4904529/

  Lichen sclerosus is a chronic inflammatory skin disease. It is thought to be underdiagnosed and undertreated. If it is not treated, lichen sclerosus is associated with a greater degree of scarring and an elevated risk of cancer in the genital area. The treatment of first choice is the local application of high-potency corticosteroids as early as possible (1/A). For boys and men in whom the condition does not remit after steroid treatment, circumcision is indicated (3/D). Anogenital itching and clinical features such as erythema, white skin changes (such as hyperkeratosis and sclerosis), and fissures should arouse suspicion of lichen sclerosus. The diagnosis should be confirmed with a skin biopsy, and early, thorough treatment should be initiated. In this way, a mutilating disease course can be averted, and the risk of cancer can be lessened. The recommended initial treatment of lichen sclerosus is a three-month application of potent to ultrapotent topical corticosteroids (level of evidence 1+/grade of recommendation A) (3, e12) (eTable 1, eTable 2). Randomized studies show that application of potent to ultrapotent topical corticosteroids significantly improves lichen sclerosus in 75 to 90% of patients, compared to roughly 10% in placebo groups (3, e12). If the initial three-month treatment with topical steroids does not lead to the desired full remission in male patients with genital lichen sclerosus, a complete circumcision should be recommended, especially in uncomplicated cases in early stages (without involvement of meatus and urethra) (level of evidence 3/grade of recommendation D) (10). This procedure is reported to lead to permanent, lifelong remission (recovery) in 90 to 100% of cases. For many patients, especially for women and girls, a long-term treatment lasting for years or even decades is reasonable (often necessary), even if there are few complaints. It has been shown that individually adapted long-term treatment with corticosteroid applications, e.g. twice a week, resulted in the suppression of symptoms in 93.3% of compliant patients versus 58% of partially compliant patients and prevention of scarring (adhesions/scarring occurred in 3.4% of compliant patients versus 40% of partially compliant patients) in female patients evaluated after an average follow-up time of 4.7 years (range, 2.0 to 6.8 years) (women: level of evidence 1+/grade of recommendation A; men and girls 3/D; boys 2+ to 1+/B) (2, 30). Calcineurin inhibitors (tacrolimus and pimecrolimus) are second choice treatment options. The effects are inferior to those of topical corticosteroids (women: level of evidence 1+/grade of recommendation BA; men 2+/C; boys and girls 3/D) (3).

• #77 Lichen Sclerosus And Cancer: Is There A Link?

  https://www.healthline.com/health/cancer/lichen-sclerosus-cancer

  Lichen sclerosus is a skin condition that can increase your risk of cancer. Its not a type of cancer on its own, but treating this condition can help you prevent vulvar cancer. […] Treatment for the condition typically involves strong corticosteroids. […] Getting effective medical care and treatment of lichen sclerosus is believed to help to reduce the risk of developing vulvar cancer. […] Lichen sclerosus is treated with prescription corticosteroid creams. Treatment is meant to help manage your symptoms, prevent scarring, and reduce the risk of cancer. […] Because lichen sclerosus is often associated with inflammation of the skin, first-line treatment typically includes the use of prescription corticosteroid creams to help restore the integrity of the tissue. […] Treating lichen sclerosus often helps prevent vulvar cancer from developing. […] Treating lichen sclerosus can help prevent the development of this type of cancer.

• #78 Lichen sclerosus: Causes, Diagnosis, and Images – DermNet

  https://dermnetnz.org/topics/lichen-sclerosus

  Patients with lichen sclerosus are best to consult a doctor with a particular interest in the condition for accurate diagnosis and treatment recommendations. […] They are advised to become familiar with the location and appearance of their lichen sclerosus. […] Topical steroids are the primary treatment for lichen sclerosus. An ultrapotent topical steroid is often prescribed (eg, clobetasol propionate 0.05%). A potent topical steroid (eg, mometasone furoate 0.1% ointment) may also be used in mild disease or when symptoms are controlled. […] Most patients will be told to apply the steroid ointment once a day. After one to three months (depending on the severity of the disease), the ointment can be used less often. […] Topical steroid may need to be continued once or twice a week to control symptoms or to prevent lichen sclerosus recurring.

• #79 Lichen Sclerosus Treatment – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-treatment/

  Treatments in the pipeline means scientists and researchers are currently investigating the efficacy and safety of new, potential treatments. […] JAK Inhibitors (aka Janus Kinase Inhibitors) are currently being trialed in multiple centers across North America. […] A clinical trial is being designed, led by Dr. Aurora Almadori in the UK, to investigate the role of fat grafting in improving scarring and helping with symptoms and quality of life. […] Overall, the authors note this is a promising result, and fat grafting may have an adjunct role for folks with scarring and fibrosis that cannot be reversed with steroids alone. […] The following are not considered treatment plans, either primary or secondary, in the medical field. […] Emollients (e.g., coconut oil) are essentially moisturizers for your vulva.

• #80 Lichen Sclerosus Treatment – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-treatment/

  Treatments in the pipeline means scientists and researchers are currently investigating the efficacy and safety of new, potential treatments. […] JAK Inhibitors (aka Janus Kinase Inhibitors) are currently being trialed in multiple centers across North America. […] A clinical trial is being designed, led by Dr. Aurora Almadori in the UK, to investigate the role of fat grafting in improving scarring and helping with symptoms and quality of life. […] Overall, the authors note this is a promising result, and fat grafting may have an adjunct role for folks with scarring and fibrosis that cannot be reversed with steroids alone. […] The following are not considered treatment plans, either primary or secondary, in the medical field. […] Emollients (e.g., coconut oil) are essentially moisturizers for your vulva.

• #81 Lichen Sclerosus Treatment – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/lichen-sclerosus-treatment/

  Treatments in the pipeline means scientists and researchers are currently investigating the efficacy and safety of new, potential treatments. […] JAK Inhibitors (aka Janus Kinase Inhibitors) are currently being trialed in multiple centers across North America. […] A clinical trial is being designed, led by Dr. Aurora Almadori in the UK, to investigate the role of fat grafting in improving scarring and helping with symptoms and quality of life. […] Overall, the authors note this is a promising result, and fat grafting may have an adjunct role for folks with scarring and fibrosis that cannot be reversed with steroids alone. […] The following are not considered treatment plans, either primary or secondary, in the medical field. […] Emollients (e.g., coconut oil) are essentially moisturizers for your vulva.

• #82 Lichen Sclerosus | Services | Peninsula Women’s Care

  https://peninsulawomenscare.com/services/lichen-sclerosus/

  A recent randomized control trial, published in the Obstetrics Gynecology Green Journal, compared steroid use with fractionated carbon dioxide laser for lichen sclerosus treatment. After 6 months of treatment, patients who received laser treatment had greater improvement in symptoms compared to patients who received steroid treatment. Additionally, there were no significant safety concerns or adverse effects demonstrated by the CO2 laser during the 6 month trial period. […] Overall, the MonaLisa Touch is a well-tolerated treatment that occurs in the office using local anesthesia. There are minimal side effects without any downtime after treatment. […] Because lichen sclerosus is a chronic condition, it requires long-term treatment to attain remission. Remission is not the same as a cure, so maintenance treatment is recommended. Maintenance therapy typically occurs one year after initial treatment. […] Peninsula Womens Care is fortunate to provide MonaLisa Touch therapy to women suffering from the chronic and inflammatory symptoms of lichen sclerosus.

• #83 Vulvar Lichen Sclerosus: Navigating Sex Hormone Dynamics and Pioneering Personalized Treatment Paradigm

  https://www.mdpi.com/2075-4426/14/1/76

  Potent topical corticosteroids (TCSs) are now widely recognized as the most effective treatment for remission in VLS. […] Topical clobetasol 0.05% ointment daily for 4–12 weeks is the gold standard for treating VLS. […] Tacrolimus and pimecrolimus, topical immunosuppressive medications, may treat VLS in children and adults. […] Photodynamic therapy (PDT) using topical 5-aminolevulinic acid (5-ALA) is a viable treatment option for uncontrollable itching in VLS when other treatments have been unsuccessful. […] Surgery for women with anogenital LS should only be considered for patients who have vulvar intraepithelial neoplasia or malignancy or for those who need correction of scarring that is affecting normal function. […] Emerging treatments, including PRP (platelet-rich plasma), stem cell therapy, and energy-based lasers like fractional CO2 and Nd-YAG, are being investigated to identify more effective VLS treatments than ultrapotent topical corticosteroids.

• #84 Vulval lichen sclerosus (LS) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/worried-about-cancer/pre-cancerous-and-genetic-conditions/lichen-sclerosus-vulva

  Your doctor will also give you advice about things you can do to improve your symptoms, such as: avoid using soap, perfumes, talc or wet wipes on the vulva, wash with an emollient soap substitute, wash your hair over the sink or bath to protect the vulval skin from shampoo, avoid hot baths wear loose fitting or no underwear, if you use a sanitary towel, use a non-perfumed type and change it regularly, use a plain emollient on the vulval skin, such as coconut oil, use a lubricant to protect the skin during penetrative sex. […] Vulval LS is a long-term condition that cannot be cured. It is usually possible to control the symptoms, and this prevents further damage to the skin.

• #85 What is the Best Treatment for Lichen Sclerosus?

  https://drbrighten.com/what-is-the-best-treatment-for-lichen-sclerosus/

  Curcumin is the active part of turmeric. There have been studies showing the benefits of turmeric in inflammatory skin conditions. […] If your body is enduring a state of chronic inflammation due to a hidden infection, food allergies, endometriosis, other autoimmune conditions, or leaky gut, its important to address those as part of your lichen sclerosus treatment plan. […] Some of my most important recommendations for treating lichen sclerosus involve developing good habits. […] Just be careful what lube you choose, whats in commercial lubricants can be irritants or endocrine disruptors. […] Cotton helps your vulva to breathe and cuts down on sweat. […] Now is not the time to rock your tightest fitting jeans. […] Wiping front to back helps prevent the spread of bacteria and is a habit that helps prevent urinary tract infections.

• #86 Genital Lichen Sclerosus Treatment: From Ointments to Self-Care

  https://www.verywellhealth.com/lichen-sclerosus-treatment-7494850

  Treatment can reduce and potentially eliminate symptoms, though periodic flares are always possible. […] The first-line treatment involves the use of a very potent steroid ointment. Lifelong follow-up and care are needed since flares can occur even after you control symptoms. When scarring occurs, surgery may be advised. […] Early treatment of this disease can help prevent problems like scarring. Lifetime care and follow-up are needed to reduce your risk of flares.

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