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Treating Vulvar Lichen Sclerosus: What Are Your Options?
Published: Dec 12, 2023
Vulvar lichen sclerosus is a chronic condition, but effective treatments are available. The main goals are to relieve symptoms and prevent complications.
First-Line Treatment: Topical Corticosteroids
The gold standard treatment for vulvar lichen sclerosus is a strong topical corticosteroid ointment. These are typically applied daily for about 3 months to get symptoms under control. After that, less frequent application is used for maintenance. This treatment can dramatically improve itching and skin appearance for many patients.
Other Medication Options
If corticosteroids aren't effective, your doctor may recommend calcineurin inhibitors like tacrolimus. These work by suppressing the immune response in the skin. For very stubborn cases, oral medications like acitretin or methotrexate might be considered. These have more side effects and require close monitoring.
Non-Medication Approaches
Proper vulvar care is important to minimize irritation. Use gentle, fragrance-free cleansers and avoid harsh soaps. Applying a moisturizer can help keep the skin hydrated. Some patients find relief from using special silk underwear. In severe cases with scarring, surgery may be an option to restore normal anatomy.
Frequently Asked Questions
Most see improvement within a few weeks.
Many need ongoing maintenance therapy.
They're usually well-tolerated when used properly.
Yes, proper hygiene and avoiding irritants is important.
Key Takeaways
While there's no cure for vulvar lichen sclerosus, treatment can effectively manage symptoms and prevent progression.
References
- Chi CC, Kirtschig G, Baldo M, et al. Topical interventions for genital lichen sclerosus. Cochrane Database Syst Rev 2011; :CD008240.
- Virgili A, Borghi A, Toni G, et al. First randomized trial on clobetasol propionate and mometasone furoate in the treatment of vulvar lichen sclerosus: results of efficacy and tolerability. Br J Dermatol 2014; 171:388.
- Goldstein AT, Creasey A, Pfau R, et al. A double-blind, randomized controlled trial of clobetasol versus pimecrolimus in patients with vulvar lichen sclerosus. J Am Acad Dermatol 2011; 64:e99.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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