Physician · Doctor of Medicine · Plastic Surgeon specializing in vulvar lichen sclerosus
Researcher — Nixarian Institute · dragutierrez.com ·
Author of the study published in Aesthetic Surgery Journal (Oxford, 2025)
How many stem cell sessions do I need for lichen sclerosus?
Three words summarize what many women with lichen sclerosus feel when they first encounter the Liquenia® Treatment: Can it be true?
This page answers that question rigorously, with data from the published clinical study, and with the honesty you deserve after all you have likely already been through.
For the vast majority of patients treated with the Liquenia® protocol since 2022, a single session has been sufficient to achieve significant and sustained clinical and histological improvement. This is confirmed by the prospective study published in Aesthetic Surgery Journal (Oxford University Press, 2025):
- 1 single session → results in over 99% of the more than 100 cases treated since 2022.
- Booster session only in 1 patient, after 3 years: exceptional profile with multiple autoimmune diseases and severe lichen since childhood.
- Clinical and histological results remain sustained in follow-up beyond discharge at one year.
What no one had explained to you yet
If you’ve made it this far, you’re probably well acquainted with the routine: medical review, topical corticosteroids, some relief, and soon after the itching returns. Sleepless nights. The feeling that the body you live in is no longer entirely your own.
Vulvar lichen sclerosus is a chronic inflammatory and autoimmune disease. It affects the skin of the genital and perianal area and, although there is no known definitive cure, there are treatments capable of radically changing the quality of life.
High-potency topical corticosteroids are, according to international clinical guidelines, the first-line treatment. They reduce inflammation and control symptoms. But they do not repair damaged tissue. They do not act on the autoimmune origin. And their prolonged use can, over time, cause skin atrophy.
The Liquenia® Treatment was specifically created to go a step further: not only to relieve symptoms, but to regenerate tissue from within, modulating the immune response with your own cells.
What is Liquenia® Treatment and why does it act differently
The Liquenia® protocol is a regenerative medicine protocol developed, researched, and performed by Dr. Patricia Gutiérrez Ontalvilla, plastic surgeon and researcher at the Nixarian Institute (Valencia). It is the only treatment of its kind available in Spain for vulvar lichen sclerosus.
It combines two components derived from your own body fat, extracted through minimally invasive microliposuction:
- Nanofat: ultra-fragmented adipose tissue, rich in mesenchymal stem cells, growth factors, and anti-inflammatory cytokines.
- SVF — Stromal Vascular Fraction: a cellular concentrate obtained by mechanical disaggregation (without collagenase, restricted by the FDA), which preserves cellular integrity and maximizes the concentration of progenitor cells.
Both components are infiltrated into the superficial dermis and subdermal plane of the vulvar area, labia minora, clitoral hood, posterior fourchette, and perianal region. The procedure is performed in an operating room under general anesthesia in a completely sterile environment. It requires a hospital stay of approximately 6-8 hours.
| Component | Documented Mechanism | Clinical Effect Confirmed in Study |
|---|---|---|
| Nanofat + SVF | Modulation of autoreactive CD3+ T lymphocytes | Significant reduction of autoimmune inflammation |
| Nanofat + SVF | Neo-angiogenesis: formation of new vessels | Significant increase in microvascular density |
| Nanofat + SVF | Reversal of fibrous stromal hyalinization | Histological reduction of sclerosis |
| Nanofat + SVF | Differentiation into fibroblasts and epithelial cells | Increased epithelial thickness, repigmentation, and restored labial volume |
How many sessions do I need? What the published clinical study says
This is the question we are asked most often. And the answer we can give today is what differentiates Liquenia® most from any other approach you may have encountered so far.
A single session. That is the standard protocol.
The open prospective study published in Aesthetic Surgery Journal (Oxford University Press, July 2025, DOI: 10.1093/asj/sjaf148) included 18 patients with moderate-to-severe vulvar lichen sclerosus, refractory to topical corticosteroids, aged between 24 and 81 years. All received a single session of the Liquenia-SVF protocol, and follow-up was conducted at 1, 3, 6, and 12 months, with histological biopsies before treatment and at one year.
| Parameter (validated scale) | Result at 12 months — 1 single session |
|---|---|
| Symptoms — CSS symptoms | Significant improvement |
| Clinical signs — CSS signs | Significant improvement |
| Itching — 5D Itch Scale | Significant improvement |
| Quality of life — Skindex-29 | Significant improvement |
| Stromal hyalinization (biopsy) | Significant reduction |
| Microvascular density (biopsy) | Significant increase |
| CD3+ T infiltrate (biopsy) | Significant reduction |
| White plaques (clinical photos) | Complete resolution in documented cases |
| Chronic fissures | Complete healing observed |
| Serious adverse events | None in the entire clinical series |
Biopsies taken before treatment and at 12 months showed objective and unequivocal transformations in the tissue:
BEFORE treatment
- Marked epithelial atrophy
- Basal vacuolization
- Hyalinized stroma (dense fibrous tissue)
- Abundant inflammatory infiltrate
AFTER — 12 months, 1 session
- Increased epithelial thickness
- Reduction of vacuolization
- Disappearance of hyaline stroma
- Drastic reduction of inflammatory infiltrate
This is not symptomatic relief. It is real tissue regeneration and immunomodulation demonstrated under the microscope.
Is there any case where a second session is necessary?
In the more than 100 patients treated with the Liquenia® protocol since 2022, a booster session has only been necessary in a single case. This patient had an exceptionally complex clinical profile: multiple concurrent autoimmune diseases and severe, long-standing lichen sclerosus, with documented onset since childhood.
In that singular case, the booster session was recommended 3 years after the initial session — not weeks, not months: three years. A fact that reflects the extraordinary durability of the Liquenia® Treatment’s regenerative effect, even in the most challenging profile possible.
The scientific study itself indicates that cases with very severe fibrosis may require a more intensive approach. That is why the initial personalized assessment is not a mere formality: it is the step that ensures the protocol is adapted exactly to your situation.
When does improvement begin to be noticed?
The study data allow for precise tracking of the treatment response evolution. One of the most valuable characteristics of the Liquenia® protocol is that improvement does not stop: it continues to progress throughout the entire year of follow-up.
- 1 monthSymptoms begin to subside. Itch scores decrease statistically significantly. The tissue begins its internal regeneration process.
- 3 monthsProgressive consolidation. Inflammation continues to decrease. Patients describe visible improvement in skin texture and the appearance of the area.
- 6 monthsActive tissue remodeling. Regeneration continues without any additional intervention. Vascularization improves, and the tissue gains hydration and elasticity.
- 12 monthsMaximum clinical and histological expression. Resolution of white plaques, restoration of mucosal pigmentation, increase in labial volume, healing of chronic fissures. All confirmed by biopsy.
Liquenia® Protocol vs. Conventional Treatment: An Honest Comparison
The ISAPS 2025 clinical guidelines, co-authored by Dr. Gutiérrez-Ontalvilla, place Liquenia-SVF within the general therapeutic context. This is the rigorous perspective specialists currently use:
| Criterion | Topical Corticosteroids | Liquenia® Protocol |
|---|---|---|
| Mechanism of action | Symptomatic suppression of inflammation | Tissue regeneration + immune modulation histologically confirmed |
| Acts on the autoimmune cause | No | Yes — significant reduction of CD3+ T lymphocytes |
| Reverses sclerosed tissue | No | Yes — histological reduction of hyalinization |
| Number of applications | Indefinite daily use | A single session in the vast majority of cases |
| Risk of skin atrophy | Yes, with prolonged use | No — autologous tissue, zero serious adverse events |
| Improves vascularization | No | Yes — demonstrated increase in microvascular density |
| Published histological evidence | Not available | Biopsy before and after at 12 months |
| Role in the protocol | First-line and maintenance | Complementary regenerative treatment in refractory cases |
The Liquenia® Treatment does not replace corticosteroids; it complements them. The ISAPS clinical guidelines recommend maintaining a reduced regimen of lower-potency corticosteroids during post-treatment follow-up to protect against progression and prevent malignant transformation. Our team guides you through this transition from the first consultation.
Who is the Liquenia® Treatment indicated for?
The clinical study included women aged 24 to 81 with moderate-to-severe vulvar lichen sclerosus who had not responded adequately to topical corticosteroids:
- 55.56% were premenopausal.
- 22.22% had other associated autoimmune diseases (hypothyroidism, atopic dermatitis, celiac disease).
- 27.78% had waited more than one year from the first symptoms to diagnosis.
- 94.44% had previously used clobetasol propionate 0.05% without sufficient response.
- 27.78% had previously attempted laser or PRP without success.
If you’ve had a diagnosis for years and feel like you’ve tried everything, this information is for you.
The treatment demonstrated efficacy in all these profiles, regardless of age, menopausal status, or the presence of other autoimmune diseases. You can consult the full scientific evidence for the Liquenia® Treatment on our website.
What patients at Nixarian Institute say
With over 163 verified Google reviews:
Laura Imbert — Verified Google Review · Liquenia
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Frequently Asked Questions about Liquenia® Treatment Sessions and Results
Yes, in the vast majority of cases. The prospective study published in Aesthetic Surgery Journal (Oxford University Press, 2025, DOI: 10.1093/asj/sjaf148) confirms this with clinical and histological data at 12 months. In clinical practice with over 100 patients since 2022, a booster session was only necessary in one case with a particularly complex profile, three years after the first.
The complete session lasts approximately 1.5-2 hours: it includes microliposuction of the donor area, processing of SVF and nanofat in a sterile environment, and infiltration into the vulvar area. It is performed in an operating room under general anesthesia. Most patients resume their usual activities within 1-2 weeks. Mild bruising or discomfort may appear in the extraction area, which resolves spontaneously in a few days.
The procedure is performed under general anesthesia. No patient in the published study required major analgesia. Mild discomfort resolved on its own or with paracetamol. No serious adverse events were recorded in the entire clinical series.
These are different therapies. PRP contains platelet growth factors but not stem cells. The Liquenia® Treatment combines nanofat and SVF, which include mesenchymal stem cells, immunomodulatory cells, and angiogenic factors. The ISAPS 2025 guidelines indicate that the evidence for PRP as monotherapy in lichen sclerosus is limited. Liquenia® is the only combined SVF + nanofat therapy with published histological data at 12 months for this disease.
Yes, temporarily. The protocol requires discontinuing high-potency topical corticosteroids 1 month before the session to optimize the regenerative response. From the third month post-treatment, patients transition to a maintenance regimen with lower-potency corticosteroids twice a week. Our team supports you at every step of this transition.
Yes. The age range of the study (24-81 years) and the inclusion of patients with long-standing disease and multiple previous failed treatments confirm that the duration of the condition is not an exclusionary factor. The initial assessment with Dr. Gutiérrez-Ontalvilla allows for determining the most appropriate protocol for your specific situation.
Yes. The protocol is supported by a prospective study published in Aesthetic Surgery Journal (Oxford University Press, 2025, DOI: 10.1093/asj/sjaf148), peer-reviewed, and included in the ISAPS 2025 clinical guidelines for the regenerative management of vulvar lichen sclerosus. It is the first and only combined SVF + nanofat therapy with published clinical and histological evidence for this disease.
The Liquenia® protocol is performed exclusively at Nixarian Institute, in Valencia (C/ Marqués de Dos Aguas 2, 46002). It is the only center where this protocol is available. You can contact us by phone/WhatsApp at +34 619 838 358 or through the form at liquenia.es/contactar.
Do you want to know if the Liquenia® Protocol is for you?
Request a personalized assessment with Dr. Gutiérrez-Ontalvilla and her team.
We will analyze your history and explain exactly what you can expect.
📍 Nixarian Institute · C/ Marqués de Dos Aguas 2 · Valencia | Monday to Friday · 10:00 AM–8:00 PM · Response within 24 hours
A single session could be the beginning of the change you’ve been looking for
We don’t ask you to trust blindly. We ask you to read the data: significant reduction in symptom scores, histologically confirmed regeneration by biopsy, zero serious adverse events, sustained results at 12 months after a single session, in patients aged 24 to 81 with all types of medical histories.
Vulvar lichen sclerosus currently has no known cure (ISSVD, 2022). But today there is a treatment capable of regenerating tissue damage, calming autoimmune inflammation, and restoring to more than 100 women a quality of life that many thought was impossible to regain.
And it starts with a single step: call, write, or fill out the form.
- Gutierrez-Ontalvilla P, et al. Clinical and Histopathological Investigation of Stromal Vascular Fraction and Nanofat in Vulvar Lichen Sclerosus. Aesthetic Surgery Journal. 2025;45(11):1166-1174. DOI: 10.1093/asj/sjaf148
- Gutierrez-Ontalvilla P, Benito-Ruiz J, Cervantes A. State of the Art for Regenerative Management of Vulvar Lichen Sclerosus. ISAPS Patient Safety Update. Aesthetic Plastic Surgery. 2025. DOI: 10.1007/s00266-025-05459-7
- Gutiérrez Ontalvilla P. Lichen Sclerosus: What No One Explained to You. Available on Amazon.
