Are you a candidate for Liquenia® Treatment?
Not all women with vulvar lichen sclerosus are candidates for Liquenia® Treatment at the same stage of their condition. On this page, I clearly explain which factors we assess and why a prior consultation is essential.
The starting point: confirmed diagnosis
The first requirement to be a candidate for Liquenia® Treatment is to have a confirmed diagnosis of vulvar lichen sclerosus. It may seem obvious, but it is a point worth emphasizing: VLS shares symptoms with other vulvar conditions—lichen planus, contact dermatitis, vulvar psoriasis—and an incorrect diagnosis would lead to inappropriate treatment.
If you do not have a diagnosis confirmed by a specialist, the first step is to obtain one. In our consultation, we perform a complete diagnostic evaluation, including biopsy when indicated.
In which situations is Liquenia® particularly indicated?
After years of consultation, we have identified four patient profiles in which Liquenia® Treatment has the greatest clinical relevance. They are not mutually exclusive—many patients recognize themselves in more than one.
Insufficient response to corticosteroids
You have followed a correctly prescribed corticosteroid treatment—clobetasol or another ultrapotent corticosteroid—for at least 3-6 months, and symptoms persist or have not improved satisfactorily. Corticosteroids are the first-line treatment according to EADV 2024 and BAD 2018 guidelines, but they do not work equally in all patients or at all stages of the disease.
Documented progressive tissue damage
Lichen sclerosus has produced visible anatomical changes: fusion of labia minora, clitoral phimosis, narrowing of the introitus, recurrent fissures. These changes significantly affect quality of life and do not reverse with corticosteroids alone. Liquenia® Treatment acts on already damaged tissue to promote its recovery.
High symptom burden with impact on quality of life
Itching, burning, pain, or dyspareunia are so intense or frequent that they affect sleep, intimate relationships, or daily life, despite conventional treatment. In these cases, the priority objective is to reduce the symptom burden sustainably.
Seeking a specialized second opinion
You have been treated at another center and have doubts about your progress, your diagnosis, or the available options. In our consultation, we evaluate your case independently and provide you with a well-founded clinical opinion, with no treatment commitment.
When Liquenia® is not indicated
Clinical honesty is part of our approach. There are situations in which Liquenia® Treatment is not the most appropriate option, and it is important that you know them:
> Pregnancy. We do not perform the procedure during pregnancy or breastfeeding.
> Severe coagulation disorders. The procedure involves a small extraction of adipose tissue and a blood draw. If there is an uncontrolled coagulation disorder or anticoagulant treatment that cannot be temporarily suspended, the hemorrhagic risk contraindicates the procedure.
> Active infection in the treatment area. Any active infectious process in the vulvar or perianal area must be resolved before considering the procedure.
> Severe uncontrolled systemic disease. Some active systemic autoimmune diseases or oncological processes under treatment may contraindicate or affect the indication. This is evaluated on an individual basis.
> VLS in very early stages with good response to corticosteroids. If the diagnosis is recent and corticosteroids are controlling the disease well, the Liquenia® Treatment does not add significant benefit at that time. In these cases, our recommendation is to optimize conventional treatment and continue follow-up.
How we evaluate your candidacy
Candidacy for Liquenia® Treatment cannot be determined remotely or without a direct clinical evaluation. In the assessment consultation, we perform:
> Complete medical history. We gather the clinical history of VLS: when it was diagnosed, what treatments you have followed, how the disease has evolved, which symptoms affect you most, and how they impact your quality of life.
> Clinical examination. We evaluate the degree of involvement, active clinical signs, and present anatomical changes. This examination is essential to determine the extent of tissue damage and the indication for treatment.
> Review of previous reports and biopsies. If you provide reports from other specialists or results from previous biopsies, we review them and integrate them into the evaluation.
> Assessment of candidacy and clinical response. At the end of the consultation, we give you a clear answer: whether you are a candidate, at what point in your progression the procedure would make the most sense, and what you can realistically expect from it.
If the consultation is conducted in person at the Nixarian Institute in Valencia, the clinical examination is complete. We also conduct initial assessments by video consultation for patients residing outside Valencia, although in that case the physical examination is completed at a subsequent visit if it is decided to proceed.
Not sure if you are a candidate? That is exactly what the assessment consultation is for.
You do not need to be certain whether Liquenia® Treatment is right for you before requesting an appointment. The assessment consultation exists precisely to resolve that doubt with clinical rigor. What you do need is a diagnosis of vulvar lichen sclerosus—or a well-founded suspicion of having it—and the desire to make an informed decision.
Frequently asked questions about candidacy
Can I be a candidate if I have had the diagnosis for a short time?
It depends on how you are responding to conventional treatment. If corticosteroids are controlling the disease well, it may not be the most appropriate time. If control is already insufficient in the first few weeks or the involvement is significant, the assessment makes sense from the beginning.
Is age a factor?
There is no established age limit. We evaluate candidacy based on clinical status, not age. We have treated patients from their 30s to beyond 70 years of age.
Can I be a candidate if I have other autoimmune diseases?
It depends on the disease and its state of control. Some systemic autoimmune diseases in active phase may condition the indication. This is evaluated individually in the consultation.
Is it necessary to have tried corticosteroids first?
In most cases yes, because corticosteroids are the first-line treatment established by international clinical guidelines. However, there are situations—such as documented intolerance to corticosteroids or very significant tissue damage from diagnosis—in which the assessment makes sense even without having completed a corticosteroid cycle.
Can I come to the consultation without having a previous biopsy?
Yes. If you do not have a previous biopsy but have a clinical diagnosis established by a specialist, it is sufficient to begin the assessment. If during the examination we consider that the biopsy adds relevant information, we will indicate it to you.
The first step is a conversation
If you recognize yourself in any of the profiles described on this page, or simply have doubts about your treatment options, our assessment consultation is the place to resolve them. No long waiting lists, no commitments, and with an honest clinical response.