Non-hormonal treatments for vulvar lichen sclerosus
Moisturizers, emollients, and topical care measures do not replace pharmacological treatment for VLS, but they are an important complement that reduces the symptomatic burden and improves quality of life.
Why topical care matters in VLS
Vulvar skin affected by VLS is fragile, dry, and sensitive. The loss of the skin barrier caused by the disease makes the tissue more vulnerable to irritation and damage from external factors. Proper topical care has three specific objectives:
Restore the skin barrier
Emollients and vulvar oils create a protective layer over the fragile epithelium, reducing transepidermal water loss and protecting against external irritants.
Reduce itching
Well-hydrated skin itches less. A good vulvar moisturizer can reduce the intensity of pruritus between corticosteroid applications.
Facilitate treatment tolerance
Proper hydration helps the skin better tolerate corticosteroid applications and reduces the burning sensation that some patients experience with clobetasol.
Which products to use
Not all moisturizing products are suitable for vulvar skin with VLS. The selection criteria are clear:
> No perfumes or fragrances. Perfumes are the main irritants for sensitive vulvar skin. Any product with fragrance should be avoided.
> No aggressive preservatives. Parabens, formaldehyde, and other preservatives can cause contact dermatitis in sensitive vulvar skin.
> Physiological pH. The pH of the vulvar area is slightly acidic. Products with a very alkaline pH disrupt the microbiota and worsen the skin barrier.
> Specifically formulated for vulvar use. Generic body moisturizers are not formulated for the specific characteristics of vulvar skin.
In our care ecosystem for patients with VLS, we recommend Dermnix — an intimate oil specifically formulated for sensitive vulvar skin, designed for women with lichen sclerosus. Its formulation respects the characteristics of the vulvar tissue affected by VLS and complements pharmacological treatment.
Vulvar hygiene adapted to VLS
The vulvar hygiene routine must be adapted to the fragility of the tissue with VLS:
> Lukewarm water — never hot. Heat intensifies itching
> Fragrance-free neutral soap if necessary, or just water
> Dry with a gentle touch, without rubbing
> Avoid scented pads or synthetic materials
> Loose-fitting cotton underwear, without seams in friction areas