Regenerative medicine for vulvar lichen sclerosus
Regenerative medicine acts where corticosteroids cannot reach: on tissue already damaged by VLS. This guide explains what techniques exist, what evidence supports them, and when they are indicated.
The role regenerative medicine plays
Topical corticosteroids effectively control VLS inflammation. However, chronic inflammation sustained over years produces tissue damage that corticosteroids cannot repair: atrophy, fibrosis, loss of elasticity, alterations in vulvar epithelial architecture.
Regenerative medicine starts from a different premise: instead of only suppressing inflammation from the outside, it provides the tissue with biological elements that activate its repair and regeneration mechanisms. This approach is biologically coherent with VLS pathophysiology—and available clinical data are beginning to confirm it.
What options exist in regenerative medicine for VLS
Platelet-rich plasma (PRP)
PRP is obtained from the patient's own blood through centrifugation. The resulting platelet concentrate is rich in growth factors that stimulate cellular repair, collagen synthesis, and tissue vascularization. It is infiltrated directly into the affected vulvar area. There is published evidence on the use of PRP in VLS—although available studies have limited sample sizes and heterogeneous designs. Results in terms of symptomatic reduction are promising, especially for pruritus and dyspareunia. A randomized controlled clinical trial (Goldstein et al., 2019) found no significant differences compared to placebo, which limits its recommendation as a first-line treatment.
Nanofat and stromal vascular fraction (SVF)—Protocolo Liquenia®
The combination of nanofat and stromal vascular fraction (SVF) from adipose tissue in a standardized protocol is the approach we have developed at Nixarian Institute under the name Liquenia® Treatment. It is the approach with the most published clinical evidence in the specific context of VLS. Both fractions are obtained from the patient's own adipose tissue. Nanofat provides growth factors and regenerative mediators that promote tissue repair and vascularization. The mesenchymal stem cells present in SVF add three documented effects: anti-inflammatory, immunomodulatory, and regenerative—acting on the underlying mechanisms of VLS, not just on its manifestations.
When to consider regenerative medicine
Regenerative medicine for VLS is especially indicated in:
> Patients with insufficient response to correct corticosteroid treatment after 3-6 months
> Patients with progressive tissue damage despite symptomatic control
> Patients with high symptomatic burden that significantly affects quality of life
> Patients seeking an approach that acts on the tissue, not just on inflammation
It is not indicated as first-line treatment or as a substitute for corticosteroids in patients who respond well to conventional treatment.