If you have come this far looking for clear answers, this article is for you.
Vulvar lichen sclerosus (VLS) is a chronic inflammatory disease that affects the skin of the vulva and, in many women, causes persistent itching, pain, changes in skin texture, and a constant feeling of discomfort that ends up affecting daily life, sexuality, and emotional well-being.
After diagnosis, it is very common to feel disoriented. Questions, fears, and contradictory messages arise about which treatments truly work and which do not. Sometimes false expectations are even created, which end in frustration.
This article has a very specific goal: to provide patients with a clear, understandable, and honest summary of the recent scientific article published in late 2025 by Dr. Patricia Gutiérrez Ontalvilla in the scientific journal ASP (Aesthetic Plastic Surgery), which analyzes—based on current medical evidence—the therapies that have demonstrated real usefulness in the treatment of lichen sclerosus, as well as their limitations.
The following lines are not intended to replace a medical consultation, but to help you better understand the condition and make informed decisions together with your specialist.
Why it is so important to guide lichen sclerosus treatment correctly
Although lichen sclerosus has no definitive cure, effective treatments do exist that allow symptoms to be controlled, slow disease progression, and reduce the risk of complications when applied correctly.
Not all patients need the same thing, and not all treatments work for every case. That is why specialist follow-up and a personalized approach are key from the outset.
A well-guided treatment not only aims to relieve itching or pain, but also to protect the skin in the long term and prevent irreversible changes.
The lichen sclerosus treatment used as the first step
It is important to start with what we know today works best.
Current scientific evidence agrees that high-potency topical corticosteroids remain the reference treatment for controlling inflammation and itching in vulvar lichen sclerosus.
These treatments:
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Are used in a scheduled and progressive manner, adjusting the frequency according to each patient’s response.
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Help stabilize the disease and reduce flare-ups.
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They do not eliminate lichen sclerosus, but they do allow it to be kept under control in many cases.
It is normal for doubts or fears to arise when hearing the word “corticosteroids,” but when used correctly and under medical supervision, they remain the cornerstone of initial treatment.
CO₂ laser and lichen sclerosus: debunking the myth
Fractional CO₂ laser has been studied as a possible adjunct in certain specific cases, but it is important to be very clear:
it is not recommended as a stand-alone treatment for lichen sclerosus.
Controlled scientific studies have not shown sufficient clinical benefits when the laser is used on its own. Therefore, it should not be presented as a miracle solution.
In very selected situations, it could be considered as a complementary treatment, for example to help improve the response to other treatments, always under medical supervision and after ruling out malignant lesions.
This does not mean the laser “never works,” but rather that it should not create false expectations, which is especially important to protect patients.
Regenerative medicine in lichen sclerosus: an option in selected cases
In recent years, regenerative medicine approaches have been investigated for women with lichen sclerosus who do not respond adequately to conventional treatment or who have significant atrophy and scarring.
These options include techniques based on the use of the patient’s own fat and its cellular components (such as Liquenia), with the aim of:
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Improving the quality of vulvar tissue.
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Reducing fibrosis and skin tightness.
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Relieving persistent symptoms.
Published results show clinical improvements and improvements in quality of life in certain patient profiles. At the same time, the authors themselves emphasize the need to continue researching with larger, controlled studies, which is common and necessary in any relatively new therapy when maximum safety is sought.
The key is to understand that it is not an option for all patients, nor does it replace baseline medical treatment; rather, it may be considered on an individualized basis in specific cases.
When surgery may be necessary in lichen sclerosus
Surgery is not the first step nor the most common option.
It is reserved for complex cases in which there are severe adhesions, significant narrowing, or structural complications—such as clitoral phimosis—that do not improve with medical treatment.
Surgical procedures are only considered when there is a clear and well-justified indication, always with the aim of improving the patient’s function and quality of life.
Long-term follow-up for lichen sclerosus: a key part of treatment
Managing lichen sclerosus does not end when symptoms improve. Long-term follow-up is part of treatment and is essential to keep the disease stable.
It includes:
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Regular check-ups to assess progress.
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Attention to any changes in the skin or the appearance of new lesions.
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Use of moisturizers and gentle vulvar care as daily support for medical treatment (such as Dermnix Oil*).
These small steps, maintained over time, make a big difference.
An important message for women with lichen sclerosus
Management of vulvar lichen sclerosus should be individualized, progressive, and based on scientific evidence, but also on listening to and understanding each patient.
There are no universal solutions or miracle treatments, but there are effective strategies to improve well-being and quality of life when action is taken early, informed, and with specialist care.
Scientific source:
