Urska Kanduc
Copywriter, Fotona
Lichen sclerosus is a chronic inflammatory skin condition causing patchy, discoloured and thin skin, mainly in genital and anal areas. It mostly affects postmenopausal women and prepubescent girls. However, it can impact anyone, including men.
Lichen sclerosus symptoms typically include itching, pain, skin changes, soreness and painful intercourse. If left untreated, it can lead to infections, vulval ulceration and an increased risk of cancer.
What causes lichen sclerosus?
The exact cause of lichen sclerosus remains unclear, though it is believed to involve genetic, hormonal, irritative, traumatic and infectious factors. Often classified as an autoimmune disorder, it is associated with antibodies targeting a specific protein. In women, the condition is most common after menopause.
What are the treatment options?
The first-line treatment for lichen sclerosus is typically the use of potent topical corticosteroids. However, because this condition is often chronic, many patients require lifelong steroid maintenance therapy along with regular follow-ups. In more severe cases, surgery may be necessary to widen the vagina or remove the foreskin. Recently, studies have shown that laser treatment is emerging as a promising alternative to corticosteroids, offering patients another potential solution.
Laser therapy is emerging as a
viable option for patients who
do not respond to corticosteroids.
Laser vs. corticosteroid therapy
Laser therapy is emerging as a viable option for patients who do not respond to corticosteroids or wish to reduce long-term steroid use.1 With corticosteroids, applying the correct amount with precision is essential. This treatment generally needs to be applied daily or, in some cases, twice weekly. Even when a patient is in remission, maintenance therapy is often required along with regular check-ups.
In contrast, laser therapy typically requires three sessions spaced two to four weeks apart, with follow-up sessions every six months. Randomised controlled trials have demonstrated that laser therapies using Fotona’s Nd:YAG and Er:YAG lasers help reduce inflammation and can be just as effective as topical corticosteroids, with no significant adverse effects.2 Patients reported minimal discomfort during the treatment, and results showed significant improvements that can last up to six months. To enhance effectiveness further, laser therapy can be combined with corticosteroid treatment.
When should you seek help?
Symptoms of lichen sclerosus are often dismissed as a normal part of ageing, which may prevent women from seeking medical advice. However, women’s health is always worth a conversation. If you notice symptoms like itching, pain and skin changes, talk to your doctor. Early intervention can prevent complications and help manage the condition more effectively. By exploring available treatment options, we can improve quality of life and ensure that those suffering from lichen sclerosus receive the care they need.
[1] doi: 10.1016/j.jogc.2019.01.023
[2] https://doi.org/10.1111/1471-0528.17737
