Lichen Sclerosus: Therapy

Notice: Early diagnosis and thus effective initiation of therapy is important!

General measures

• Cleaning and care of the intimate area
  • Use little soaps when washing in the genital area.
  • Mild substances should be used for washing; use neutral fat ointments in intervals without treatment.
  • Several times daily application of emollients (bes. fatty ointments) and / or oils e.g. almond oil, olive oil.
  • Apply ointments containing fat before bathing in chlorinated water.
• Careful hygiene after visiting the toilet:
  • Using a bidet after using the toilet or (if this is not available):
  • Dabbing with damp toilet paper and then dabbing the lesions with oil-soaked sanitary wipes.
• Avoid local irritation:
  • Rough paper towels, damp toilet paper, hard towels.
  • Intimate sprays
  • Tight / abrasive clothing
  • Cycling; if cycling, then with windowed saddle.
  • Riding
• Use silk underwear instead of cotton underwear.
• For children, pay attention to short fingernails (due toScratching).
• Avoid sexual intercourse in any case; if necessary, use lubricant.
• Before sports or after long marches apply an ointment (eg dexpanthenol cream (also known as pantothenol, D-panthenol or panthenol) or petroleum jelly. alb.)

Conventional non-surgical therapy methods

• Conventional non-surgical therapeutic procedures are available for
  • The overall problem of vulvovaginal atrophy, genitourinary menopause syndrome (vulva, vagina, bladder, urethra).
    • As vaginal fractionated laser therapy (vulvovaginal laser therapy).
      • It is an innovative, minimally invasive, non-surgical and non-hormonal procedure for the treatment of vulvovaginal dysfunctions, mostly recurrent, difficult to treat, esp. concerning sexuality and diseases in the intimate area. Predominantly women in premenopausal/menopausal or other estrogen deficiency situations suffer from it. Also mild forms of urinary incontinence (bladder weakness), urge symptoms, chronic recurrent cystitis (recurrent cystitis) and descensus complaints (lowering symptoms) can improve.
      • Particularly noteworthy are the excellent results in the therapy of lichen sclerosus, which usually make cortisone therapy unnecessary.
      • The minimal side effect rate and lack of complications with this method is impressive, as is the possibility of its use after chemotherapy or radiation therapy. However, evaluation by controlled studies is currently lacking. For details see chapter: laser therapy for lichen sclerosus“, “Vulvovaginal laser therapy“, “Laser therapy for bladder problems in women“.

Regular checkups

• Since there is a slightly increased risk of skin cancer of the affected region, regular check-ups are required!In the case of non-healing wounds or lump formation, the attending gynecologist must be consulted immediately!

Physical therapy (including physiotherapy)

• UVA1 phototherapy (UVA1 wavelength: 340-400 nm) – this specific phototherapy is able to induce apoptosis (programmed cell death) in patients’ T cells (belong to the lymphocyte cell group; inflammatory cells of the skin).