Lichen Sclerosus
Lichen Sclerosus is a chronic, inflammatory disorder of the skin that most commonly affects post-menopausal women. It can affect any area of the body but is mostly seen on the female anogenital epithelium. Lichen sclerosus can be classified as an autoimmune disease and can present with other autoimmune diseases. It can also be genetic and is seen among family members. Sometimes lichen sclerosus can go unrecognized or misdiagnosed for several years, but over time it can lead to scarring, sexual dysfunction, and malignancy. Lichen sclerosus is not contagious and cannot be spread during sexual intercourse.
Lichen sclerosus can present as the following:
- Itchiness
- Vulvar pain or burning
- Pain during intercourse
- Discoloration including white plaques and papules
- Thin and fragile skin that can tear and bleed easily
The standard treatment for lichen sclerosus has included a 3-month application of potent topical corticosteroids, which have been shown to prevent malignant transformation but can produce side effects and ultimately lead to damage of the anogenital epithelium. In addition, due to inconsistent prescribing, topical steroids do not often adequately treat lichen sclerosus. Recently, practitioners and researchers have started evaluating the effectiveness of using a fractional laser called the Pixel CO2 to treat lichen sclerosus. Recent studies have shown CO2 laser therapy results in symptom resolution, return to normal skin texture and color, and reduced risk of vulvar cancer. In addition, when compared to the standard corticosteroid treatment, the CO2 laser resulted in greater improvement in symptoms and better patient satisfaction.
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