If you read our previous blog post, you should already be a bit more familiar with lichen sclerosus. In case you need a refresher: lichen sclerosus is a chronic inflammatory skin disease that affects the vulva, and it becomes more common as women age.

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All right, I get it— you must be thinking. Lichen sclerosus is a serious thing. But how do you actually treat it?

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Don’t worry, there are effective treatments for it — so let’s break it down:

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Topical Treatments and Supportive Care

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Because it’s an inflammatory condition, lichen sclerosus is often categorized alongside autoimmune diseases. We frequently see it in patients who also have conditions like rheumatoid arthritis, lupus, eczema, or vitiligo. It’s also more common in women with lower estrogen levels, as estrogen itself plays an anti-inflammatory role.

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Lichen sclerosis is generally treated with high-dose topical steroids. Many patients worry about steroids, but I explain that while we taper the dose over time, they are often necessary at the beginning if symptoms are severe or if there are changes to the normal skin appearance.

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Treatment usually begins with topical steroid ointments applied nightly to the affected area, then gradually tapered based on severity and symptoms. I typically recommend ointments over creams because they adhere better to the skin.

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To support healing and moisture, I often add estradiol vaginal cream as well as an emollient such as Aquaphor or coconut oil—depending on each patient’s lifestyle and comfort.

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Tailoring Therapy for Long-Term Relief

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Once the skin regains moisture and elasticity, treatment can be tailored further. Daily therapy can feel time-consuming or messy, but many patients who have suffered for years don’t mind as long as they finally find relief.

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Finally, maintenance therapy is essential. Lichen sclerosus is a lifelong condition with periods of flares and dormancy. Ongoing care helps manage symptoms, prevent scarring, and maintain vaginal health.

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Here at Gliss, we specialize in the diagnosis, treatment, and long-term management of lichen sclerosus as part of our vaginal care unit, so you don’t have to navigate it alone. No matter where you are in the U.S., don’t hesitate to reach out to us to find out the best treatment options for you.

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Book a 15-min FREE virtual consultation with us to see if we’re the right fit for your menopause care.

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And don’t forget to visit our Services page to explore our perimenopause and menopause care packages!

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References:

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De Luca, D.A. et al. (2023). “Lichen sclerosus: The 2023 update”.

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Gulin, S.J., Lundin, F. and Seifert, O. (2023). “Comorbidity in patients with Lichen sclerosus: a retrospective cohort study”.

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