What are effective treatment protocols for Lichen Sclerosus (LS)?

Dealing with lichen sclerosus can be very frustrating, especially when it affects the vaginal opening caliber. First of all, some women go for years without a proper diagnosis, because it often takes the trained eye of a vulvovaginal specialist to accurately diagnose lichen sclerosus. Once confirmed, it must be efficiently managed in order to avoid itching, cracking and then burning. Bit also vaginal senosis must be addressed to relieve pain and/or tearing with penetration. So what are the most effective treatment protocols for lichen sclerosus?

Lichen Sclerosus Signs and Symptoms
Lichen sclerosus is a intrinsic skin disorder in the dermatosis group. It is chronic and once it has been diagnosed it requires life time treatment. The signs of LS include wrinkly, shiny and sticky skin of the labia minora, peri-clitoral tissues perneal body which is the bridge of tissue between the vagina and rectum. As the condition progresses the tissues stick together where they lie adjacent to each other, and become thinner and shiny. The tissues often develop a whitening that can be  symmetric or splotchy. When the tissues are subject to traction, the fused areas can pull apart causing fissures or cracks/paper-like cuts. If neglected the tissues can thicken and turn precancerous and then become squamous cell cancer.

In the early stages women experience vaginal itchiness and external dryness, along with the need to scratch the tissues.  Left untreated, the symptoms can intensify to include burning and stinging when fisures develop.

Medical researchers are not sure of the precise cause of lichen sclerosus, but the condition has a weak link to the autoimmune conditions.

Treatment
Lichen sclerosus cannot be cured, but it is possible to effectively manage the symptoms. At Fowler GYN international, this is done with the help of a customized treatment protocol. This may include the use of a Class I corticosteroid, to get the symptoms under control.  The initial treatment is then followed up by intermediate potent, class III corticosteriod use then maintainance therapy with a class VII  corticosteroid. The problem is that most practitioners just provide episodic potent corticosteriod treatment and the second problem is that rarely do they address the potential vaginal caliber narrowing caused by those who have midline fusion either above or below the vaginal opening. Without addressing this problem, intercourse will remain painful with recurrent tearing, usually at the base of the vagina.

Women that have received treatment for lichen sclerosus at Fowler GYN International report experiencing significant improvement in symptoms, within 2-3 months of starting treatment.

If you are experiencing symptoms that you think may be the result of lichen sclerosus, contact Fowler GYN International, Phoenix, AZ. Call 480-420-4001 to schedule an appointment with board certified gynecologist Dr. R. Stuart Fowler. You can also request a free pre-registration call online at www.fowlergyninternational.com/contact-us.

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