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What is Lichen Sclerosus?

Lichen Sclerosus is a chronic skin condition that can affect any part of the body, but most commonly affects the vulva and skin around the anus in women.  Lichen Sclerosus can affect females from pre-pubescent to post-menopausal, and anyone in between.

How do I know if I have Lichen Sclerosus?

It is very common not to know if you have Lichen Sclerosus (it can be a hard area to examine on your own).  If you have chronic itching, pain with intercourse and have repeatedly been told that you have a yeast infection, yet you do not respond to typical yeast treatment, there is a good chance you have Lichen Sclerosus.

You might notice a change in the appearance in the skin of your vulva or may start to experience some of the symptoms described below.  Usually the skin appears “spotted or patchy white,” the skin can appear shiny.  Over time the skin becomes thin with a “crinkled” appearance.  You may also notice scarring around the lips of the vagina or over the clitoris.  If you are noticing any of these changes or new symptoms, it is very important to see your gynecologist for an exam.

If you have these symptoms, you may have seen several physicians without being diagnosed.  Unfortunately, many gynecologists do not know about Lichen Sclerosus or how to diagnose the condition.  The average time from onset of symptoms to diagnosis is 2.5 years!

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Before and After of Lichen Sclerosus affecting the hands
after treatment with PRP (platelet rich plasma)
Photo Credit: Dr. Mark Lowney

Before and After of Lichen Sclerosus of the vulva after treatment with the O-Shot® PRP (platelet rich plasma) eight weeks after treatment by Dr. Amy Brenner

What are the symptoms of Lichen Sclerosus?

Symptoms can range from mild discomfort with sexual intercourse to severe itching, tearing and blistering of the skin, causing significant pain and decreased sensation.  Over time, the lips of the vagina can become scarred and fused together.

What causes Lichen Sclerosus?

The cause of lichen sclerosus is unknown, however, it has been proposed to be an auto-immune condition (your own immune system attacking itself).

Before and After of Lichen Sclerosus of the vulva
after treatment with the
O-Shot® PRP (platelet rich plasma)
Photo Credit: Dr. Andrew Goldstein

Am I contagious?

No, lichen sclerosus is not contagious and cannot be passed to others through skin contact or sexual intercourse.

How do I treat Lichen Sclerosus?

First, it is very important that you see your gynecologist if you are having new vulvar symptoms or suspect you may have lichen sclerosus.  The diagnosis is often suspected by the appearance of the skin, however, a skin biopsy is necessary to confirm the diagnosis.  Women with lichen sclerosus are more likely to develop vulvar cancer, thus it is very important that your physician monitors the area and performs a biopsy on any changing/suspicious lesions.  Furthermore, if you do not treat lichen sclerosus, the condition can continue to worsen, causing permanent scarring of the vulva and introits (entry to the vagina), which can make sexual intercourse extremely painful, if not impossible.  Even if you are not currently experiencing symptoms of Lichen Sclerosus, but have been diagnosed in the past, you want to seek treatment to prevent long term complications. 

Dr. Thieman addresses Lichen Sclerosus at approximately 1:46 in the video

What are the treatment options for Lichen Sclerosus?

Until recently, the only effective treatment for Lichen Sclerosus has been very strong topical steroids.  These medications must be used on a daily basis until the tissue improves, then decreased to several times a week for maintenance.  Chronic steroid use can cause skin thinning and tearing, allergic reactions, and cause chronic yeast infections.  Thankfully, a better treatment option is now available called PRP, or platelet rich plasma.

For women with scarring of the labia or clitoris, our physicians are able to release the scar tissue to restore normal anatomy.  This procedure can be performed in the comfort of our AAASF accredited procedure room under IV sedation.

What is PRP?

During a procedure called the O-Shot®, a small amount of blood is drawn from your arm.  Using a centrifuge, the platelets are isolated from the rest of the blood products to create platelet rich plasma, or PRP.  The platelets are then “activated” to release at least eight growth factors that would normally be used to heal injured tissue.  These growth factors work like magic to increase collagen, improve blood flow, and heal soft tissue.  This technology has been used for over 10 years in wound healing and orthopedic surgery, and now is being utilized in healing the tissue impacted by Lichen Sclerosus.

Before and After of Lichen Sclerosus of the vulva after treatment with the O-Shot® PRP (platelet rich plasma) by Dr. Amy Brenner

Not all PRP is created equal!

Our office utilizes the PRP produced using the Harvest® SmartPrep® Multicellular Processing System, which delivers the highest concentration and yield of platelets when compared to 12 other systems, as shown by the data (click here to find more information on Harvest technology https://www.harvesttech.com/clinician/clinician-home/harvest-platelet-concentrate-system).  Data suggests the more concentrated the plasma, the better the outcome.

Why choose us to treat your Lichen Sclerosus?

Amy Brenner, MD & Associates is truly a “one stop women’s shop.”  We specialize in gynecology and gynecologic surgery, bio-identical hormone replacement therapy, and approaching women’s care from a holistic, functional, and natural approach.  Not only are we able to care for Lichen Sclerosus, but we can manage any female concerns you may have.

Before and After of Lichen Sclerosus of the vulva after treatment with the O-Shot® PRP (platelet rich plasma) eight weeks after treatment by Dr. Amy Brenner

The following websites can be very helpful for patients diagnosed with Lichen Sclerosus:

www.ilsvh.org

www.lichensclerosustreatment.com

oshot.info
click on RESEARCH to read an article published by Dr. Andrew Goldstein, who held faculty positions at Johns Hopkins and George Washington University, demonstrating the statistically significant benefits of PRP in decreasing inflammation and healing tissue impacted by Lichen Sclerosus.

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