Symptoms and skin changes
Itching, burning, soreness, fragile or white skin, small tears, pain with sex, or discomfort with urination are common. Scarring can narrow the vaginal opening or change the labia or clitoral hood.
Medical Center · Vulvar Skin & Structural Care
Vulvar Lichen Sclerosus
Control inflammation. Protect anatomy.
Restore comfort.
Lichen sclerosus is a long-term inflammatory skin condition. Good care controls inflammation, protects normal anatomy, relieves symptoms, and watches for skin changes.
Care for the whole condition
Inflammation · Skin integrity · Structural changes
Understanding lichen sclerosus
A quiet condition can still be active
Some people have few symptoms even when the skin inflammation is active. Examination and long-term follow-up help protect comfort, skin health, and normal anatomy.
A careful vulvar exam
Diagnosis is usually based on examination. A small skin biopsy may be recommended if the diagnosis is uncertain, an area looks unusual, or the skin does not respond as expected. Lichen sclerosus is not contagious.
Regular skin checks matter
Follow-up remains important even when symptoms improve. A new lump or an area that stays thickened, rough, dark, red, ulcerated, bleeding, or does not heal should be examined promptly.
The treatment foundation
Control inflammation first
A strong prescription corticosteroid ointment is the best-supported treatment. Use it exactly as directed, including any maintenance schedule.
Protect the skin barrier
Plain moisturizers or barrier ointments can reduce friction and irritation. Individual instructions depend on examination findings and skin sensitivity.
Continue medical follow-up
Procedures may be added to care, but they do not replace prescribed medication or regular vulvar examinations.
Emerging tissue treatments
Laser and RF microneedling
These treatments deliver energy differently and are used to address different tissue layers and treatment goals.
Established care and optional add-ons
Treatment options and where they fit
Fractional laser therapy
Fractional laser creates controlled treatment zones, usually in more superficial tissue layers. The goal is to improve surface tissue quality, flexibility, blood flow, and collagen remodeling. Recovery and results depend on the laser, settings, and condition of the skin.
Morpheus8V RF microneedling
Morpheus8V uses fine pins to place radiofrequency energy at selected depths. A potential advantage is that it can penetrate deeper into the layers of the skin, where healthier tissue may remain. The controlled injury starts a healing response involving blood vessels, fibroblasts, and collagen.
PRP and PDGF
Platelet-rich plasma is prepared from your own blood and contains a mixture of healing signals. PDGF is one signaling protein and may also be supplied as a manufactured product. Early research and providers are optimistic about the benefit for lichen sclerosus, although results vary and larger studies are needed.
Exosome products
Exosome products are used in dermatology and plastic surgery as add-ons intended to support skin repair, appearance, and longevity. Some providers prefer them because they may cause less inflammation than the broader mixture of platelet-derived growth factors found in PRP. Products vary in source, contents, purity, and testing.
Stem-cell approaches
Stem-cell approaches remain investigational for lichen sclerosus. They are not routine treatment. Any discussion should clearly address the source, evidence, oversight, risks, and alternatives.
Structural care
Clitoral or Labial Adhesion Surgery
Adhesions are often managed surgically. Many can be repaired in the office under local anesthesia; more severe cases may require an outpatient surgical setting. Surgery helps the structural problem but does not cure the underlying inflammation, so ongoing medical treatment and follow-up remain important.
Your safety and follow-up
Know when the skin needs attention
Call APSU
Call 980-771-0726 for increasing pain, redness, swelling, drainage, fever, trouble urinating, heavy bleeding, worsening sores, or symptoms that do not settle as expected after treatment.
Seek urgent care
Seek urgent care for severe pain, rapidly spreading swelling or redness, inability to urinate, uncontrolled bleeding, fainting, trouble breathing, or signs of a serious allergic reaction.
Do not stop prescribed lichen-sclerosus medication unless Dr. Stepp changes your plan.
Common patient questions
Lichen sclerosus FAQ
Is lichen sclerosus contagious?
No. Lichen sclerosus is a long-term inflammatory skin condition and is not contagious.
What is the foundation of lichen sclerosus treatment?
A strong prescription topical corticosteroid ointment used on the prescribed treatment and maintenance schedule is the best-supported treatment. Skin protection and regular vulvar examinations remain important even when symptoms improve.
Do laser or Morpheus8V treatments replace steroid therapy?
No. Laser and radiofrequency microneedling are optional add-on treatments. They do not replace prescribed steroid care or regular vulvar examinations.
When is surgery used for lichen sclerosus adhesions?
Clitoral or labial adhesions are often managed surgically. Many can be repaired in the office under local anesthesia, while more severe cases may require an outpatient surgical setting. Surgery helps the structural problem but does not cure the underlying inflammation.
Can lichen sclerosus be active without symptoms?
Yes. Some people have few symptoms even when skin inflammation is active, which is why regular vulvar examinations and ongoing treatment remain important.
Where can I be evaluated for lichen sclerosus in Charlotte?
Kevin Stepp, MD, FACOG, URPS evaluates and treats vulvar lichen sclerosus at Advanced Pelvic Surgery and Urogynecology of Charlotte, 11210 Golf Links Dr North, #100, Charlotte, NC 28277.
A clear plan for inflammation, skin health, and structure
Consultation includes a careful vulvar examination, review of current treatment, and discussion of medical, procedural, and surgical options appropriate for your findings.
Schedule a Consultation