Newly diagnosed and confused over treatment for lichen sclerosus

Posted by ronag @ronag, Jan 24, 2023

I've been diagnosed with lichen sclerosus. I have questions as to what is the best treatment: which steroid and at what dosage. My gynecologist initially prescribed mometasone cream 0.1% twice a week. This didn't really control the itching. My dermatologist is recommending clobetasol ointment 0.05% once a day for 2 months, followed by twice weekly forever. Itching, while not completely gone, is certainly more controlled after a week's treatment with the clobetasol. However, I'm a bit concerned over using it daily for 2 months. Can you please share what's worked for you? Can I expect to be using a steroid for life? To throw into the mix--I have long covid. Thank you for any help in navigating this.

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I’ve had LS for over 20 years. The newer thinking is that steroid creams only dry the area out more, thin the tissue, and cause further cracks and pain. My Urogynocologist has now recommended Ozonated Coconut Oil and I haven’t had a lesion since February, using it twice daily, gently massaging it into the entire area that’s normally affected. (I just buy it on Amazon. It smells of Ozone, but it’s so helpful, who cares?)
I wish I had had this in the initial phase.
Stay on this forum! It can be so helpful to know others who are dealing with your same issues!

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Profile picture for upartist @upartist

Hi Minnie23. You are doing many things to treat the lichen sclerosus. It can be so very uncomfortable. While Lichen sclerosus was ruled out with me, i did have the biopsy. Negative. However, I do deal with chronic mucositis in that area. I use Strata Mgt ointment (per my Mayo OBGYN). It is a wet wound barrier, and is applied under any prescription meds and moisturizers. It has been a game changer for my pain, inflammation, and skin breakdown. I have to order it, as it is not available on the shelf. This might help. Good luck!

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Would you mind sharing how the biopsy was? I was diagnosed without a biopsy and I am thinking I should really have one.

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Profile picture for 2thfairy @2thfairy

I’ve had LS for over 20 years. The newer thinking is that steroid creams only dry the area out more, thin the tissue, and cause further cracks and pain. My Urogynocologist has now recommended Ozonated Coconut Oil and I haven’t had a lesion since February, using it twice daily, gently massaging it into the entire area that’s normally affected. (I just buy it on Amazon. It smells of Ozone, but it’s so helpful, who cares?)
I wish I had had this in the initial phase.
Stay on this forum! It can be so helpful to know others who are dealing with your same issues!

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That's very helpful thank you for sharing. I have had LS for 12 years and have tried everything and was just about to go back to steroid cream which I didn't want to do, and I then see your message, so shall try this and hopefully can have an effect.

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Profile picture for hungryhat64 @hungryhat64

That's very helpful thank you for sharing. I have had LS for 12 years and have tried everything and was just about to go back to steroid cream which I didn't want to do, and I then see your message, so shall try this and hopefully can have an effect.

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I have also had treatments at Coyle Institute in Pensacola, FL that helped tremendously. I live in AZ, so have to travel there, but Dr Coyle’s Tulip Procedure halts MY LS, removed scarring from over my clitoris, reopened fused areas that had nearly closed over my urethra. He talks to my husband about the importance of maintaining our intimacy via other methods.
The LS always has returned, but Tulip Procedure gives me great relief for a year in between treatments. I’m now using Ozonated Coconut Oil since my last procedure, and am lesion free for the past 4 months.
(I tried doctors in Tucson, Phoenix, Scottsdale, LA, and San Diego.)

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Profile picture for dorothy314 @dorothy314

Would you mind sharing how the biopsy was? I was diagnosed without a biopsy and I am thinking I should really have one.

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Hi Dorothy314. Since vulvar lichen sclerosus is considered a pre-cancerous condition (for vulvar cancer) they do the biopsy. Plus sometimes other things resemble vulvar cancer, like chronic mucositis in that area. The procedure itself was done carefully, and with minimal pain. They have you use a lidocaine spray to control pain after. Then the use of the strata MGT ointment facilitates healing of the tissue. The whole thing was quite tolerable. Fear was my biggest nemesis. Good luck!
Upartist

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Profile picture for upartist @upartist

Hi Dorothy314. Since vulvar lichen sclerosus is considered a pre-cancerous condition (for vulvar cancer) they do the biopsy. Plus sometimes other things resemble vulvar cancer, like chronic mucositis in that area. The procedure itself was done carefully, and with minimal pain. They have you use a lidocaine spray to control pain after. Then the use of the strata MGT ointment facilitates healing of the tissue. The whole thing was quite tolerable. Fear was my biggest nemesis. Good luck!
Upartist

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Thank you for your explanation. I thought it must be an ordeal because the Dr. said she thought I presented with LS and would "spare" me the biopsy.

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Profile picture for 2thfairy @2thfairy

I have also had treatments at Coyle Institute in Pensacola, FL that helped tremendously. I live in AZ, so have to travel there, but Dr Coyle’s Tulip Procedure halts MY LS, removed scarring from over my clitoris, reopened fused areas that had nearly closed over my urethra. He talks to my husband about the importance of maintaining our intimacy via other methods.
The LS always has returned, but Tulip Procedure gives me great relief for a year in between treatments. I’m now using Ozonated Coconut Oil since my last procedure, and am lesion free for the past 4 months.
(I tried doctors in Tucson, Phoenix, Scottsdale, LA, and San Diego.)

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You are very brave indeed, sending you lots of hugs. Unfortunately I am unable to order the cream you recommended as they don't deliver to Ireland which is where I am based, however I have tried organic coconut cream before and it didn't work. I struggle with the dryness and itching in my groin area. Thankfully everything else in that region is fine, but the itching is intolerable at times and I find most creams, organic or holistic or herbal all work for a while and the immune symptom which is very clever, finds a way around the creams, that's why the steroid cream works as it tricks the immune symptom. I hope some day an holistic solution is found.

REPLY
Profile picture for 2thfairy @2thfairy

I have also had treatments at Coyle Institute in Pensacola, FL that helped tremendously. I live in AZ, so have to travel there, but Dr Coyle’s Tulip Procedure halts MY LS, removed scarring from over my clitoris, reopened fused areas that had nearly closed over my urethra. He talks to my husband about the importance of maintaining our intimacy via other methods.
The LS always has returned, but Tulip Procedure gives me great relief for a year in between treatments. I’m now using Ozonated Coconut Oil since my last procedure, and am lesion free for the past 4 months.
(I tried doctors in Tucson, Phoenix, Scottsdale, LA, and San Diego.)

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I also was diagnosed years ago and tired of using steroid creams. My gynecologist recommended coconut oil and wipes and it definitely helped. I' be used a coconut cream and wipes for 10 years and have had no flare ups or discomfort. Easy solution and worth a try.

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Profile picture for fehrlady @fehrlady

I also was diagnosed years ago and tired of using steroid creams. My gynecologist recommended coconut oil and wipes and it definitely helped. I' be used a coconut cream and wipes for 10 years and have had no flare ups or discomfort. Easy solution and worth a try.

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That’s an incredible tissue response, and gives me greater hope that Coconut Oil will be my best solution long term, as well! Thank you for posting!

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Profile picture for fehrlady @fehrlady

I also was diagnosed years ago and tired of using steroid creams. My gynecologist recommended coconut oil and wipes and it definitely helped. I' be used a coconut cream and wipes for 10 years and have had no flare ups or discomfort. Easy solution and worth a try.

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Thank you for sharing your experience with coconut oil, wipes, and cream. Can you share what brand of these products you use, I would be grateful. Thanks

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