Both gynecologists and dermatologists can treat lichen sclerosis. Originally, it was my gynecologist who diagnosed my lichen sclerosis. By not using the steroid, clobetasol, because it caused stinging, it got much much worse. My gynecologist who is practicing less now, (I am 65 and this was diagnosed in my early 30's), referred me on to a new gynecologist who sees many women with lichen sclerosis. There are a few other steroid ointments you can try and sometimes compounded as a cream as opposed to a gel consistency works better in terms of the burning. I know use my clobetasol religiously and there has been some improvement and it no longer stings as much. It is definitely an autoimmune condition and doing nothing is not an option: it will get worse. In addition to the clobetasol, you should use coconut oil or olive oil or crisco shortening on the area for dryness. There is a risk of cancer of the vulva, not sure what it is but I'm sure that statistic is easy to find and/or the gynecologist would know. Oh, it's not really all that rare. I also have a other autoimmune conditions.