Lichen sclerosis is a chronic inflammatory dermatosis that can cause severe discomfort (intense and treatment-resistant itching, tenderness, constipation and painful sexual intercourse) and high morbidity (narrowing of the vaginal entrance, persistent burning sensation in the clitoris and atrophy of the inner lips).
It may involve the entire vulva and may extend to the anus. The diagnosis is often made by clinical observation; however, sometimes when the initial diagnosis cannot be confirmed or if malignancy is suspected a biopsy is required. Symptoms include itching, which is especially evident at night, and skin recessions and adhesions that make sexual intercourse difficult. The skin covering the clitoris may be pulled due to chronic inflammation, covering the clitoris completely. The disease rarely affects vagina.
The etiology of lichen sclerosus is unknown. Sometimes it can start after a trauma or irritation to the skin. The first symptoms and the main complaint are often itching. This itching can sometimes be so
severe that it can cause tears in the skin, sometimes bleeding may occur in the vulva after itching unconsciously at night. The majority of patients are initially treated with potent steroid creams. However, many patients experience progression of symptoms and scarring despite steroid therapy.
Laser therapy is a very promising application in lichen symptoms and most of the patients may need less steroids after laser treatment. Laser treatment can be applied to all lichen patients with dryness, itching and discomfort.
The group of patients who cannot be applied laser is very small; limited to patients with active bacterial or fungal infections, pre-cancerous dysplastic lesions or suspected cancer.
The treatment of lichen sclerosis with Fotona Smooth Laser takes between 10-15 minutes. It is usually painless, but there may be a slight warming or burning sensation; before the procedure, a local anesthetic cream is applied and waited for a while. It is generally well tolerated and the
discomfort does not exceed 24 hours. No ongoing or persistent post-treatment pain has been reported.
Before the procedure, you must have a PAP smear test performed within the last year with a normal result. Apart from this, no special pre-operative preparation or post-operative precautions are required and there is no need to use antibiotics after the procedure. There is no visible damage to the tissue, blood loss or surgical intervention. In the laser treatment of lichen sclerosis, since tissue healing will take longer than atrophy and similar applications, the application intervals may be longer than one month, it can be applied every one and a half months, a total of two or three sessions are recommended.
Without a recovery period, patients can continue their daily lives immediately after the application. Sexual intercourse or bathing with hot water is not recommended for 72 hours after treatment. It is also not recommended to use steroids for one or two weeks after the application.