The Use of Laser Therapy in the Treatment of Vulvar Lichen Sclerosus: Clinical Approaches, Perspectives and Literature Review

Literature Review

Abstract

Vulvar Lichen Sclerosus (VLS) is a chronic inflammatory dermatosis characterised by atrophic lesions and intense pruritus that can significantly impair quality of life. Topical corticosteroids remain the standard treatment, yet their long-term use is limited by adverse effects and incomplete symptom control. The integration of laser technologies has therefore emerged as a promising alternative, targeting both fibrosis and underlying inflammation.

This study is based on a corpus of recent scientific literature, including randomised clinical trials, prospective studies, and systematic reviews assessing the efficacy and safety of fractional CO₂, Er:YAG lasers, and low-level laser therapy (LLLT). Clinical outcomes evaluated include pruritus intensity, dyspareunia, tissue fibrosis, and quality of life improvement. A synthesis of laser treatment protocols was conducted, comparing laser monotherapy with its combination with corticosteroids. Evaluation criteria included clinical outcomes (symptom reduction, tissue elasticity), histological findings (fibrosis regression), and socioeconomic parameters (costs, recurrence of medical visits).

Optimisation of laser parameters (fluence, number of sessions) and combination with topical agents may significantly enhance the management of VLS. Faster reduction of inflammation and fibrosis is expected, potentially lowering long-term corticosteroid dependence. These benefits could translate into improved patient comfort, fewer recurrences, and greater overall satisfaction