Lichen Sclerosus Medication

Updated: May 17, 2018
  • Author: Lisa K Pappas-Taffer, MD; Chief Editor: William D James, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy in lichen sclerosus (LS) are to reduce morbidity and to prevent complications.

 

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Corticosteroids

Class Summary

Reducing inflammation helps reduce symptoms and, in some cases, helps resolve the lesion.

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Retinoid-like Agents

Class Summary

Mechanism of action for successful effects systemic retinoids have had in lichen sclerosus (usually studied in female genital cases) is not clear but may have to do with down-regulation of fibroblast function.

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Topical Skin Products

Class Summary

Many have concerns about the use of potent topical corticosteroids in occluded areas such as the genitals. They often do not work as well or as fast as the corticosteroids when used as monotherapy, but this class of medications may have a role either as maintenance medications after steroid-driven improvement or in conjunction with them in a pulse-steroid regimen (ie, superpotent corticosteroid on weekend days and a topical immunomodulator during the week). Some believe this may delay or obviate the onset of tachyphylaxis and reduce the risk of steroid atrophy. This is an off-label use for both medications. Some have raised concerns about the use of these medications long term, especially in young children and infants. The exact risks of long-term use, if any, remain to be defined, but the prescriber should be aware of the issues. 

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