In January 2017 in the Journal of the American Academy of Dermatology1 a paper was published where 15 women with proven Vulva Lichen Sclerosus (VLS) received two treatments of PRP separated by six weeks, each of 5mls.  A repeat biopsy was performed six weeks after the second treatment and the patients were not allowed to use their normal steroid cream during the trial.  Of the 12 women who completed the trial, seven had decreased inflammation on a follow up biopsy plus a decrease in the hyperkeratosis (thickening of the skin).

There has been a previous study using PRP published in Plastic Reconstructive Surgery 2010.  In this study all patients reported total disappearance of pain and symptoms.

There was also a recent paper in Lasers in Surgery and Medicine2 which was a review of treatments around the vulva and vagina.  They summarized five papers, two of them published in 2016, in the Australasian Dermatology and in The Journal of Gynecological Surgery, demonstrating significant improvements in Lichen Sclerosus with fractionated CO2, such as we can do with the Mona Lisa Touch laser.  They had high rates of cessation of itching and pain, improvement of colour and elasticity and being able to cease or reduce steroids.

As yet, nobody has published a paper combining PRP and Fractionated CO2 laser.  Hopefully that will be forthcoming.  There is one gynaecologist in Adelaide who is doing this already and reports good improvements.  So, hopefully this is an alternative to potent steroids for women with VLS.

1.    Journal of the American Academy of Dermatology Intradermal injection of autologous platelet-rich plasma for the treatment of vulvar lichen sclerosus. Andrew T. Goldstein, MD, Michelle King, MSc, Charles Runels, MD, Meghan Gloth, MD, Richard Pfau, MD
2.    Lasers in Surgery and Medicine 2017 Light and Energy Based Therapeutics for Genitourinary Syndrome of Menopause: Consensus and Controversies
3.    JOURNAL OF GYNECOLOGIC SURGERY Volume 32, Number 6,2016 Fractional CO2 Laser Treatment for Vaginal Atrophy and Vulvar Lichen Sclerosus.  Michael S. Baggish, MD

April 10, 2017

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