Carbon dioxide laser as a new valid treatment of lichen sclerosus

Purpose of Investigation: To investigate the role of CO2 laser in the patients affected by lichen sclerosus (LS), analyzing histological changes and relief of feminine discomfort. Materials and Methods: The authors report a case series of ten patients with histologically verified LS, undergoing fractional CO2 laser, from January-2017 to December 2017. The mean age of the participants was 55 (range 4068) years, and five had been previously treated with the topical corticosteroid clobetasol propionate 0.05% ointment with limited efficacy. The overall sessions varied depending on the lichen extension, from one to three treatments. Results: All the patients tolerated the procedure well with re-epithelialization occurring within 3-4 weeks in all cases. Carbon dioxide laser was successful in achieving remarkable symptoms reduction or remission. There was an improvement in the appearance of the introitus, and in elastic opening and closing. Post-treatment histology revealed trophic epithelium with mild acanthosis and small areas with superficial hyperkeratosis. These results were maintained throughout the three-month post-treatment follow-up period. Conclusion: Laser treatment is relatively simple and effective. The histological changes observed in these patients suggest a more comprehensive healing effect of the fractional CO2 laser, not only symptomatic approach. The authors await the next follow-up to establish the duration of the effects. Content: CO2 laser is a valid treatment option for LS, improving discomfort through histological changes of tissue.