Use of Er:YAG Laser in the Treatment of Vulvar Lichen Sclerosus
Matilde Gómez Frieiro, Elena Laynez Herrero International Journal of Women's Dermatology (2019). doi: 10.1016/j.ijwd.2019.05.007
The aim of this research was to evaluate the efficacy and safety of Er:YAG laser for the improvement of signs and symptoms of vulvar lichen sclerosus.
The study population was 28 women with symptomatic vulvar lichen sclerosus. Three non-ablative thermal-only Er:YAG laser treatment sessions (7 J/cm2, 2 Hz, 7 mm spot) were performed at 4 weeks intervals. Each patient was asked about the presence of symptoms such as itching, pain and coital pain. Clinical diagnosis was established based on presence of lesions such as hypopigmentation, ecchymosis, hyperkeratosis, excoriations or fissures. Affected areas were divided by zones (clitoris, introitus, labia minora, labia majora, perineum, labial fusion, and effacement) and were visually evaluated. Based on the presence of symptoms, lesions and affected zones, a scale with a maximum of 14 scores was established for use before and after treatment. The impact of lichen sclerosus on patients' life before and after treatment was evaluated with 11-point VAS, and at each session treatment discomfort was assessed.
After analysis of each component of the scoring, individual statistically significant reductions were observed in itching, pain, ecchymosis, excoriations and hypopigmentation.
The Er:YAG laser is a safe, well tolerated and effective method for the adjuvant treatment of vulvar lichen sclerosus. Three sessions with monthly intervals using the indicated parameters are able to obtain a quantified reduction of the impact of lichen sclerosus on patients' life.
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