Recommended Diet for Lichen Sclerosus
There is no specific therapeutic diet proven to treat or cure lichen sclerosus, but dietary supplementation with antioxidants may serve as a rational adjunctive therapy alongside standard topical corticosteroid treatment, based on the role of oxidative stress in disease progression and malignant transformation. 1
Evidence-Based Dietary Considerations
Antioxidant Supplementation
- Oxidative stress plays a documented role in both the pathogenesis and progression of lichen sclerosus, including its potential malignant transformation through DNA damage and lipid peroxidation. 1
- A dietary supplement containing avocado and soybean extracts, vitamin E, and para-aminobenzoic acid demonstrated effectiveness in treating mild-to-moderate vulvar lichen sclerosus when used for 12 weeks alongside topical therapy, with 100% of patients achieving at least 50% improvement in symptoms. 2
- The anti-inflammatory, anti-fibrotic, and antioxidant properties of these supplements appear to counteract oxidative DNA damage, which is the most important factor for disease progression. 2, 1
Weight Management
- Obesity in both children and adults, particularly in male patients, is a factor that may accelerate scarring in lichen sclerosus, making weight management an important consideration. 3
- Weight reduction should be addressed as part of comprehensive treatment, especially for patients with genital involvement. 3
What Diet Cannot Do
No Hormonal Dietary Interventions
- Despite the higher incidence of female lichen sclerosus in low estrogen states (prepubertal girls and postmenopausal women), there is no association between the disease and pregnancy, contraceptive use, or hormone replacement therapy, suggesting dietary phytoestrogens are unlikely to be beneficial. 4
Primary Treatment Remains Topical
- Dietary modifications and supplements should only be considered as adjunctive therapy to the gold standard treatment of clobetasol propionate 0.05% ointment, not as a replacement. 3, 5
- Potent or ultra-potent topical corticosteroids remain the only proven first-line treatment for symptom relief, prevention of anatomical changes, and theoretical prevention of malignant transformation. 6, 7
Practical Dietary Recommendations
Consider These Supplements
- Avocado and soybean extracts combined with vitamin E and para-aminobenzoic acid for the first 12 weeks of treatment, particularly for mild-to-moderate disease. 2
- General antioxidant-rich foods may theoretically help counteract oxidative stress, though specific dietary patterns have not been studied. 1
Avoid Dietary Irritants
- While not specifically dietary, patients must eliminate all fragranced products including scented foods or beverages that might come into contact with affected genital areas. 3