From the Guidelines
Lichen sclerosis treatment from a functional medicine perspective should prioritize a multi-faceted approach, including an anti-inflammatory diet, stress management, and targeted supplements, while supporting conventional treatments like topical corticosteroids, as recommended by the British Association of Dermatologists' guidelines 1. When considering treatment options, it's essential to address potential underlying causes of lichen sclerosis, such as autoimmune components, hormonal imbalance, and gut health.
- An anti-inflammatory diet, eliminating processed foods, refined sugars, and potential allergens like gluten and dairy, can help reduce systemic inflammation.
- Stress management techniques, such as meditation or yoga, can also help mitigate the condition.
- Targeted supplements, including vitamin D3 (2000-5000 IU daily), omega-3 fatty acids (1-3g daily), and probiotics (containing Lactobacillus and Bifidobacterium strains, 10-50 billion CFU daily), can support immune function and overall health. Topical treatments, such as applying calendula or chamomile-infused oils after conventional treatments, may also be beneficial.
- Conventional treatments, like topical corticosteroids (clobetasol propionate 0.05% ointment applied once daily for 2-4 weeks, then tapered), should be used in conjunction with functional medicine approaches, as recommended by the British Association of Dermatologists' guidelines 1. Regular follow-ups with both conventional and functional practitioners are crucial to monitor progress and adjust treatments as needed, considering the risk of malignant transformation and the importance of early histological confirmation by biopsy 1. Gentle hygiene practices, using mild, fragrance-free products and wearing loose-fitting cotton underwear, can help minimize irritation during healing. By adopting a comprehensive approach, patients with lichen sclerosis can better manage their condition, reduce symptoms, and improve their overall quality of life.
From the Research
Lichen Sclerosis from a Functional Medicine Perspective
- Lichen sclerosis is a chronic, inflammatory, mucocutaneous disorder that can affect genital and extragenital skin, causing symptoms such as itch, pain, and dysuria 2.
- The exact cause of lichen sclerosis is still unknown, but it is believed to be an autoimmune-induced disease in genetically predisposed patients, with preceding infections and trauma potentially playing a role 2.
- From a functional medicine perspective, treatment options for lichen sclerosis focus on reducing inflammation and promoting healing, with potent and ultrapotent topical corticosteroids being a common first-line treatment 3, 2, 4, 5.
- Topical calcineurin inhibitors, topical and systemic retinoids, and phototherapy may also be used as alternative or adjunctive treatments for lichen sclerosis 2.
- Some studies suggest that probiotics may have a beneficial effect on the treatment of lichen sclerosis, particularly when used in conjunction with topical corticosteroids 6.
- Treatment of lichen sclerosis often requires long-term follow-up and maintenance therapy to prevent recurrence and promote healing, with follow-up recommended every 3-6 months for the first two years and then at least yearly 5.
Treatment Options
- High-potency topical steroids, such as clobetasol propionate, are considered the standard of care and first-line treatment for lichen sclerosis 3, 4, 5.
- Topical calcineurin inhibitors, such as pimecrolimus and tacrolimus, may be used as alternative or adjunctive treatments for lichen sclerosis 2.
- Probiotics may be used as a supplementary treatment to reduce inflammation and promote healing, particularly when used in conjunction with topical corticosteroids 6.
- Phototherapy and systemic retinoids may also be used as treatment options for lichen sclerosis, particularly in cases that are refractory to topical treatments 2.
Lifestyle and Dietary Considerations
- While there is limited research on the specific dietary and lifestyle considerations for lichen sclerosis, a healthy diet and lifestyle may help to reduce inflammation and promote healing 2.
- Avoiding irritants and allergens, managing stress, and getting regular exercise may also be beneficial for reducing symptoms and promoting healing 2.