Here’s tips on how to treat lichen sclerosus

Only treat lichen sclerosus if there’s been a proven biopsy of what you’re treating. Watch some of our videos and talk with some of our providers who have treated it. This is not for everyone–but it can be very life-changing, so do learn to treat it if you are interested.

Courtesy of Red Alinsod. Lichen sclerosus treated with PRP alone.Courtesy of Red Alinsod. Lichen sclerosus treated with PRP alone.
Courtesy of Red Alinsod. Lichen sclerosus treated with PRP alone.
  1. Before treating lichen, you should already be comfortable with the basic O-Shot® procedure.
  2. If you are going to treat lichen, please be committed to understanding all of the ideas on this list and looking at every minute of every video.
  3. Go here and watch this webinar on lichen in general (done before we started our first research protocol). (click)<–
  4. Go by the following protocol…
      1. Don’t treat lichen unless the patient supplies a biopsy proving the diagnosis.
      2. If you’re not a gynecologist, dermatologist, or strong surgical background so you’re able to do skin biopsies of the area, refer the patient for a biopsy before treating.
      3. After biopsy proven lichen & no sign of squamous cell carcinoma (a 10% lifetime incidence in these women), then you can treat.
      4. If the person has extensive scaring of the clitoral hood–i.e. if you cannot retract the hood to see the clitoris–then you should refer the woman to one of the providers in our group who do this surgery. As of now–that’s Michael Goodman, Red Alinsod, Kathleen Posey, Amy Brenner, Elizabeth Owings, & Melvin Ashford. If you also do this surgery, please let me know and I will list your name here.
      5. Stop steroids the day of treatment.
      6. Use something for pain more than just topical cream. Let the person take a Lortab + Xanax or whatever your combination is.  Of course this means the person will need a driver. Still use the topical cream but recommend that you use something more than that when you treat lichen.  With the regular O-Shot® procedure, you usually do not need anything more than the way the procedure is described (topical plus injectable lidocaine–but if the person has to get nitrous gas at the dentist, you may still need oral agents with the regular O-Shot®.
      7. Inject at least 5 ml of PRP everywhere that you see lichen. Intra & subdermally. She stays off of steroid creams for now. I would still do the regular O-Shot® (clitoris and anterior vaginal wall) in addition to treating the lichen–so you’ll need a total of 10 ml.  5 to treat the lichen and 5 for the regular O-Shot® procedure.
      8. Bring the woman back at 6 weeks after injection. She will be better but may still have areas that are active (usually does).  Retreat everywhere you see active disease.
      9. If she has dyspareunia (likely) have her use a vibrator about the size of her lover (if it’s a man) so she can safely expand the area (without worrying about her husband hurting her). If she has much pain, start her off with a very small vibrator and have her work up.
      10. Amazon is a great safe place to buy vibrators/dilators. Here’s a dilator set but I prefer gradually increasing vibrators (click)<–  After the woman can tolerate dilators the size of her husband, then allow penis-in-vagina sex.
      11. Follow up again at 6 weeks after the second shot.  After this, most women will be symptom free for a year or more.
      12. If the woman is followed by a dermatologist or gynecologist, make a phone call to her other doctor–as a true consultant would–so that serial biopsies can continue as needed. Refer that doctor to our research page.
      13. If symptoms recur, she could have another O-Shot® treatment or she could go back on steroids as thought needed.
      14. We are hoping that the decrease in inflammation seen on biopsy on this study means that the O-Shot® decreases the chances of squamous cell carcinoma but we do not know if it decreases cancer risk–we only have a biopsy study showing that we decreased inflammation (research here)<–
      15. Leave comments and questions below on this page for comment and help from other providers…

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