Regenerative Approach for Lichen Sclerosus: A Case Series Combining Monopolar and Fractional RF Therapy with Biologics
Dr. Shari Caplan* and Dr. Yalda Nasir
ABSTRACT
Background: Lichen sclerosus (LS) is a chronic inflammatory dermatosis affecting anogenital skin, often associated with vulvar pain, sexual dysfunction, and increased risk of malignancy. Despite its significant impact on quality of life, there is no definitive cure. This case series explores a multimodal regenerative approach with promising potential to improve symptoms and patient well-being.
Objective: To evaluate the clinical benefits of combining energy-based modalities with either exosomes or platelet-rich plasma (PRP) in the treatment of LS, aiming to achieve synergistic regenerative effects.
Methods: In this prospective, single-center case series, ten patients (n=10, 9 women, 1 man, 39-88 years) were enrolled. Each patient received an individualized treatment protocol consisting of monopolar radiofrequency (RF), fractional RF, and either exosomes or PRP. Up to three treatment sessions were administered per patient, spaced 14 days apart.
Results: Patients reported significant symptomatic improvement following treatment. Distress related to inability to orgasm dropped by 100%. Relief from itching and burning was reported by 88% of patients, 80% were able to discontinue steroid use, and 75% experienced improvement in vaginal dryness.
Conclusion: This case series demonstrates notable clinical improvements across a range of patient-reported outcomes following combination regenerative therapy for LS. Observed outcomes show reductions or complete resolution of symptoms such as vaginal dryness, atrophy, itching, burning, and interference with daily activities. Additionally, several patients reported improvements in sexual health, contributing to an overall enhancement in quality of life.
