Features of genital LS in women — Some women with genital LS feel dull, painful discomfort in the vulva, while other women have no symptoms. The most common symptoms include:

• Vulvar itching – The most common symptom of LS is itching. It may be so severe that it interferes with sleep.
• Anal itching, fissures, bleeding, and pain
• Painful sexual intercourse (dyspareunia) – This can occur as a result of repeated cracking of the skin (fissuring) or from narrowing of the vaginal opening due to scarring.
• Typically, women with genital LS have thin, white, wrinkled skin on the labia, often extending down and around the anus. Purple-colored areas of bruising may be seen. Cracks (also known as fissures) may form in the skin in the area around the anus, the labia, and the clitoris. Relatively minor rubbing or sex may lead to bleeding due to the fragility of the involved skin. If genital LS is not treated, it may progress and change the appearance of the genital area as the outer and inner lips of the vulva fuse (stick together) and cover the clitoris. The opening of the vagina can become narrowed, and cracks, fissures, and thickened, scarred skin in the genital and anal area can make sexual intercourse or genital examination painful. LS does not affect the inner reproductive organs, such as the vagina and uterus.
• Features of genital LS in men — In men, LS may appear on the head of the penis. Men who develop LS are usually uncircumcised (they have not had the foreskin of the penis removed), and the foreskin can become tight, shrunken, and scarred over the head of the penis. Men with LS may also have problems pulling back the foreskin and may experience decreased sensation at the tip of the penis, painful erections, or problems with urination
• Features of LS in other areas — LS may also cause lesions to occur in areas outside the genitals, especially the upper body, breasts, and upper arms. These lesions tend to be white, flat or raised, and are not as itchy as the affected skin of the genitals and anus.

Topical steroid ointments such as clobetasol have previously been the mainstay of treatment, but require daily application and have significant side effects. In many women, there is only partial symptom control.

At Renew MediSpa, we utilize platelet rich plasma (PRP) to treat LS effectively. We have been able to get patients off of steroid creams, symptom free, and even reduce scarring.

1. You must have had a biopsy confirming the diagnosis
2. If extensive scarring is present, surgical revision may be recommended prior to PRP intervention
3. Steroid cream should be discontinued
4. Premedication will be discussed, if taken you will need to have someone drive you to your appointment. We do use topical numbing agents and a small lidocaine injection as well for the procedure.
5. First session- The standard O shot will be performed, and an additional quantity of PRP will be injected into the regions of skin involved with LS.
6. A second injection (external) is scheduled for 6 weeks later. Thereafter, subsequent external treatments are on an as needed basis (range 3 times a year or less in most cases)
7. You MUST continue to be followed by your specialist (ObGyn, Dermatology), with surveillance biopsies to monitor for squamous cell skin cancer- there is a slightly higher incidence of this skin cancer in LS patients.