What’s The Best Lichen Sclerosus Treatment?

Until you live with the challenges of Lichen Sclerosus, you can’t understand the frustration and disappointment that having an ‘incurable’ condition can give you.

Many of our patients have spent years trying to manage their symptoms, trying cream after cream in search of the best Lichen Sclerosus treatment.

Some alleviate the painful, itchy and easily broken skin, but more often than not, the condition returns, leaving patients asking if there is a Lichen Sclerosus genital treatment that actually works.

In this blog, we look at the types of treatments used for healing Lichen Sclerosus so you can decide which might be best for you.

Goals for Lichen Sclerosus Treatment

The goals for most patients when searching for a Lichen Sclerosus treatment are to:

Effectively Manage Symptoms

Common symptoms include itching, pain, inflammation, and extreme discomfort day to day. This makes the main goal of the treatment being to reduce these symptoms.

Slow Down The Progression

This is a condition in which symptoms can increase and progress to such a level that it can become unbearable for sufferers. Most patients are looking for something that prevents further skin thinning, scarring, and complications.

Improve Quality of Life

Because the symptoms can become so extreme, patients are looking for an effective treatment to reduce symptoms and improve sufferers’ quality of life. Any treatment that can address sexual dysfunction and emotional distress is very welcome to those suffering from LS.

To date, there is sadly no Lichen Sclerosus treatment that will ‘cure’ the condition indefinitely, but effective management can significantly improve life with the condition.

Conventional Medical Treatments

The most common Lichen Sclerosus treatment prescribed by doctors is topical creams (similar to those used when treating conditions like thrush), such as:

Topical Corticosteroids

These creams work to reduce inflammation and itching. The most common ones are clobetasol. While these can provide some relief, for long-term use, they prove to be ineffective as your body builds up a tolerance to them, and they stop being as effective, even though they are very strong steroids. 

For some people, there are unwelcome side effects, such as skin irritation that results in even more itching and skin inflammation.

Calcineurin Inhibitors

These are great for those who either can not use corticosteroids or don’t like the idea of using strong steroids. Inhibitors work by blocking a protein called calcineurin that contributes to inflammation. Whilst they will not cure Lichen Sclerosus, they could provide some much-needed respite from an unwelcome flare-up.

Home Remedies and Lifestyle Changes

For many, lifestyle changes can make a big difference in the severity and frequency of their flare-ups. While they might not be a Lichen Sclerosus cure, they can offer valuable help for Lichen Sclerosus.

Some of the most effective natural ways of managing symptoms include:

• Switching to sensitive hygiene products: Use mild, fragrance-free soaps and avoid irritants like bubble baths or harsh detergents. This can help reduce itching and inflammation in the genital area.
• Using emollients and moisturisers: Apply soothing creams or ointments to help protect and hydrate the skin, providing relief from dryness and discomfort.
• Applying cold compresses: A cold compress can temporarily reduce itching and inflammation during a flare-up.
• Dietary changes: An anti-inflammatory diet rich in fruits, vegetables, and whole grains can help reduce inflammation throughout the body, potentially lessening the severity of LS symptoms.

The O-Shot: A Long-Term Solution

The O-Shot (or Orgasm Shot) is a revolutionary, non-surgical treatment for Lichen Sclerosus genital treatment. It has quickly become a popular option because it harnesses the natural healing power of your own body for long-term relief.

PRP is a platelet-rich plasma treatment that is proven to help heal damaged tissue, reducing the need for unnatural treatments such as topical steroid creams, especially where you may have built up resistance.

PRP contains cell-regenerating growth factors that are essential for treatment. It uses the body’s growth factors to stimulate healing and is a natural treatment.

Many benefits of this treatment are specific to Lichen Sclerosus, such as reduced inflammation, tissue repair, improved blood flow, and decreased pain. But there are many other surprising benefits, such as:

• Increased natural lubrication for women
• Improved appearance of the labia
• Alleviation from stress incontinence 
• Enhanced arousal
• Stronger and more frequent orgasms

Although the results won’t last forever, the treatment can be easily repeated when needed. Our patients find that results last for around 12-18 months.

Compared to other treatments for LS, the O-Shot is one of the longest-lasting treatments available, and because of this, it is often regarded as the best treatment for Lichen Sclerosus.

What To Expect From Your O-Shot Treatment

When you have the O-Shot, your doctor will take a small sample of your blood, which is spun at a high frequency in a centrifuge to isolate the plasma in your blood. The platelets within the plasma contain all-important growth factors. 

Once your doctor has the platelet-rich plasma, they can inject it into the treatment area. This works by stimulating the body’s stem cells to produce new tissue, such as collagen and adipose (fatty) tissue, nerve endings and blood vessels. 

Treatment areas, such as vaginal tissue, become rejuvenated and thicker, and the sensitivity can be heightened by increased blood flow to the erogenous zones.

It is a non-invasive procedure that does not require any downtime. You should be able to resume your day-to-day activities immediately. You might experience slight bruising, but this will quickly subside. 

Where Can You Get Help For Lichen Sclerosus

Suffering from this condition can feel incredibly overwhelming, and you might feel like you’ve tried every treatment available. 

But that doesn’t have to be the case; you can get effective help for Lichen Sclerosus. The O-Shot has been hugely successful, so it is worth considering if you’re struggling with this condition. One of our patients, Sam, shared her story about LS and how The O-Shot helped treat her condition. You can read about it in detail here. 

The O-Shot is fast becoming known as the best treatment for Lichen Sclerosus and if you think that it could help you, then the first thing that you need to do is book a consultation.

You can contact us by calling 01322 381 205, emailing info@elite-aesthetics.co.uk, or WhatsApp us. 

We hold consultations online and in our award-winning clinic based in Greenhithe, Kent, just 20 minutes away by train from St. Pancras, London. 

 

We are here to help.

Reach out to us for compassionate, caring advice and support, your well-being matters to us. We promise to listen.

Dr Shirin x

📱 01322 381 205

💬 Chat on WhatsApp

✉️ info@elite-aesthetics.co.uk

The Lichen Sclerosus Companion Book For Women

Chapter 1: You’re Not Imagining It: Understanding Lichen Sclerosus   5

Chapter 2: The Symptoms No One Talks About – But We Should. 6

Chapter 3: Why It Took So Long to Get a Diagnosis. 7

Chapter 4: It’s Not Just in Your Head: The Real Impact of LS. 8

Chapter 5: Looking at Your Body with Kindness Again. 10

Chapter 6: You Deserve Answers – Let’s Start with the Basics. 11

Chapter 7: How LS Affects Daily Life, Intimacy and Confidence. 12

Chapter 8: The Guilt, the Grief, the Fear – And How to Manage Them.. 14

Chapter 9: Talking to Your Partner – When Words Feel Impossible. 15

Chapter 10: Managing Menopause When You Already Feel Broken. 16

Chapter 11: Yes, LS Affects Mental Health Too – Let’s Talk About It 18

Chapter 12: Real Women. Real Stories. Real Strength. 20

Chapter 13: First-Line Treatments: What Steroids Can (and Can’t) Do. 21

Chapter 14: Beyond Steroids – Advanced and Holistic Options for LS. 22

Chapter 15: The O Shot®: A Regenerative Approach to Healing. 24

Chapter 16: Morpheus8V – Restoring Skin and Confidence. 26

Chapter 17: Why We Combine Treatments – Because You Deserve Better. 28

Chapter 18: Tracking Progress with Patience and Self-Compassion. 29

Chapter 19: Learning to Care for Your Vulva – Gently and Confidently. 31

Chapter 20: Flare-Ups Happen – But They Don’t Define You. 33

Chapter 21: Sex and Lichen Sclerosus – Finding Pleasure Again. 34

Chapter 22: Periods, Pads and Pain – Managing Menstruation with LS. 36

Chapter 23: Choosing Clothes That Support Your Healing, Not Hurt You. 37

Chapter 24: Yes, You Can Still Move – Exercising with LS Safely. 39

Chapter 25: What Happens Next? Understanding How LS May Change Over Time. 41

Chapter 26: If LS Progresses – You Still Have Options. 42

Chapter 27: Vulval Cancer and VIN – What You Should Know (Not Fear) 43

Chapter 28: LS After Menopause – A New Chapter, Not the End. 45

Chapter 29: Supporting Someone with LS – A Guide for Partners and Carers. 47

Chapter 30: You Are More Than Your Diagnosis – A Letter of Hope. 48

 

Chapter 1: You’re Not Imagining It: Understanding Lichen Sclerosus

If you’re reading this, chances are you’ve experienced itching, soreness, pain, or changes to your intimate skin — and maybe you’ve been told it’s “just thrush,” “eczema,” or “all in your head.” Let me start by saying this: you are not imagining it. Your symptoms are real, and they matter. You matter.

Lichen Sclerosus (LS) is a chronic inflammatory skin condition that most often affects the vulva in women, although it can appear in other areas and affect people of all ages and genders. Despite its life-altering impact, it’s still not widely recognised — even among healthcare professionals — and many people suffer for years before receiving an accurate diagnosis.

What Is Lichen Sclerosus?

Lichen Sclerosus causes thinning, inflammation, and white patches of skin, most commonly on the vulva. It can lead to intense itching, discomfort, tearing, and pain — especially during sex, toileting, or daily movement. Over time, it can cause scarring and structural changes if left untreated. But with proper care, it is manageable.

LS is not an infection, it’s not contagious, and it’s not caused by poor hygiene. Most experts believe it’s autoimmune in nature, meaning the body’s immune system mistakenly attacks its own skin cells. Hormonal shifts, genetics, and trauma to the skin (like friction or injury) may also play a role.

Why Is It So Often Misdiagnosed?

There are a few key reasons:

• Lack of awareness: Many GPs and nurses are unfamiliar with LS, especially in its early stages.
• Shame and silence: Because LS affects intimate areas, many people hesitate to speak up or seek help.
• Similarity to other conditions: LS can look like thrush, dermatitis, or lichen planus, leading to misdiagnoses and ineffective treatments.

You’re Not Alone

If you’ve been dismissed, misunderstood, or misdiagnosed — I hear you. So many of my patients arrive at Elite Aesthetics feeling exhausted and defeated, having been passed from doctor to doctor without answers. By the time they receive a diagnosis, they’ve often endured months or years of unnecessary suffering.

That’s why education is so important. When you understand what’s happening in your body, you can begin to reclaim control and find hope.

What This Book Will Help You Do

Over the chapters ahead, you’ll learn:

• How to recognise and manage symptoms
• What treatments are available (both NHS and private)
• How to advocate for yourself in a medical setting
• How LS affects mental health, sex, and relationships
• How to live confidently and fully, even with a chronic condition

You are not defined by your diagnosis. And you’re not broken. With the right support and care, healing — emotionally and physically — is possible.

Let’s begin.

Chapter 2: The Symptoms No One Talks About – But We Should

One of the most heartbreaking things I hear from patients is, “I didn’t know what was normal anymore.” Lichen Sclerosus can make you question your body, your sanity, and your sense of self — especially when no one around you is talking about the symptoms you’re experiencing.

In this chapter, we’ll walk through both the common and the less-talked-about symptoms of LS, not just to educate, but to validate. If you see yourself in these words, please know: you are not alone, and your experiences are real.

The Most Common Symptoms

These are the signs that usually bring people to the doctor (or the internet):

• Intense itching – often worse at night or after urination
• Burning or stinging sensations – especially after washing, sex, or wearing tight clothing
• White patches or thin, shiny skin – usually on the vulva or around the anus
• Painful sex (dyspareunia) – from tearing, dryness or skin changes
• Bleeding or tearing – even with gentle activity
• Discomfort when passing urine – especially in younger girls or more advanced cases

These symptoms can fluctuate, and sometimes they disappear entirely for periods of time. This can make it even more confusing, especially when you’re trying to track patterns or explain your symptoms to a healthcare provider.

The Symptoms No One Talks About — But We Should

Many people with LS live with quiet, unseen burdens. Here are some of the symptoms my patients have shared with me — symptoms that are rarely found in leaflets or mainstream resources:

• Skin fusing or shrinking – the labia minora may reduce or disappear altogether, and the vaginal opening may narrow
• Loss of clitoral hood or reduced clitoral sensation – which can affect intimacy and sexual pleasure
• Chronic fissures or open wounds – that never seem to fully heal
• Persistent rawness or burning – even without visible skin changes
• Loss of pigmentation or increased whiteness – that doesn’t fade with time
• A feeling of constant irritation or ‘sandpaper’ friction – despite hygiene and care
• Emotional symptoms – like shame, grief, anxiety, and isolation

Why These Symptoms Often Go Undiscussed

• Embarrassment: It’s incredibly hard to talk about our vulvas, especially when things feel “wrong.”
• Normalisation of discomfort: Many women are taught that pain is just part of being female — especially around periods, sex, and menopause.
• Dismissal by professionals: Sadly, many patients have been told their symptoms are “just thrush,” “in your head,” or “nothing serious.”

Your Experience Is Valid

Whether you’re in pain, confused by what you’re seeing, or just have a gut feeling that something isn’t right — trust yourself. Lichen Sclerosus may be invisible to others, but its impact is deeply personal and real. You deserve a diagnosis. You deserve treatment. And above all, you deserve to feel well again.

In the next chapter, we’ll look at why so many people are misdiagnosed and what you can do to push for the answers you need.

Chapter 3: Why It Took So Long to Get a Diagnosis

If it took you months or even years to receive a diagnosis, you are not alone — and it’s not your fault. One of the most painful truths about Lichen Sclerosus is that it’s often missed, misdiagnosed, or minimised for far too long. Many of my patients have been told it’s just thrush, eczema, or a hygiene issue. Others have been prescribed creams that never worked — not because they were wrong about their symptoms, but because they were handed the wrong label.

In this chapter, we’ll explore why the path to a correct diagnosis is so often delayed and how you can advocate for better, faster care.

1. The Condition Is Under-Recognised

Despite affecting around 1 in 70 women, Lichen Sclerosus is still poorly understood by many GPs, nurses, and even gynaecologists. It’s not routinely taught in depth in medical training, which means many clinicians simply haven’t seen enough cases to recognise the signs early.

2. The Symptoms Mimic Other Conditions

LS symptoms overlap with many common conditions, including:

• Thrush (itching, discharge)
• Eczema or dermatitis (redness, inflammation)
• Menopausal changes (dryness, irritation)
• Urinary tract infections (burning with urination)

This can lead to repeated misdiagnosis, leaving the root cause untreated.

3. Vulval Health Is Still a Taboo

Let’s be honest — vulval and vaginal health is still cloaked in silence. Many people feel too embarrassed or ashamed to speak up about intimate symptoms. Others are taught to tolerate discomfort or told it’s just part of being a woman.

Even within healthcare, there’s a systemic discomfort around examining and discussing vulvas. In some cases, a visual inspection isn’t even carried out, and vital clues are missed.

4. Patients Are Often Dismissed

Far too many patients have told me they were told:

• “It’s all in your head.”
• “There’s nothing to see.”
• “Try a different soap.”
• “Come back if it gets worse.”

These responses are not just frustrating — they’re harmful. They delay treatment, worsen emotional distress, and reinforce the idea that your pain isn’t valid.

5. LS Can Look “Normal”

In its early stages, Lichen Sclerosus doesn’t always present with dramatic visible changes. For some, the skin looks largely unchanged even while symptoms are intense. This can cause healthcare professionals to overlook the condition unless they’re highly trained in vulval dermatology.

How to Advocate for Yourself

It’s not fair that the burden of diagnosis often falls on the patient — but many have had to push hard for answers. Here are some ways to empower yourself:

• Keep a symptom diary: Note when symptoms occur, how they feel, and how they affect your life.
• Ask for a vulval exam: This should be done gently and respectfully, ideally by someone with experience in vulval conditions.
• Request a referral: If your GP isn’t sure, ask to see a vulval dermatologist or gynaecologist.
• Know the language: Mentioning Lichen Sclerosus by name can prompt your doctor to consider it more seriously.
• Bring resources: Patient information leaflets or printouts can support your case and show you’ve done your homework.

You Deserve to Be Heard

A delayed diagnosis is frustrating and painful — emotionally and physically. But please know this: you are not difficult, dramatic, or wrong for seeking answers. You are doing exactly what you should be doing.

In the next chapter, we’ll talk about how LS affects your whole self — not just your skin. Because the emotional and psychological toll is just as real.

Chapter 4: It’s Not Just in Your Head: The Real Impact of LS

When you live with Lichen Sclerosus, it doesn’t just affect your skin — it affects your entire life. Yet because it’s a condition that isn’t always visible, people often downplay or dismiss its impact. That can leave you feeling unseen, unheard, and even doubting yourself.

But the truth is this: LS affects your body, mind, emotions, relationships, and sense of self. It is real. And it’s time we talked about it that way.

The Physical Toll

Lichen Sclerosus can cause pain, itching, tearing, and structural changes to your vulva. These symptoms can make everyday activities — like sitting, exercising, using the toilet, or wearing certain clothing — incredibly uncomfortable. Many people live with a background level of discomfort that never fully switches off.

It can also severely affect your ability to have sex. For some, it becomes too painful to continue. For others, they push through discomfort because they feel obligated or afraid of being misunderstood. Either way, it chips away at confidence, trust, and desire.

And because LS is a long-term condition, this isn’t something that just comes and goes. It requires ongoing treatment, maintenance, and adjustments — which can be draining both physically and emotionally.

The Emotional Weight

Here’s what patients have told me:

• “I feel broken.”
• “I’m terrified to look at myself.”
• “I’ve lost touch with my body.”
• “I feel dirty — even though I know I’m not.”

These feelings are heartbreakingly common, and they stem from more than just physical symptoms. They come from shame, stigma, and silence. From being told it’s “just in your head” or having your suffering ignored. From the deep cultural discomfort around women’s health, especially when it involves our most intimate areas.

The emotional impact can manifest as:

• Anxiety
• Depression
• Grief over lost intimacy or identity
• Avoidance of mirrors, partners, or appointments
• Isolation from not feeling understood

And all of this is made worse when there’s a lack of validation or support.

The Social Disconnect

Because LS isn’t widely discussed, most people with it feel completely alone. Friends might not understand. Partners might not know what to say. Healthcare professionals may be dismissive or misinformed.

This lack of understanding can make social situations exhausting. Whether it’s avoiding holidays due to flare-ups, skipping intimacy, or dreading medical exams — it takes a toll.

Reclaiming Your Story

You didn’t choose LS, and you’re not weak for struggling with it. Chronic conditions ask a lot from you, day after day. But you are still here. Still trying. Still showing up.

Your experience matters. Your pain is real. And healing starts with acknowledging that Lichen Sclerosus is not just a skin condition — it’s a whole-body, whole-life experience.

In the next chapter, we’ll explore how to reconnect with your body and begin rebuilding a relationship based on kindness, not shame.

Chapter 5: Looking at Your Body with Kindness Again

One of the most painful consequences of Lichen Sclerosus isn’t just the physical discomfort — it’s the loss of connection with your body. When pain, fear, and medical trauma are centred around your most intimate area, it’s no wonder that many people start to dissociate from that part of themselves altogether.

You may avoid looking. You may feel shame or disgust. You may even feel like your body has betrayed you. These are deeply human reactions — and they are valid. But they are not permanent.

This chapter is a gentle invitation to begin rebuilding a relationship with your body. Not through forced positivity, but through compassion, patience, and truth.

Your Body Has Been Through a Lot

It’s okay to grieve the changes. It’s okay to feel angry. Your body has carried you through discomfort, appointments, invasive procedures, and perhaps silence and dismissal. It has held so much.

Rather than blaming it, what if we recognised its strength? What if we honoured it for alerting you that something was wrong — even if it took time to get a name for it?

Relearning the Landscape

Many patients have told me they avoid mirrors, or have never really looked closely at their vulva. That’s understandable — especially if what you see has changed.

But when we don’t look, we lose connection. We hand over all power to others. We feel less able to notice when something changes or goes wrong.

Reclaiming your gaze doesn’t have to be clinical or cold. It can be small and soft. It might start with:

• Touching your skin with clean, gentle hands
• Using a mirror to observe your vulva without judgment
• Noticing texture, colour, shape — not to critique, but to witness
• Saying to yourself: “This is my body. It has carried me through.”

Let Go of Shame That Was Never Yours

So much of the shame we carry about our bodies — especially our vulvas — isn’t ours. It’s taught. It’s inherited. It’s enforced by silence and stigma.

But you don’t have to carry that anymore. There is nothing shameful about having a vulva. There is nothing shameful about a medical condition. And there is nothing shameful about wanting to feel whole again.

Body Neutrality vs Body Positivity

You don’t have to love your body every second. For many, especially after trauma or illness, the goal isn’t body positivity — it’s body neutrality. A place where you can say:

• “I may not love this part of me today, but I will care for it.”
• “I can listen to my body without hating it.”
• “I deserve comfort and dignity.”

That’s where healing starts.

Practical Ways to Reconnect

• Gentle vulval care: Warm water rinses, patting dry, avoiding triggers
• Affirmations: Written or spoken, reminding yourself of your worth
• Supportive underwear and fabrics: Choosing comfort over aesthetics
• Therapy or journaling: Exploring the emotional aspects of disconnection

You Are Still Whole

No matter how your body has changed, you are not broken. You are whole, and worthy of care, intimacy, and love — from others, and from yourself.

In the next chapter, we’ll go back to the beginning and walk through the foundational facts of Lichen Sclerosus — so you’re equipped with knowledge to match your self-compassion.

Chapter 6: You Deserve Answers – Let’s Start with the Basics

When you’re first told you have Lichen Sclerosus, it can feel like a tidal wave of unfamiliar terms, confusing instructions, and unanswered questions. You deserve better than that. You deserve to understand what’s happening in your body, what your diagnosis means, and how to take your next steps with confidence.

Let’s break down the fundamentals together.

What Is Lichen Sclerosus?

Lichen Sclerosus (LS) is a chronic inflammatory skin condition that most commonly affects the vulva, but can also appear around the anus or, less frequently, on other parts of the body. It causes thinning, irritation, and whitening of the skin, leading to discomfort and — over time — potential scarring or fusion of the tissue.

LS is not contagious, not a sexually transmitted infection, and not caused by poor hygiene. Most researchers believe it’s autoimmune in origin, meaning the immune system mistakenly attacks healthy skin cells. Hormonal changes (such as menopause), genetic factors, and trauma or friction to the area may also play a role.

Who Gets It?

Anyone can develop Lichen Sclerosus, but it’s most commonly seen in:

• Postmenopausal women
• Prepubescent girls
• Men (typically around the foreskin)
• People with other autoimmune conditions (like thyroid disease or vitiligo)

Many women with LS were told for years that their symptoms were due to age, hormones, or infections — when in fact, it was LS all along.

How Is LS Diagnosed?

Diagnosis should start with a visual examination of the vulva, done gently and respectfully. In many cases, an experienced clinician can diagnose LS based on appearance alone. Classic signs include:

• Thin, white, shiny patches of skin
• Loss of vulval structure (e.g. reduced labia minora)
• Tears or fissures
• Bruising or bleeding

Sometimes, a vulval biopsy is needed to confirm the diagnosis or rule out other conditions. This involves taking a small tissue sample under local anaesthetic.

What Does “Chronic” Mean?

“Chronic” simply means long-term. Lichen Sclerosus doesn’t currently have a cure, but it is treatable and manageable. With the right care, many people find that their symptoms improve significantly and that they can live full, comfortable lives.

The Goals of Treatment

The main goals of treatment are:

• Reducing symptoms like itching and pain
• Preventing flare-ups and long-term skin changes
• Protecting vulval structure and function
• Supporting emotional wellbeing and intimacy

We’ll explore all treatment options in detail in upcoming chapters, from NHS-prescribed steroid creams to advanced regenerative treatments like the O Shot and Morpheus8V.

You Deserve to Know the Truth

Too many people are left in the dark — given a name, but no guidance. That’s not good enough. You have the right to understand your condition, explore your options, and ask questions until you feel safe and informed.

In the next chapter, we’ll talk about how Lichen Sclerosus affects daily life — from self-esteem and intimacy to exercise and clothing choices — and how to adapt without losing yourself along the way.

Chapter 7: How LS Affects Daily Life, Intimacy and Confidence

Living with Lichen Sclerosus doesn’t begin and end with physical symptoms. It quietly seeps into the day-to-day details of your life — sometimes in ways that are hard to describe to others. The constant itch, the uncertainty, the discomfort, the impact on relationships, and the erosion of self-confidence can all take a toll.

This chapter shines a light on those often invisible struggles and reminds you: your experience is valid. And you are not alone.

The Everyday Disruptions

Even the most basic tasks can become challenging:

• Choosing clothes that don’t irritate your skin
• Planning your day around toilet access or flare-up management
• Avoiding activities like cycling or long walks due to discomfort
• Sleeping poorly due to itching or soreness

Many patients find themselves making constant adjustments — wearing loose cotton underwear, skipping baths, avoiding sex — just to avoid triggering symptoms. Over time, these changes can feel like you’re shrinking your world to stay safe.

The Impact on Intimacy

LS doesn’t just affect your skin. It affects how you feel about being touched, being seen, and being vulnerable.

You may:

• Feel too sore or anxious to be intimate
• Dread sex because it hurts, or because you’re worried about tearing
• Avoid relationships altogether, fearing judgment or rejection
• Feel disconnected from your body and your desire

Even if you’re in a loving relationship, it can feel incredibly difficult to explain what’s going on. And if your partner isn’t aware of LS, their lack of understanding can unintentionally make you feel more alone.

Confidence and Self-Esteem

LS can change how you feel about your body — not just physically, but emotionally. You may avoid mirrors. You may feel shame or embarrassment. You may start to believe that you’re not attractive, feminine, or whole.

These feelings are compounded by silence. Because LS isn’t widely talked about, many people live with these fears quietly, believing they’re the only ones going through it.

But here’s the truth: your worth is not defined by your symptoms. Your femininity is not lost because your vulva looks different. You are still deserving of intimacy, joy, and self-love.

Relationships and Communication

The effects of LS ripple outwards — into friendships, partnerships, and social life. You might cancel plans due to flare-ups. You may find it difficult to open up about your diagnosis, worried about being misunderstood. Even medical appointments can feel exhausting when you’re constantly having to explain or justify your condition.

If this is your reality, know this: your boundaries are valid. You do not owe anyone an explanation. But when you do choose to share, it can be powerful. There is strength in being seen.

Finding Balance Again

Although LS creates challenges, many people find ways to navigate life with compassion and confidence:

• Building a comfortable wardrobe
• Creating intimate experiences that are about closeness, not pressure
• Journaling, therapy, or support groups to rebuild self-esteem
• Educating partners, friends, and even professionals about your needs

In the next chapter, we’ll talk more deeply about the emotional landscape of LS — the guilt, the grief, and the fear — and how to begin healing from within.

Chapter 8: The Guilt, the Grief, the Fear – And How to Manage Them

Living with Lichen Sclerosus is not just a physical experience — it’s an emotional one. Many people with LS carry silent burdens: guilt for not noticing symptoms sooner, grief over what’s been lost, and fear about what the future might hold.

These feelings are incredibly common. You are not weak for feeling overwhelmed. You are human. And you’re navigating a condition that touches deeply personal parts of your life.

Let’s name these emotions together, and explore gentle ways to manage them.

The Guilt

You may feel guilty for not seeking help earlier. For thinking it was something minor. For blaming yourself. For not being able to “fix it.”

Here’s the truth: you did the best you could with the information you had. Lichen Sclerosus is often misdiagnosed. Many people are dismissed multiple times before finally being taken seriously. You are not at fault for the delays in your care.

Guilt often grows in silence. The more you talk about your experience — even with yourself in a journal — the more that guilt loses its grip.

The Grief

Grief is a quiet companion to chronic illness. It may come in waves:

• Grief over the loss of a “normal” body
• Grief over missed or painful sexual experiences
• Grief over your younger self, who didn’t have answers
• Grief over the disconnect from your own skin

This kind of grief isn’t always recognised, but it deserves to be. It’s not about giving up — it’s about acknowledging change. And from that honesty, healing can begin.

Let yourself feel it. Cry if you need to. Rage if you need to. You don’t have to stay in grief, but you do have the right to move through it.

The Fear

Fear may show up as:

• “Will this get worse?”
• “What if I lose more of my vulva?”
• “What if my partner leaves me?”
• “What if it’s cancer?”

Living with a chronic condition means living with uncertainty. But fear doesn’t have to control you. The antidote to fear is knowledge and support.

The more you understand your condition — and know your options — the more grounded you’ll feel. And the more you talk to others who understand, the less alone you’ll be.

Coping Tools That Help

• Journaling: Let your emotions out safely and without judgement
• Support groups: Online or local — being heard by others who “get it” can be life-changing
• Therapy: Especially with someone experienced in chronic illness or sexual health
• Meditation and mindfulness: Not to silence emotions, but to observe them gently
• Setting boundaries: It’s okay to say no. To rest. To prioritise yourself.

You Are Allowed to Feel It All

There is no “right way” to cope with Lichen Sclerosus. Some days you might feel strong. Other days, fragile. All of it is okay.

Emotions don’t make you weak — they make you real. And the more we acknowledge them, the more power we take back.

In the next chapter, we’ll explore how to talk to your partner about LS — even when the words feel impossible to find.

Chapter 9: Talking to Your Partner – When Words Feel Impossible

Talking about Lichen Sclerosus with a partner can feel like walking through fog. How do you explain something so personal, so intimate, and sometimes so painful — especially if you’re still trying to understand it yourself?

Whether you’re in a new relationship or a long-term one, opening up about LS can bring up fear, shame, and vulnerability. But with the right approach, these conversations can also build intimacy, empathy, and trust.

Why This Feels So Hard

Many people with LS avoid the topic out of fear:

• Fear of being rejected
• Fear of being seen as broken or unattractive
• Fear of not being understood
• Fear of losing desire or connection

These fears are real and valid. LS affects your body, your confidence, and your sense of self. It’s not just a skin condition — it’s an emotional one too.

But your partner can’t support you if they don’t know what’s going on. Silence creates distance, while openness builds bridges.

Starting the Conversation

Here are some gentle ways to approach the topic:

1. Choose the right moment
   Pick a calm, private time — not in the middle of intimacy or an argument. You deserve to be heard without distraction or pressure.
2. Use clear, kind language
   You don’t need to explain everything in one go. Try phrases like:

• “There’s something I’ve been dealing with that I want to share with you.”
• “It affects how I feel about sex, and I’d love your support.”
• “It’s called Lichen Sclerosus — it’s a skin condition that affects me intimately.”

3. Share what you’re comfortable with
   You don’t have to share every detail. Focus on how it affects you and what you need. If you feel comfortable, you can also offer written information or a website for them to learn more.
4. Allow space for questions — and emotions
   Your partner might not know what to say right away. That’s okay. It’s a lot to take in. Let them process and reassure them that you’re sharing because you trust them.

What Support Can Look Like

• Listening without judgment
• Adjusting sexual expectations with kindness
• Checking in on your comfort level
• Going to appointments with you, if helpful
• Learning about LS to better understand your experience

Partners can’t fix everything — but they can walk beside you. And that’s often what matters most.

What If You’re Met With Silence or Dismissal?

Not everyone reacts with sensitivity right away. If your partner minimises your experience or pressures you to “just get over it,” that’s not okay.

You deserve respect, care, and patience. If you’re not receiving that, it may be time to re-evaluate whether that relationship is serving your wellbeing.

Love Isn’t Defined by Skin

You are not broken. You are not less lovable. You are not a burden.

Real intimacy isn’t just about bodies — it’s about emotional connection, trust, and mutual care. By sharing your truth, you’re creating space for deeper, more honest connection.

In the next chapter, we’ll explore how LS and menopause intersect — and why this stage of life can bring both challenges and opportunities for healing.

Chapter 10: Managing Menopause When You Already Feel Broken

For many women, menopause marks a powerful — yet challenging — transition. It’s a time of hormonal shifts, physical changes, and emotional reckoning. But if you’re also living with Lichen Sclerosus, the impact can feel doubled. Exhausting. Even defeating.

This chapter is here to help you understand what’s happening in your body and how to find your way through with support, compassion, and strength.

Why Menopause and LS Often Collide

Lichen Sclerosus frequently develops or worsens around the time of menopause. That’s because oestrogen — a hormone that naturally declines during menopause — plays a protective role in maintaining healthy, elastic vulval tissue.

When oestrogen drops:

• Vulval skin becomes thinner and more fragile
• Natural lubrication decreases
• Symptoms of dryness, itching, and tearing worsen

This makes it harder to tell whether symptoms are caused by menopause, LS, or both — and unfortunately, they are often misdiagnosed or lumped together.

Common Overlapping Symptoms

• Vulval dryness
• Burning or soreness
• Painful sex
• Recurrent infections or irritation
• Loss of elasticity and sensation

If you’re experiencing these, you’re not imagining it — and you’re not alone.

You Are Not Broken

Many women say they feel like they’re falling apart during this time. That their bodies are betraying them. That they’ve lost their femininity, their desire, their confidence.

But here’s what I want you to know: menopause and LS do not diminish your worth. They do not erase your sexuality. They do not cancel your right to comfort, pleasure, or peace.

You are still whole.

Treatment and Relief Options

You do not have to simply “put up with it.”

1. Topical Steroids (for LS)
   Still the NHS gold standard for managing LS symptoms and preventing progression. When used correctly, they are safe and effective.
2. Vaginal Oestrogen (for menopausal symptoms)
   Low-dose vaginal oestrogen (creams, pessaries, or rings) can help relieve dryness, rebuild tissue strength, and improve comfort during sex. These treatments are safe for long-term use and work locally (not throughout the whole body).
3. Regenerative Treatments
   Advanced therapies like the O Shot® or Morpheus8V can offer non-hormonal, non-invasive relief by stimulating tissue healing, improving sensitivity, and reducing inflammation.
4. Lifestyle Support

• Use gentle, fragrance-free washes (or plain water)
• Avoid tight clothing or synthetic underwear
• Use vaginal moisturisers and lubricants regularly
• Prioritise sleep, nutrition, and mental wellbeing

Talking to Your Doctor

You deserve to be taken seriously. Ask your GP or gynaecologist to:

• Differentiate between menopausal atrophy and LS
• Consider a combined treatment plan
• Offer you specialist referrals if needed

If you don’t feel heard, keep pushing. Or seek a second opinion. You have every right to advocate for your body and your comfort.

This Is Not the End — It’s a New Chapter

Yes, your body is changing. But so are your sources of power. Menopause can be a time of liberation, clarity, and reconnection — especially when you have the knowledge and support to care for yourself fully.

You are not broken. You are becoming.

In the next chapter, we’ll explore how LS impacts your mental health — and how to care for both body and mind together.

Chapter 11: Yes, LS Affects Mental Health Too – Let’s Talk About It

When we talk about Lichen Sclerosus, we often focus on the physical symptoms — the itching, the tearing, the flare-ups. But what about the emotional scars? The fear, the shame, the anxiety that creeps in after another sleepless night or another appointment where you weren’t heard?

The psychological impact of LS is profound. And yet, it’s rarely discussed.

This chapter is here to change that.

The Emotional Weight of LS

Living with LS can feel like carrying a secret you never asked for. The chronic nature of the condition, the intimate location, and the lack of public awareness all add up to a unique emotional burden. Many patients describe feelings of:

• Shame: About how their vulva looks, smells, or feels
• Fear: About intimacy, progression, or cancer risk
• Anxiety: Around doctor visits, flare-ups, or being misunderstood
• Isolation: Because no one in their life seems to understand
• Depression: From the persistent sense of loss and frustration

If any of these resonate with you, please know: what you’re feeling is normal. You are not overreacting. You are not weak.

Why Mental Health Matters in Chronic Conditions

Chronic illness is a full-body, full-life experience. When your symptoms are ongoing, unpredictable, and misunderstood, it’s natural for your mental health to suffer.

Ignoring the emotional side doesn’t make it go away. In fact, studies show that untreated anxiety and depression can worsen physical symptoms and reduce the effectiveness of treatments.

You deserve holistic care — for your body and your mind.

Coping With the Mental Load

Here are some strategies to support your emotional wellbeing:

• 1. Talk About It
  Find a therapist who understands chronic illness or vulval health. You don’t have to explain from scratch — and you deserve a space to be heard.
• 2. Join a Support Group
  Connecting with others who truly “get it” can be transformative. Online or in-person, these communities can provide both information and emotional relief.
• 3. Practice Self-Compassion
  On hard days, try saying to yourself: “This is difficult, but I am doing my best.” Your inner voice matters. Make it a kind one.
• 4. Create Safe Rituals
  Small routines — like a warm bath, journaling, or gentle stretching — can ground you when emotions feel overwhelming.
• 5. Educate and Empower
  The more you understand your condition, the less power it holds over you. Knowledge reduces fear.

When to Seek Professional Support

If you’re experiencing any of the following, it’s time to reach out:

• Persistent low mood or hopelessness
• Panic attacks or intense anxiety
• Avoidance of all intimacy or relationships
• Feeling like you don’t want to continue living

These are signs that you need — and deserve — support. Speak to your GP, a mental health professional, or a trusted loved one. You do not have to carry this alone.

Your Emotions Are Valid

There is no weakness in feeling overwhelmed. LS is a tough condition to live with — physically, emotionally, and socially. But by acknowledging your mental health, you’re not giving up. You’re stepping into your power.

In the next chapter, we’ll share real stories from women who’ve lived with LS — not as victims, but as survivors. Because healing begins when we stop hiding.

Chapter 12: Real Women. Real Stories. Real Strength.

There’s something powerful about hearing someone say, “Me too.” It shatters the loneliness. It softens the shame. It reminds us that we are part of something bigger — a community of women who have walked through fire and found a way to keep going.

In this chapter, I want to share the real stories of real women who’ve lived with Lichen Sclerosus. These stories have been anonymised, but they are all true. Each one reflects a journey of resilience, healing, and hope.

Emma, 47 – “I finally stopped blaming myself.”

Emma spent years thinking she was just unlucky. That her constant itching and pain were somehow her fault — maybe poor hygiene, maybe bad luck, maybe even something she deserved. She was diagnosed at 45, after being told for a decade that it was just thrush.

“Once I had a name for it, I cried. Not because I was sad — but because I was relieved. I wasn’t crazy. I wasn’t dirty. I was dealing with a real condition. I started treatment, joined a support group, and for the first time, I began to feel hopeful.”

Priya, 33 – “I took back my sex life.”

Priya was newly married when her LS symptoms started. Sex became painful, then impossible. She didn’t know how to talk to her husband about it. For a while, she withdrew emotionally and physically, terrified she’d lose her relationship.

“Therapy helped me find the words. My husband cried when I finally told him — not because he was upset, but because he hated seeing me suffer in silence. We learned to be close in new ways. And once I started on the O Shot and Morpheus8V, things changed. Sex became possible again. Even pleasurable.”

Lorraine, 69 – “I thought it was just ageing.”

Lorraine assumed her symptoms were just part of getting older. She lived with discomfort for years before a new nurse practitioner gently suggested a referral.

“It was like someone finally turned on the lights. I didn’t realise how much I’d normalised my pain. Now, I use my steroid cream properly, I’ve got a vulval care routine, and I feel like I have control again. At 69, I feel more empowered than I did at 39.”

Zoe, 25 – “I was the youngest person in my support group — but I felt seen.”

Zoe’s LS was diagnosed at 21. She felt totally alone. None of her friends had even heard of it. She kept it hidden for years.

“Eventually, I found an online forum. I met women of all ages — some younger than me, many older — and suddenly, I wasn’t a freak. I was just someone with a condition. I started talking about it more openly, even did a podcast episode about it. Sharing my story became part of my healing.”

Each woman’s experience with LS is different. Some find relief quickly. Others walk a longer road. But every story here has something in common: strength.

Strength doesn’t always look like fighting. Sometimes, it looks like resting. Or crying. Or asking for help. Sometimes, strength means surviving one day at a time — and then waking up to try again.

Your story matters too. And one day, it may help someone else feel seen.

In the next chapter, we’ll explore your treatment options — starting with what the NHS currently recommends as the gold standard.

Chapter 13: First-Line Treatments: What Steroids Can (and Can’t) Do

If you’ve been diagnosed with Lichen Sclerosus by an NHS doctor, chances are you were prescribed a steroid cream — usually something like clobetasol propionate 0.05%. This is currently considered the gold-standard treatment for LS across the UK and much of the world.

But what do these creams actually do? How should they be used? And why do they work for some people, but not for others?

Let’s break it down.

How Topical Steroids Work

Topical corticosteroids reduce inflammation in the skin. In the context of LS, they help:

• Calm down the immune system’s overreaction
• Reduce redness, itching, and soreness
• Prevent further skin thinning, scarring or architectural change
• Lower the risk of skin cancer in the vulval area, which is slightly higher in long-term untreated LS

When used properly, steroids can dramatically improve symptoms and halt disease progression.

Common Steroids Used for LS

• Clobetasol propionate 0.05% – a very potent steroid, used as first-line treatment
• Mometasone furoate or betamethasone valerate – sometimes used for maintenance after symptoms are controlled

You may be given an ointment (greasier, more hydrating) or a cream (easier to apply, but may be more irritating).

How to Apply Topical Steroids Correctly

Many people are scared of steroid creams. And it’s true that overuse can thin the skin. But underuse — or using it incorrectly — is often the bigger problem with LS.

Here’s how to use them safely:

• Start with daily use: Apply once a day (usually at night) for 4–6 weeks, or as prescribed.
• Use a fingertip unit: One fingertip’s worth of ointment should cover the entire vulval area.
• Apply to clean, dry skin: Use after washing with water or a gentle, fragrance-free cleanser.
• Massage in gently: Don’t rub aggressively.
• Tailor your use: Once symptoms settle, reduce to alternate days or twice a week for maintenance.

If your doctor hasn’t shown you how to apply it — ask. Or find a vulval specialist who can guide you.

What Steroids Can’t Do

While steroids can be life-changing, they aren’t a cure. They don’t:

• Reverse skin scarring or architectural change
• Restore lost elasticity or sensation
• Address hormonal imbalance
• Heal emotional trauma or sexual pain

Some people also find that steroids irritate their skin or simply don’t work well enough. In those cases, alternatives or additional therapies are needed.

Side Effects to Watch For

When used correctly, side effects are rare. But long-term misuse or overuse can cause:

• Skin thinning (atrophy)
• Stretch marks
• Secondary infections (e.g. thrush)
• Irritation or stinging

Always check in with your doctor if you’re unsure — especially if symptoms worsen or change.

What to Do If Steroids Aren’t Enough

If you’re still experiencing discomfort, or if your symptoms come back quickly after stopping treatment, don’t panic. This doesn’t mean you’re beyond help — it means your treatment plan may need adjusting.

Many people benefit from combining steroid treatment with:

• Hormonal therapy (e.g. vaginal oestrogen)
• Advanced treatments like the O Shot® or Morpheus8V
• Pelvic floor therapy or counselling for sexual pain

We’ll explore all these options in the chapters ahead.

For now, know this: topical steroids are not your enemy. When used properly, they’re one of the most effective tools we have for controlling LS and protecting your skin.

In the next chapter, we’ll look at what happens when steroids alone aren’t enough — and what other options might help you feel like yourself again.

Chapter 14: Beyond Steroids – Advanced and Holistic Options for LS

If topical steroids have helped you but haven’t solved everything — or if they’ve been difficult to tolerate — you’re not alone. For many patients, steroids are a powerful first step, but they’re not the whole journey.

This chapter explores what else is available. Whether you’re seeking additional symptom relief, structural repair, or a more holistic approach, there are options to help you feel more like yourself again.

Why Look Beyond Steroids?

Even when used correctly, steroids can only go so far. They manage inflammation — but they don’t:

• Restore lost tissue or elasticity
• Resolve sexual discomfort or trauma
• Rebuild sensation or intimate confidence
• Support long-term hormonal balance

For women looking to not just manage but heal and rebuild, combining medical and regenerative approaches can be life-changing.

Advanced Regenerative Treatments

1. O Shot® (Orgasm Shot)

This treatment uses your own platelet-rich plasma (PRP) to stimulate tissue repair and regeneration in the vulval and vaginal area. Benefits include:

• Improved skin texture and strength
• Reduced pain and inflammation
• Increased natural lubrication and sensitivity
• Better sexual function and pleasure

Many women with LS report significant symptom relief and improved quality of life after a course of O Shot treatments.

2. Morpheus8V

This non-invasive radiofrequency microneedling treatment stimulates collagen production and cellular renewal. It can:

• Tighten and firm vulval and vaginal tissue
• Improve tone and elasticity
• Reduce itching and discomfort
• Help rebuild confidence and comfort

It’s especially effective when combined with PRP as part of a tailored protocol.

Hormonal Support

If you’re postmenopausal or perimenopausal, a drop in oestrogen can exacerbate LS symptoms. Local oestrogen treatments — such as vaginal tablets, creams, or rings — can help:

• Thicken and nourish vulval skin
• Reduce dryness and soreness
• Improve comfort during intimacy

This is not the same as full-body HRT. Vaginal oestrogen is safe for most women, including those who can’t take systemic hormones.

Other Holistic and Supportive Therapies

• Pelvic floor therapy – for those experiencing pain or tension during sex or movement
• Psychosexual therapy – to address emotional trauma, intimacy fears, and sexual confidence
• Mind-body practices – such as breathwork, mindfulness, or yoga to reduce stress and inflammation
• Dietary support – some people report improvements with anti-inflammatory diets or supplements (though evidence is anecdotal)

There Is No One-Size-Fits-All

Every body is different. Every story is different. Some people find relief with steroid cream alone. Others need a combination of approaches. What matters most is finding what works for you, without shame or pressure.

And if you’ve been told there’s “nothing more we can do” — please don’t accept that. There are always more options. There is always more hope.

In the next chapter, we’ll walk through what a holistic LS care plan might look like — one that honours your whole self, not just your skin.

Chapter 15: The O Shot®: A Regenerative Approach to Healing

For many women living with Lichen Sclerosus, traditional treatments can feel limiting. Steroid creams may help manage symptoms, but they don’t always restore confidence, comfort, or intimacy. That’s where the O Shot® (short for Orgasm Shot) comes in — a regenerative, non-surgical treatment designed to help your body heal from the inside out.

Let’s explore what it is, how it works, and why it’s helping so many women reclaim their quality of life.

What Is the O Shot®?

The O Shot® is an innovative treatment that uses your own body’s natural healing components — specifically platelet-rich plasma (PRP) — to promote tissue repair, reduce inflammation, and improve vulval health.

It’s a gentle, outpatient procedure that involves drawing a small amount of your blood, spinning it in a specialised centrifuge to extract the PRP, and then injecting it into specific areas of the vulva and vagina, including around the clitoris and vaginal wall.

How Does It Help with Lichen Sclerosus?

Lichen Sclerosus is an inflammatory skin condition, and the goal of the O Shot® is to:

• Stimulate the growth of new, healthy tissue
• Reduce pain, itching, and sensitivity
• Improve moisture levels and skin resilience
• Enhance sexual function and clitoral sensation
• Help reduce the frequency and intensity of flare-ups

By introducing PRP into the affected area, we trigger a cascade of healing responses that can lead to stronger, healthier vulval skin.

What’s the Procedure Like?

• Step 1: A small amount of blood is taken from your arm — similar to a routine blood test.
• Step 2: The blood is placed into an FDA-approved centrifuge to isolate the PRP.
• Step 3: A numbing cream is applied to the treatment area for comfort.
• Step 4: The PRP is then precisely injected into areas most impacted by LS (this is tailored to your needs).

The entire process takes around 30–45 minutes, and downtime is minimal — most people resume normal activity the same day.

Is It Safe?

Yes. The O Shot® uses your own blood, which means there’s no risk of allergic reaction or rejection. At Elite Aesthetics, we use a high-grade, medically regulated centrifuge and advanced injection techniques to ensure the highest standards of safety and precision.

Some women may experience mild swelling or sensitivity in the hours following treatment, but side effects are rare and short-lived.

How Soon Will I Notice Results?

Many patients begin to feel improvement within 1–2 weeks, though the full benefits can take up to 3 months to develop as collagen and tissue renewal take place.

Some women experience dramatic changes, while others notice more subtle improvements. In some cases, a second treatment may be recommended for optimal results.

Can the O Shot® Replace Steroid Creams?

For some women, the O Shot® reduces their dependence on steroids. For others, it works alongside conventional treatment to improve quality of life and skin resilience.

It’s important to remember that Lichen Sclerosus is a chronic condition. The O Shot® is not a cure — but it can be a powerful tool in your management plan.

Real Patient Experiences

Patients often report:

• Less frequent flare-ups
• Greater comfort during daily activities
• Improved confidence with intimacy
• Feeling more in control of their condition

It’s not just about physical relief — it’s about emotional healing too.

Is the O Shot® Right for You?

If you:

• Feel frustrated with steroid-only treatment
• Want a natural, regenerative approach
• Struggle with painful sex or loss of sensation
• Are ready to explore a private, advanced option

…then the O Shot® may be worth considering.

In the next chapter, we’ll introduce Morpheus8V, another powerful regenerative treatment that can be used alone or alongside the O Shot® to strengthen and rebuild vulval skin from the inside out.

Chapter 16: Morpheus8V – Restoring Skin and Confidence

While steroid creams and platelet-rich plasma (PRP) offer significant relief for many people with Lichen Sclerosus, some need a more targeted, structural approach to rebuild fragile, inflamed skin. That’s where Morpheus8V comes in — a cutting-edge radiofrequency microneedling treatment that stimulates deep healing and restoration.

Morpheus8V is about more than just symptom relief. It’s about supporting your body to regenerate stronger, healthier skin — and helping you reclaim your confidence in the process.

What Is Morpheus8V?

Morpheus8V is a non-surgical, minimally invasive treatment that uses a combination of microneedling and radiofrequency (RF) energy to stimulate collagen and elastin production deep within the skin.

Unlike topical treatments or surface-level therapies, Morpheus8V works in the dermal layers where skin structure and resilience are formed. It is specially designed for use in delicate areas like the vulva and vagina.

How Does It Help with Lichen Sclerosus?

LS causes thinning, inflammation, and scarring of vulval tissue. Over time, this can lead to tearing, discomfort, and loss of structure. Morpheus8V targets these issues by:

• Stimulating new collagen and elastin to strengthen skin
• Improving tissue density and elasticity
• Reducing skin fragility and susceptibility to trauma
• Soothing chronic inflammation
• Supporting post-steroid or regenerative protocols

In essence, it helps rebuild a stronger, more resilient foundation — not just on the surface, but beneath it.

What’s the Procedure Like?

At Elite Aesthetics, here’s what to expect:

1. Consultation: We assess your suitability and discuss your symptoms and goals.
2. Numbing cream applied: This ensures a comfortable experience.
3. Treatment begins: A small handheld device with microneedles delivers RF energy deep into the skin.
4. Session time: Each session takes about 30–45 minutes.
5. Downtime: Most people return to normal activity within a day, though we advise avoiding intercourse and strenuous exercise for 48 hours.

How Many Treatments Will I Need?

Most patients benefit from a course of 3 treatments, spaced about 4–6 weeks apart. Maintenance treatments may be recommended annually, depending on your needs.

How Soon Will I See Results?

Some improvements can be felt within a few weeks — such as reduced sensitivity or irritation — but the full benefits typically develop over 3 months, as collagen remodelling takes place.

Why Combine Morpheus8V with the O Shot®?

While the O Shot® delivers biological healing through PRP, Morpheus8V offers structural reinforcement. Together, they:

• Improve skin quality from both the inside and out
• Target both inflammation and weak tissue structure
• Offer a more comprehensive treatment plan for stubborn LS

Many patients find that the combination reduces flare-ups, improves sexual comfort, and enhances confidence.

Is It Safe?

Yes — when performed by a trained professional. At Elite Aesthetics, we use settings tailored to your skin and condition, and we monitor every step of the procedure. Mild redness or swelling is normal for a few hours afterward.

Emotional Benefits of Morpheus8V

LS doesn’t just affect your skin — it affects your sense of self. Morpheus8V offers emotional as well as physical relief:

• Confidence in your body’s ability to heal
• Empowerment through proactive treatment
• A renewed sense of ownership over your body

Patients often say they feel more hopeful and more themselves again after treatment — and that’s just as important as the clinical outcomes.

Could Morpheus8V Be Right for You?

You might consider this treatment if:

• You have advanced LS with structural skin changes
• Steroid creams haven’t offered lasting relief
• You want to improve vulval skin texture, strength, or comfort
• You’re looking for a non-hormonal, regenerative option

In the next chapter, we’ll look at why combining therapies like Morpheus8V and the O Shot® may offer the best possible results — and how we personalise treatment plans to meet your unique needs.

Chapter 17: Why We Combine Treatments – Because You Deserve Better

Lichen Sclerosus is not a one-dimensional condition — so why should the treatment be? While some people respond well to a single therapy, others find the best relief when treatments are thoughtfully combined. At Elite Aesthetics, our approach is always tailored, personal, and rooted in the belief that you deserve better than a one-size-fits-all solution.

Combining treatments doesn’t mean overloading your body — it means strategically using different tools that work together to address different layers of the condition.

Why Combine Therapies?

Lichen Sclerosus affects skin on multiple levels:

• Surface: Irritation, dryness, inflammation
• Structure: Thinning, tearing, architectural changes
• Function: Pain during sex, loss of sensation
• Emotion: Shame, fear, anxiety, loss of confidence

By combining treatments, we can:

• Calm active inflammation (e.g. with topical steroids)
• Rebuild tissue strength (e.g. with Morpheus8V)
• Regenerate cells and stimulate healing (e.g. with the O Shot®)
• Support hormonal balance (e.g. with vaginal oestrogen)
• Address emotional wellbeing (e.g. with education, therapy, and support)

Common Combinations That Work Well

1. Steroids + O Shot®

Topical steroids reduce inflammation and manage symptoms. The O Shot® stimulates deeper healing and may help reduce dependence on long-term steroid use.

2. Morpheus8V + O Shot®

Morpheus8V strengthens the skin’s structure, while the O Shot® improves tissue health and sensitivity. The combination often leads to improved comfort and sexual function.

3. Steroids + Vaginal Oestrogen

This duo addresses both LS and genitourinary symptoms of menopause, like dryness and atrophy.

4. Advanced Treatments + Lifestyle Support

Good vulval hygiene, avoiding triggers, emotional care, and relationship support all play an important role in long-term outcomes.

How We Personalise Your Plan

At Elite Aesthetics, we start with a full consultation, taking time to understand:

• Your symptoms and how they affect your life
• Your past treatments and response
• Your personal goals (e.g. less pain, more pleasure, more confidence)

We then recommend a plan that might include one or more of the following:

• Topical prescription treatments
• The O Shot® (PRP)
• Morpheus8V
• Vaginal oestrogen (if indicated)
• Nutritional, psychological, or sexual health support

What About Safety?

All our combination plans are built with your safety as the top priority. We:

• Use medically approved equipment (e.g. FDA-approved centrifuge for PRP)
• Space treatments appropriately to allow for optimal healing
• Provide follow-up support to ensure you’re responding well

You Deserve Holistic, Personalised Care

You are not just a patient. You are a whole person. Your skin, your body, your emotions, your relationships — they all matter.

Combining treatments allows us to support all of you — not just suppress symptoms, but nurture healing.

In the next chapter, we’ll talk about what healing really looks like, and how to track your progress with patience, clarity, and compassion.

Chapter 18: Tracking Progress with Patience and Self-Compassion

Healing from Lichen Sclerosus is rarely linear. Some days you might feel like you’re making great progress, and then — seemingly out of nowhere — a flare-up appears. This can be disheartening, especially when you’re trying your best. But here’s what I want you to remember: progress is not perfection. It’s the quiet, steady commitment to your wellbeing — even when it doesn’t look or feel perfect.

In this chapter, we’ll explore how to track your journey with clarity, curiosity, and kindness.

Why Tracking Matters

When you’re dealing with a chronic condition like LS, it can be easy to forget how far you’ve come. By documenting your experiences, you can:

• Notice early warning signs of a flare-up
• See patterns in what helps or worsens symptoms
• Communicate more clearly with healthcare providers
• Reclaim a sense of agency and control

But the goal isn’t to obsess or micromanage — it’s to understand and support yourself better.

What to Track

You don’t need a complex system. Even a simple notebook or notes app can help. Consider tracking:

• Symptoms: Itching, burning, tearing, pain during sex or urination
• Flare-ups: When they happen, how long they last, possible triggers
• Treatments used: Creams, ointments, PRP, Morpheus8V, etc.
• Hormonal changes: Menstrual cycle, menopause, HRT
• Emotional wellbeing: Stress, anxiety, mood changes
• Lifestyle factors: Diet, clothing, exercise, sexual activity

Over time, these notes can reveal helpful insights — such as whether flare-ups coincide with stress, hormonal shifts, or certain products.

Be Gentle with Yourself

Healing is a process, not a race. There will be ups and downs. Some days will feel like setbacks. Others will bring tiny, quiet victories.

• Didn’t need to apply cream today? That’s progress.
• Managed intimacy without pain? That’s progress.
• Advocated for yourself at a doctor’s appointment? Huge progress.

Celebrate these moments. They matter.

How to Measure Progress (Beyond Symptoms)

Your skin might be healing — but that’s only one part of the picture. True progress includes:

• Feeling more confident in your body
• Being able to enjoy activities you’d been avoiding
• Improved sleep, comfort, or intimacy
• Reduced anxiety about symptoms or flare-ups

Even if your LS hasn’t “gone away,” your ability to live well with it is a powerful sign of healing.

Managing Setbacks

Flare-ups don’t mean failure. They don’t erase your progress. They are a normal part of living with a chronic condition.

When setbacks happen:

• Go back to your soothing routines
• Use your prescribed treatments as directed
• Revisit your notes to look for triggers
• Reach out for support — you don’t have to do this alone

The Power of Reflection

Every few weeks or months, take a moment to reflect:

• What’s working?
• What’s not?
• What do I want to try or explore next?

This isn’t about judging yourself — it’s about supporting yourself.

Progress Looks Different for Everyone

Some people see quick changes. Others experience gradual improvement. There’s no “right” pace — only your pace.

Trust your process. Trust your body. And remember: even when it feels like you’re standing still, your commitment to healing is carrying you forward.

In the next chapter, we’ll shift from monitoring symptoms to nurturing self-care — and explore how to create a daily vulval care routine that supports comfort, healing, and confidence.

Chapter 19: Learning to Care for Your Vulva – Gently and Confidently

When you live with Lichen Sclerosus, caring for your vulva becomes more than a routine — it becomes an act of healing, self-respect, and empowerment. Many people are never taught how to properly look after their intimate skin, let alone how to do it when that skin is irritated, painful, or changing. This chapter will give you the tools to care for yourself with both gentleness and confidence.

Why Vulval Care Matters

Good vulval care doesn’t just support physical healing — it also helps:

• Reduce irritation and flare-ups
• Strengthen your skin’s natural barrier
• Prevent secondary infections
• Restore a sense of comfort and control

Even small, consistent changes in how you treat your skin can lead to big improvements over time.

The Basics of Daily Vulval Care

Here’s a simple, soothing routine you can adapt to your needs:

1. Cleanse Gently

• Use warm water only — no soaps, bubble baths, or scented products
• If you need a cleanser, choose a pH-balanced, fragrance-free wash
• Gently pat the area dry with a soft towel — don’t rub

2. Moisturise Daily

• Apply a plain, unperfumed emollient (like Epaderm, Hydromol, or Diprobase)
• Use it as a barrier after washing and as needed throughout the day

3. Use Steroid Creams as Prescribed

• Always apply to clean, dry skin
• Wait 5–10 minutes after moisturising, or apply the steroid first (follow your doctor’s guidance)

4. Wear Breathable Clothing

• Choose cotton underwear and loose-fitting bottoms
• Avoid tight jeans, leggings, or synthetic fabrics that trap moisture and heat

5. Stay Fragrance-Free

• Skip scented wipes, sprays, douches, and pads
• Use unbleached, non-perfumed toilet paper if possible

Tips for Soothing a Flare-Up

During a flare, your skin may feel raw, itchy, or fragile. Try the following:

• Take a short sitz bath in lukewarm water with a teaspoon of baking soda
• Use a cold compress wrapped in soft fabric to calm itching
• Reapply emollient more frequently to reduce friction
• Avoid intercourse until symptoms settle

Intimacy and Moisture Support

If dryness or discomfort affects intimacy:

• Use water-based lubricants or vaginal moisturisers regularly
• Consider vaginal oestrogen (available by prescription)
• Communicate openly with your partner about what feels comfortable

Protecting Your Skin

• Avoid shaving or waxing the vulval area — this can trigger flare-ups
• After using the toilet, wipe front to back and pat (don’t rub) dry
• After exercise, rinse with water and change into dry clothes promptly

Reclaiming Body Confidence Through Care

Vulval care is not just about hygiene or treatment — it’s about rebuilding your connection with your body. Each act of care is a message: I deserve to feel comfortable. I deserve to feel safe in my skin.

Even if your vulva looks or feels different than it once did, it is still worthy of love, attention, and kindness.

In the next chapter, we’ll discuss how to handle those inevitable flare-ups with grace and reassurance — so you feel prepared, not powerless.

Chapter 20: Flare-Ups Happen – But They Don’t Define You

No matter how well you care for yourself or how consistent you are with treatment, flare-ups can still happen. And when they do, it’s easy to feel like you’ve failed, like you’re back at square one. But here’s the truth: flare-ups are part of the journey — not a sign of failure.

In this chapter, we’ll help you understand what causes flare-ups, how to soothe them effectively, and how to approach them with compassion instead of fear.

What Is a Flare-Up?

A flare-up is a temporary worsening of Lichen Sclerosus symptoms. You might notice:

• Increased itching or burning
• Skin splitting or tears
• Redness, soreness, or inflammation
• Pain during sex or urination

Some flare-ups last a few hours, others linger for days. But they will settle — especially when handled with care.

Common Triggers

Knowing your triggers can help you prevent or reduce flare-up frequency. Some of the most common include:

• Stress or emotional upset
• Menstrual cycle or hormonal changes
• Tight or synthetic clothing
• Friction from exercise, sex, or wiping
• New soaps, detergents, or hygiene products
• Overuse or underuse of steroid creams
• Heat, sweat, or prolonged moisture

Keeping a symptom diary can help you spot patterns over time.

What to Do When a Flare Hits

1. Pause and breathe – Remind yourself: this is temporary, and you have tools to handle it.
2. Simplify your routine – Stick to gentle cleansing with water only, avoid any irritants.
3. Apply your prescribed steroid – Follow your doctor’s instructions. Don’t skip it out of fear.
4. Use a barrier ointment – Emollients help protect sore skin and reduce friction.
5. Avoid further irritation – Postpone intercourse, shaving, tight clothing, or vigorous exercise.
6. Try a sitz bath – Lukewarm water with a teaspoon of baking soda may help soothe itching and inflammation.
7. Cold compresses – Wrapped in a soft cloth, these can calm the area and reduce swelling.

How to Talk to Yourself During a Flare

Flare-ups can bring back old fears and frustrations. You might feel:

• Helpless
• Angry
• Embarrassed
• Discouraged

This is when self-talk matters. Try saying:

• “This is a setback, not the end.”
• “My body is reacting, not betraying me.”
• “I have handled this before. I can do it again.”

Your thoughts during a flare can shape how you experience it. Speak to yourself like you would a dear friend.

When to Seek Medical Help

Sometimes, flare-ups need professional attention. Contact your GP or specialist if:

• Symptoms don’t settle after a few days of treatment
• You see signs of infection (pus, unusual discharge, fever)
• You develop new or worsening pain that doesn’t feel familiar
• You’re unsure about medication use or side effects

You don’t have to push through alone. Support is available.

Flare-Ups Are a Chapter, Not the Whole Story

It’s okay to feel frustrated. It’s okay to take a step back. But don’t let a flare define your progress or self-worth. Healing is not about never having bad days — it’s about knowing how to respond when they come.

In the next chapter, we’ll explore intimacy in more depth — and how to rediscover sexual pleasure and confidence, even after trauma and pain.

Chapter 21: Sex and Lichen Sclerosus – Finding Pleasure Again

Sexual health is deeply personal. It’s about more than just physical function — it’s about connection, confidence, identity, and pleasure. When Lichen Sclerosus enters the picture, it can impact every one of those areas. Pain, fear, changes in appearance, and lack of information can lead to avoidance and emotional distress.

But here’s what I want you to know: pleasure is still possible. You are still deserving of intimacy — with yourself and with others. Healing your sexual self after LS is not about returning to how things used to be. It’s about discovering new ways to connect, to feel, and to be present in your body again.

The Most Common Challenges

People with LS often face:

• Pain or tearing during sex
• Loss of sensitivity or desire
• Fear of triggering a flare-up
• Embarrassment or shame about appearance
• A feeling of disconnect from their sexual identity

These experiences are normal. They are not a reflection of your worth or your ability to experience intimacy. They are simply challenges to be met with care.

Redefining What Sex Means

We are often taught that sex means penetration — and that anything else is foreplay. But true intimacy can look like:

• Touch, cuddling, skin-to-skin closeness
• Kissing, massage, mutual exploration
• Clitoral stimulation, sensual talk, shared fantasy

Redefining sex takes the pressure off performance and opens the door to new kinds of pleasure.

Preparing for Intimacy

If you’re nervous about becoming sexually active again — whether alone or with a partner — these steps can help:

• Get to know your body again
  Use a mirror. Touch gently. Explore what feels good and what doesn’t. Reconnect without pressure.
• Use lubrication
  Fragrance-free, water-based lubricants or vaginal moisturisers can reduce friction and increase comfort. Don’t be afraid to use them liberally.
• Time it right
  Avoid intimacy during flare-ups. Wait until your skin feels calm, and you feel mentally ready.
• Communicate openly
  Tell your partner what you need — whether that’s slowness, pauses, or non-penetrative options. Let them know this is a journey you’d like to take together.
• Explore at your own pace
  There is no rush. Let intimacy evolve naturally. Consent, trust, and comfort come first.

When to Get Extra Support

If you’re still struggling, you might benefit from:

• Seeing a psychosexual therapist
• Talking to your LS specialist about regenerative treatments like the O Shot® or Morpheus8V
• Exploring pelvic floor therapy if you experience tension or vaginismus

You Are Still Deserving of Pleasure

LS may have changed your relationship with sex, but it does not erase your right to feel desired, touched, loved — or to experience pleasure again.

Healing your sexual self is an act of courage. You are not broken. You are simply learning to relate to your body in a new, gentler way.

In the next chapter, we’ll address another intimate topic: how to navigate your menstrual cycle with LS and stay comfortable through each phase.

Chapter 22: Periods, Pads and Pain – Managing Menstruation with LS

Managing your menstrual cycle can be challenging at the best of times. But when you have Lichen Sclerosus, your period can feel like a physical and emotional minefield — increased irritation, soreness, and stress often coincide with the hormonal fluctuations of your cycle.

This chapter will guide you through ways to protect your skin, ease discomfort, and take control of your period, one step at a time.

Why Periods Can Trigger Flare-Ups

Hormonal changes — particularly oestrogen dips before and during your period — can make the vulval skin more sensitive and vulnerable to inflammation. Add to that the friction of pads, the moisture of blood, and the use of products not designed for sensitive skin, and it’s no surprise that many people with LS find this time of the month especially difficult.

Common Menstrual Challenges with LS

• Increased itching or soreness
• Tearing or fissures
• Difficulty using tampons
• Sensitivity to sanitary products
• Disrupted sleep or hygiene concerns

Tips for a More Comfortable Period

1. Choose Pads Carefully

• Opt for organic, unbleached, fragrance-free pads
• Consider cloth pads (washed with non-bio detergent) for breathability and softness
• Change pads frequently to minimise moisture and irritation

2. Use Tampons with Caution

• If using tampons, select the smallest absorbency needed
• Apply a small amount of emollient or lubricant to the tip before insertion
• Avoid tampons entirely during a flare-up or if you experience discomfort

3. Explore Menstrual Cups or Discs (If Suitable)

Some people with LS find menstrual cups or discs more comfortable than tampons — others do not. If you try one, ensure it’s made of medical-grade silicone and practice insertion with care. Stop use if you experience pain or friction.

4. Consider Period Pants

Absorbent underwear designed for menstruation can be an excellent, low-friction alternative. Choose high-quality, breathable brands free from dyes and chemicals.

5. Apply a Barrier Ointment

Using an emollient as a protective barrier before and after pad use can reduce friction and soothe irritation.

6. Use Steroids as Directed

Continue your prescribed treatment through your cycle unless advised otherwise. Don’t skip applications out of fear — consistent use helps reduce flares.

7. Rinse Gently

Use warm water to rinse after changing pads or tampons. Avoid wipes or soaps, which can cause stinging or imbalance the delicate skin.

Tracking Symptoms

If your LS worsens consistently around your period, it may be helpful to:

• Track flare-up timing in relation to your cycle
• Talk to your GP about hormonal support (e.g. oestrogen creams or HRT)
• Consider adjusting your treatment plan for the days leading up to your period

Emotional Impact

For many people, periods already carry emotional weight — from mood swings to body discomfort. LS can amplify this. Be kind to yourself. Rest when needed. Prioritise comfort. And remind yourself that this phase will pass.

You Deserve a Gentle Cycle

Having LS doesn’t mean you have to dread your period every month. With the right products, preparation, and support, you can navigate menstruation with far less pain and much more ease.

In the next chapter, we’ll talk about how to dress with LS in mind — choosing clothing that supports your healing, not hinders it.

Chapter 23: Choosing Clothes That Support Your Healing, Not Hurt You

Living with Lichen Sclerosus means being more mindful of what touches your skin — and that includes what you wear every day. Clothing choices can either soothe or aggravate your symptoms. The goal is comfort, breathability, and freedom from friction. But dressing with care doesn’t mean giving up on style — it simply means choosing fabrics and fits that prioritise your wellbeing.

Why Clothing Matters for LS

The skin affected by LS is often thin, fragile, and prone to irritation. Tight, synthetic, or poorly ventilated clothing can:

• Increase sweating and moisture retention
• Cause painful rubbing or chafing
• Aggravate inflammation or trigger flare-ups

On the other hand, breathable, soft, and well-fitted clothing can help:

• Keep the vulval area cool and dry
• Reduce pressure on sensitive skin
• Support healing and daily comfort

Best Fabrics for Sensitive Skin

Choose natural, breathable fabrics that allow airflow and wick moisture away:

• Cotton: Ideal for underwear, pyjamas, and everyday wear
• Bamboo: Naturally antibacterial and soft, great for sensitive skin
• Linen: Breathable and light, especially in warm weather
• Modal and Tencel: Plant-based, smooth, and gentle on the skin

Avoid:

• Nylon
• Polyester
• Lace (especially in underwear)
• Synthetic blends that trap heat and moisture

Underwear Tips

• Choose 100% cotton or bamboo briefs
• Opt for full coverage styles that don’t dig into your skin
• Avoid thongs, tight seams, or synthetic gussets
• Change your underwear if it becomes damp with sweat or discharge
• Wash with fragrance-free, non-bio detergent and rinse thoroughly

Bottoms That Work With You

• Look for loose, breathable styles — wide-leg trousers, soft joggers, maxi skirts
• If you wear leggings, make sure they’re made of soft cotton blends and worn with moisture-wicking underwear
• Avoid high-rise styles that press into the vulval area
• Go up a size if needed — comfort matters more than labels

Sleepwear and Loungewear

• Choose breathable pyjamas or nightgowns
• Consider sleeping without underwear to allow airflow and reduce moisture
• Keep your bedding clean and cool — natural fibre sheets like cotton or bamboo can make a difference

During a Flare-Up

• Go commando at home to reduce friction
• Stick to loose, lightweight dresses or kaftans
• Avoid any tight waistbands or seams near the vulva

Your Style, Your Comfort

It’s possible to feel stylish and confident while still honouring your body’s needs. There’s no shame in prioritising comfort — in fact, it’s an act of self-respect. And with growing awareness, more brands are now offering inclusive, skin-friendly fashion options.

A Final Word on Choice

You get to decide what feels good. Some days you might wear something flowy and soft. Other days, you may want the structure of jeans or workout wear — and that’s okay too. What matters is listening to your body and adjusting as needed.

In the next chapter, we’ll discuss movement — how to stay active and enjoy exercise without aggravating symptoms.

Chapter 24: Yes, You Can Still Move – Exercising with LS Safely

Movement is powerful. It supports mental health, boosts circulation, strengthens your body, and helps you feel connected to yourself. But when you’re living with Lichen Sclerosus, exercise can feel daunting — will it cause friction? Will it trigger a flare-up? Will I feel sore afterward?

These are valid concerns, and they deserve gentle, informed answers. The good news is: you absolutely can stay active with LS — it just requires a little extra planning and self-awareness.

Why Exercise Matters

Regular movement can:

• Improve mood and reduce stress (both common LS triggers)
• Enhance blood flow to support healing
• Help manage weight and hormonal balance
• Build confidence and body awareness

You don’t need intense workouts to benefit. Even light, consistent activity can make a big difference.

Choosing the Right Activity

When living with LS, opt for low-impact, gentle forms of movement, especially during flare-ups:

Recommended Options:

• Walking: Gentle and low-friction, especially in breathable clothing
• Swimming: Soothing and joint-friendly — just avoid chlorinated pools if sensitive, and rinse off straight after
• Pilates and yoga: Excellent for pelvic floor awareness, flexibility, and stress relief
• Cycling (with caution): Some people find it uncomfortable; try padded seats and short rides
• Strength training: Focus on form and wear soft, supportive workout gear

Activities to Approach with Care:

• Running or high-intensity interval training (HIIT), which may cause excessive sweat and friction
• Horse riding or spinning, unless specially modified
• Hot yoga or saunas, which can increase heat and irritation

Clothing Tips for Exercise

• Wear moisture-wicking, breathable fabrics (like cotton blends or bamboo)
• Avoid tight seams in the vulval area — seamless underwear is ideal
• Consider cycling shorts over underwear to reduce friction
• Change out of sweaty clothes immediately after your workout

Hygiene After Exercise

• Rinse gently with warm water — avoid wipes or soaps
• Pat dry with a clean towel
• Reapply a barrier emollient or prescribed cream if needed
• Let your skin breathe before dressing again

Listening to Your Body

Every day is different. On some days, movement will feel energising. On others, your body may ask for rest. That’s okay.

Signs to pause or modify your workout:

• Increased itching or soreness
• New or worsening tears
• Unusual discharge or burning

Adjust as needed. Your healing matters more than any fitness goal.

The Emotional Benefits of Moving Again

For many women with LS, returning to exercise after diagnosis is about more than just fitness — it’s about rebuilding trust in your body. It’s about reclaiming space, feeling capable, and reconnecting with joy.

Start small. Celebrate every step. And most of all, move in a way that feels good for you.

In the next chapter, we’ll look ahead — at how LS can evolve over time, and what to expect from the months and years ahead.

Chapter 25: What Happens Next? Understanding How LS May Change Over Time

A diagnosis of Lichen Sclerosus often comes with more questions than answers — especially when it comes to the future. Will it get worse? Will it go away? What happens if I stop treatment? These are all valid concerns, and it’s important to have honest, compassionate guidance.

This chapter is designed to help you understand what to expect in the months and years ahead, so you can move forward with clarity and confidence.

Is LS a Progressive Condition?

Lichen Sclerosus is considered a chronic and potentially progressive condition. This means it tends to persist long term and may change over time — especially without consistent treatment.

However, progression is not inevitable. With the right management, many people achieve long-term symptom control and maintain a good quality of life.

What Might Change Over Time?

Without proper treatment, LS can lead to:

• Thinning or shrinking of vulval tissue
• Fusion of the labia minora
• Narrowing of the vaginal opening (introital stenosis)
• Loss of clitoral hood or reduced sensation
• Scarring or white, thickened plaques

These changes can affect comfort, intimacy, and emotional wellbeing. That’s why ongoing care and early intervention matter.

The Good News: You Have Control

With the right approach, most people can:

• Stabilise their symptoms
• Prevent structural damage
• Improve skin quality
• Maintain or even restore comfort and confidence

This is especially true when combining evidence-based treatments like topical steroids with regenerative therapies and vulval self-care.

Will I Always Need Treatment?

Because LS is chronic, maintenance treatment is often recommended — even after symptoms improve. This usually means applying a mild steroid (like clobetasol) once or twice a week to prevent flare-ups and progression.

Think of it like brushing your teeth. It’s a small act of care that prevents bigger problems later on.

What About Remission?

Some people do experience periods of remission — months or even years where symptoms reduce or disappear. But remission doesn’t always mean the condition has gone away.

For this reason, it’s important to continue some form of maintenance even when you’re symptom-free.

Monitoring Changes

It’s helpful to:

• Check your vulva monthly with a mirror, noting any new changes in skin colour, shape, or texture
• Track your symptoms and flare-ups
• Attend regular check-ups, especially if you’ve had moderate to severe LS

If you notice any new patches, thickening, bleeding, or lesions that don’t heal, speak to your doctor. These changes may need further investigation.

Looking Ahead With Confidence

While LS is long-term, it does not have to control your life. The key is consistent care, open communication with your healthcare team, and a willingness to adapt your routine as your body changes.

You are not powerless. You are informed, equipped, and supported.

In the next chapter, we’ll explore what to do if LS progresses — and how to face that possibility with strength and options, not fear.

Chapter 26: If LS Progresses – You Still Have Options

For many people living with Lichen Sclerosus, there’s a quiet, nagging fear: What if it gets worse? Maybe you’ve already noticed skin changes. Maybe your symptoms have become harder to manage. Or maybe your doctor has used the word “progression,” and it’s left you feeling anxious or unsure.

If LS progresses, it can feel overwhelming. But please hear this: you still have options. You are not out of choices. You are not alone. And your future is not defined by a diagnosis.

What Does “Progression” Actually Mean?

Progression refers to ongoing changes in the skin — often in the absence of consistent treatment — including:

• Loss or fusion of vulval structures
• Tightening of the vaginal opening
• Scarring or white plaques
• Reduced elasticity or comfort

While these changes can be distressing, they’re not a life sentence. They can often be slowed, managed, and in some cases, improved.

You’re Not Too Late

One of the most heartbreaking things I hear is: “I wish I’d come sooner.” But here’s the truth — starting now is still powerful. Whether it’s been 6 months or 6 years since your diagnosis, positive change is still possible.

What to Do If LS Has Progressed

1. Reassess your treatment plan
   You may need a period of more intensive topical steroid use or a new formulation. Sometimes what worked before needs adjusting.
2. Explore regenerative treatments
   Treatments like the O Shot® and Morpheus8V can help improve skin quality, stimulate healing, and restore comfort — even in advanced cases.
3. Request a specialist referral
   If you’re not under the care of a vulval dermatologist or gynaecologist, ask to be referred. They can assess structural changes, offer biopsies if needed, and guide long-term care.
4. Address sexual discomfort with support
   Sexual pain doesn’t have to be permanent. Psychosexual therapy, pelvic floor physio, and gentle reintroduction to intimacy can all make a difference.
5. Take care of your mental health
   Progression can feel like a loss — of ease, confidence, or identity. It’s okay to grieve. It’s also okay to reach out for emotional support.

Surgical Options (When Needed)

In rare cases, structural changes — like complete fusion of the labia or severe narrowing of the vaginal opening — may require minor surgical correction. These procedures are not cosmetic. They’re functional and aimed at improving quality of life.

Surgery is not a failure. It’s simply another tool to help you feel more comfortable in your own body.

You Are More Than Your Skin

Even if LS has changed your body, it hasn’t changed you. You are still whole. You are still worthy of intimacy, joy, and peace. There is no shame in seeking support, exploring treatments, or starting again.

Progression isn’t the end of your story. It’s just another chapter — one you don’t have to write alone.

In the next chapter, we’ll explore the topic of vulval cancer and VIN — with facts, not fear — so you feel empowered, not overwhelmed.

Chapter 27: Vulval Cancer and VIN – What You Should Know (Not Fear)

Let’s start with a deep breath.

Talking about cancer is never easy, especially when you’re already living with a chronic condition like Lichen Sclerosus. But knowledge isn’t just power — it’s reassurance. The goal of this chapter isn’t to frighten you, but to equip you with facts, so you feel prepared, not panicked.

First, the Good News

Vulval cancer is rare. And when it’s caught early, it’s highly treatable. Regular monitoring, consistent treatment, and simply being aware of what’s normal for your body significantly reduce the risk.

What Is Vulval Intraepithelial Neoplasia (VIN)?

VIN is a precancerous condition where cells in the vulval skin begin to change in a way that could (but doesn’t always) develop into cancer. There are two main types:

• uVIN (usual type) – often linked to HPV (human papillomavirus)
• dVIN (differentiated type) – more commonly associated with Lichen Sclerosus

dVIN is rarer but carries a higher risk of progression to vulval cancer. This is why regular check-ups and long-term management of LS are so important.

What Is Vulval Cancer?

Vulval cancer is a type of skin cancer affecting the external genitalia. It usually develops slowly and is often preceded by VIN. Common signs include:

• A persistent lump or ulcer that doesn’t heal
• Changes in the colour or texture of the skin
• Bleeding or discharge unrelated to menstruation
• Pain, itching, or burning that feels different than a flare-up

Should You Be Worried?

Living with LS does slightly increase your risk of vulval cancer — especially if the condition is not treated or monitored. But this does not mean you’ll get cancer.

With proper care, your risk remains low.

What You Can Do

Here’s how to stay empowered, not afraid:

1. Stick to your treatment plan
   Using topical steroids as prescribed helps reduce inflammation and cellular changes that may lead to dVIN.
2. Check your skin monthly
   Use a mirror in good lighting. Look for new patches, ulcers, thickening, colour changes, or anything that doesn’t feel right.
3. See your specialist regularly
   Yearly (or more frequent) vulval reviews allow professionals to catch any changes early. Don’t hesitate to request a biopsy if something looks or feels new.
4. Know when to ask questions
   If a lesion persists for more than a few weeks, bleeds, or looks unusual — get it checked.
5. Don’t skip emotional support
   Cancer anxiety is real. Whether you’ve known someone affected, or you’re facing your own fears, it’s okay to talk about it.

If You’re Diagnosed With VIN or Vulval Cancer

You are not alone. And you are not powerless.

Treatment may include topical therapies, surgical excision, or laser therapy — often done with the goal of preserving function and comfort. Most women with early VIN or vulval cancer recover well.

Support is available through:

• Gynaecological cancer nurses
• Counsellors or psychosexual therapists
• LS support groups
• Holistic wellness practitioners

Let Knowledge Be Your Strength

It’s normal to feel fear when reading about cancer. But try to let that fear guide you toward awareness, not avoidance.

You are already doing something powerful by reading this book, learning about your condition, and caring for your body. Keep going. Keep asking questions. Keep looking after yourself.

In the next chapter, we’ll explore how LS may behave after menopause — and how to continue living confidently through every stage of life.

Chapter 28: LS After Menopause – A New Chapter, Not the End

Menopause marks a significant shift in a woman’s body — and for those living with Lichen Sclerosus, it can bring new challenges as well as new opportunities for healing. While declining oestrogen levels can intensify LS symptoms, this stage of life can also be a turning point: a time for reclaiming control, embracing self-care, and finding comfort in your own skin again.

What Changes After Menopause?

After menopause, the body produces far less oestrogen — the hormone that helps keep vulval tissue supple, thick, and well-lubricated. This natural shift can:

• Increase dryness and sensitivity
• Reduce tissue resilience
• Heighten the risk of flare-ups
• Cause symptoms that overlap with LS, like soreness or discomfort during sex

It’s common for LS to first appear, worsen, or return post-menopause. But this doesn’t mean your body is giving up on you — it simply needs different support.

The Importance of Ongoing Treatment

Postmenopausal LS still responds well to topical steroids. In fact, continued use of maintenance treatment is often essential to prevent flare-ups and long-term structural changes.

It’s also a good time to explore:

• Vaginal oestrogen therapy – to restore moisture and tissue strength
• Moisturisers and emollients – for daily comfort and barrier protection
• Regenerative options – like the O Shot® and Morpheus8V, which stimulate tissue healing

With the right care, many women find their symptoms become more stable after menopause.

Sex and Intimacy After Menopause

Changes in desire, comfort, and confidence are all common — but they don’t mean sex is over.

If you experience:

• Pain or tightness during intercourse
• Loss of sensation or libido
• Anxiety around intimacy

…you’re not alone. These changes are physiological, not personal. Support is available through:

• Vaginal oestrogen
• Lubricants and moisturisers
• Psychosexual therapy
• Regenerative treatments to rebuild sensitivity and reduce pain

This stage of life can be a chance to rediscover intimacy on your own terms — without pressure or shame.

Mental and Emotional Health

Postmenopausal life is often a time of reflection and redefinition. Some women feel liberated. Others may grieve the changes in their body or identity. Both responses are valid.

LS may have changed your skin — but it hasn’t changed your strength. Every act of care you give your body is a reminder that you are still worthy of peace, comfort, and joy.

What to Watch For

Even in stable cases, postmenopausal women with LS should:

• Check their vulval skin monthly for any new thickening, ulcers, or colour changes
• See a specialist yearly, or more often if needed
• Report any persistent itching or new lesions that don’t improve with treatment

Living Fully, Now and Always

Menopause doesn’t mark the end of vitality. It’s simply a new phase — one where your needs shift, but your power remains. Lichen Sclerosus may be part of your story, but it’s not the whole book.

In the next chapter, we’ll talk about how loved ones can support someone living with LS — and how to invite care without losing your sense of autonomy.

Chapter 29: Supporting Someone with LS – A Guide for Partners and Carers

When someone you love is living with Lichen Sclerosus, it can be hard to know how to help. You may not have heard of the condition before. You might feel helpless watching them struggle. Or you might be worried about saying or doing the wrong thing.

This chapter is here to support you — the partner, friend, family member, or caregiver — so you can show up with empathy, compassion, and understanding. Because the truth is, support doesn’t always mean fixing. Sometimes it means listening, learning, and being present.

What LS Feels Like (From the Inside)

To understand how to help, it helps to understand what LS can feel like for the person living with it:

• Chronic discomfort (itching, burning, soreness)
• Embarrassment or shame about their body
• Fear of flare-ups, pain, or progression
• Anxiety around intimacy or medical exams
• Frustration with being dismissed or misdiagnosed

LS is not just a physical condition — it affects confidence, sexuality, mental health, and relationships.

Ways You Can Offer Meaningful Support

1. Learn About the Condition
   Take the time to read reliable resources (like this book). Understanding the basics shows you care — and helps reduce the emotional load on your loved one to explain everything.
2. Ask What They Need — Then Listen
   Try questions like:

• “Is there anything that makes things easier for you during a flare-up?”
• “Would you like to talk about it, or just have company right now?”
• “Is it okay if I ask questions, or would you prefer space today?”

Let them lead. Everyone’s comfort levels are different.

3. Support Without Pressure
   Your loved one may need time to navigate how LS affects their body, sexuality, and confidence. Respect their pace. Never pressure them into intimacy, activities, or conversations they’re not ready for.
4. Be Patient During Flare-Ups
   Offer practical help — like making a soothing bath, picking up prescriptions, or simply sitting with them in quiet support. A flare-up isn’t their fault, and it’s not personal.
5. Acknowledge, Don’t Minimise
   Instead of saying, “It’s not that bad” or “At least it’s not cancer,” try:

• “That sounds so hard — I’m here with you.”
• “I can’t imagine how uncomfortable that must feel. What would help right now?”

Empathy builds trust. Dismissiveness erodes it.

6. Encourage Medical Support Without Pushing
   If your loved one is struggling to seek treatment or follow up with doctors, gently offer support:

• “Would it help if I came with you to the appointment?”
• “You deserve relief — maybe it’s time for another opinion.”

Supporting Intimacy

If you’re a romantic or sexual partner:

• Prioritise communication over assumptions
• Be open to non-sexual closeness (touch, cuddling, shared rituals)
• Explore new ways to experience pleasure together — without pressure or shame

LS may change how intimacy looks, but it doesn’t have to eliminate it.

Taking Care of Yourself Too

Caring for someone with a chronic condition can be emotionally taxing. Make sure you:

• Have space to express your own feelings
• Seek support if needed (therapy, peer groups, or reading)
• Respect your own limits while offering care

Support doesn’t mean self-sacrifice. It means compassion — for both of you.

You Make a Difference

Your presence, patience, and willingness to learn mean more than you probably realise. You don’t have to get it perfect. Just showing up with an open heart is enough.

In the next and final chapter, we’ll bring this journey full circle — with a letter of hope for everyone living with Lichen Sclerosus.

Chapter 30: You Are More Than Your Diagnosis – A Letter of Hope

Dear Reader,

If you’ve made it this far, thank you. For your time, your presence, and most of all — your courage. Reading a book like this isn’t always easy. It means facing hard truths, unravelling silent grief, and confronting the reality of life with a chronic condition. But it also means something else: hope. Because every page you’ve turned has been an act of self-care. An act of defiance against shame. A step towards healing.

Lichen Sclerosus may be part of your story — but it does not define you. You are not a diagnosis. You are not your flare-ups, your creams, or your discomfort. You are so much more.

You are resilience. You are kindness. You are all the moments you kept going, even when it was hard. You are the breath you took when pain made it hard to sleep. You are the voice that asked for help, the hand that applied the cream even when you were tired, the spirit that refused to give up.

You Deserve More Than Survival

You deserve comfort. Pleasure. Safety. Joy. You deserve to look at your body with gentleness — not judgment. To speak about your symptoms without shame. To feel seen, heard, and respected in every consultation.

This isn’t just about managing symptoms. It’s about reclaiming the right to live fully — in a body that may be healing, changing, or imperfect, but is still yours.

You Are Not Alone

There are so many others walking this path beside you. Women who once felt invisible but are now finding strength in their voice. Women who once whispered about LS and now speak openly, helping others feel less alone. You are part of that community now.

Every time you share your story, you light the way for someone else.

Healing Is Not Linear

You will have good days and hard days. There may be setbacks. But every act of care — from a soothing bath to a kind word to yourself — is progress. Healing is not a destination. It’s a relationship with yourself that deepens with time.

So please, keep going. Keep advocating for yourself. Keep learning, asking, resting, rising.

And when you doubt, return to this truth:
You are more than your diagnosis. You are whole. You are worthy. You are loved.

With compassion and admiration,

Dr Shirin Lakhani
Medical Director, Elite Aesthetics

If you have any questions or concerns about LS, we’re here to help.

Reach out for advice and support, your well-being matters to us.

Book your complimentary 15-minute consultation today:

• 📱 01322 381 205
• 💬 Chat on WhatsApp
• ✉️ info@elite-aesthetics.co.uk