Lichen Sclerosus — Men & Women

Lichen Sclerosus

Lichen sclerosus is one of the most underdiagnosed and undertreated conditions we see. Most patients have been living with it for years before receiving a correct diagnosis — and many more years before finding treatment that actually addresses the tissue rather than just managing symptoms. PRP injection is one of the most promising regenerative approaches currently available for lichen sclerosus, with a growing body of published evidence and meaningful patient outcomes.

What It Is

Lichen sclerosus — the honest explanation

Lichen sclerosus is a chronic inflammatory skin condition that causes thinning, whitening, and scarring of genital and perianal tissue. In women it primarily affects the vulva and perianal area. In men it affects the foreskin and glans of the penis. It is not contagious, not sexually transmitted, and not caused by anything the patient did or did not do.

Left untreated, lichen sclerosus causes progressive architectural changes — fusion of the labia, narrowing of the vaginal opening in women, and phimosis (tightening of the foreskin) in men. In a small percentage of cases, long-standing untreated lichen sclerosus is associated with an increased risk of squamous cell carcinoma. This is why diagnosis and ongoing management matter.

The standard first-line treatment is high-potency topical corticosteroid (clobetasol). This manages symptoms and slows progression but does not reverse existing damage or regenerate tissue. PRP injection addresses the regenerative component that steroids do not.

Symptoms

What patients describe

Intense itching — often worse at night
White, patchy, or shiny skin in the genital area
Skin that tears or bleeds easily
Painful intercourse or pain with any penetration
Burning or soreness
Scarring or skin fusion (advanced)
Narrowing of the vaginal opening (women)
Tightening of the foreskin — phimosis (men)
Difficulty urinating (men — advanced)
Years of misdiagnosis as yeast infection or eczema

The Treatment

PRP for lichen sclerosus — what the evidence shows

Platelet-rich plasma (PRP) contains growth factors — PDGF, TGF-β, VEGF, EGF — that stimulate tissue regeneration, reduce inflammation, promote collagen remodeling, and improve blood flow in the treated area. These are exactly the mechanisms that lichen sclerosus disrupts. PRP does not replace steroid therapy — it works alongside it to address what steroids cannot: actual tissue regeneration.

Published Evidence Multiple published case series and pilot studies have shown meaningful improvement in lichen sclerosus symptoms following PRP injection. A study by Goldstein et al. (Journal of Sexual Medicine) reported significant improvement in FSFI scores, symptom severity, and tissue appearance following PRP injection in women with vulvar lichen sclerosus. Histological analysis in some studies has confirmed actual tissue regeneration — increased collagen density, improved vascularity, and reduced inflammatory infiltrate — rather than symptom masking alone. Research is ongoing and larger controlled trials are in progress. Shannon will give you an honest picture of what the evidence currently supports and what remains to be proven.

The O-Shot® protocol — PRP injected into clitoral and anterior vaginal wall tissue — is the specific injection method used for women with lichen sclerosus at Revitalize Your Health. Shannon holds Canadian Clinical Instructor certification for this procedure under Dr. Charles Runels. Verify at oshot.info.

Men and Lichen Sclerosus

This condition affects men too

Lichen sclerosus in men — sometimes called balanitis xerotica obliterans (BXO) — is significantly underdiagnosed. It affects the foreskin and glans, causing whitening, tightening, and eventually phimosis. Men are rarely told PRP is an option. It is. PRP injection into the affected tissue uses the same regenerative mechanism as in women and is performed using the P-Shot® protocol adapted for this indication.

If you are a man who has been told you need circumcision due to phimosis caused by lichen sclerosus, PRP is worth discussing before surgery. It does not replace surgical intervention in advanced cases, but in earlier-stage disease it may reduce the need for it.

What to Expect

Treatment timeline

Sessions

3 treatments recommended

Spacing

4–6 weeks apart

Downtime

None

Initial Response

4–8 weeks after first treatment

Used Alongside

Topical steroid therapy (not replacing it)

Maintenance

Annually or as needed

Candidacy

Is PRP appropriate for your situation?

Likely appropriate

  • Confirmed lichen sclerosus diagnosis
  • Symptoms not fully controlled by steroid alone
  • Wanting to address tissue quality not just symptoms
  • Early to moderate stage disease
  • Men with phimosis from LS — pre-surgical discussion

Discuss first

  • Active infection at treatment site
  • Active cancer or chemotherapy
  • Pregnancy or breastfeeding
  • Unconfirmed diagnosis — assessment required
  • Very advanced scarring — realistic expectations needed

Shannon will not take your money if she does not believe treatment is likely to help your specific situation. That is a standing commitment of this clinic.

You have been managing this long enough. There are options.

A free Discovery Conversation is the first step. No exam, no obligation — just an honest conversation about what is possible for your situation.

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Individual results vary and are not guaranteed. PRP for lichen sclerosus is not a Health Canada-approved treatment for this specific indication. All procedures at Revitalize Your Health Inc. are performed under medical delegation from our Medical Director. PRP does not replace topical steroid therapy and ongoing dermatological or gynecological monitoring remains important.
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