Vulvar atrophy lichen sclerosus, these methods are used to treat

Vulvar atrophy lichen sclerosus is a skin disease that has a great impact on women. The most common manifestations are whitening of the vulva, vulvar itching, and pain during sexual intercourse, which can cause great harm to women. The most important thing in treating this disease is to keep the vulva clean and dry and to receive timely drug treatment.

1. General treatment: Keep the vulva clean and dry, do not use irritating drugs or soaps to clean the vulva, avoid wearing non-breathable synthetic underwear, and do not eat spicy and allergic foods. For those with severe itching symptoms leading to insomnia, sedatives, sleeping pills and anti-allergic drugs can be added.

2. Local drug treatment: The main symptom of this disease is severe itching, and the general recommendation is to use glucocorticoids for treatment, which has a definite effect. Commonly used: 1% to 2% hydrocortisone ointment or 0.025% fluocinolone ointment, 3 to 4 times a day. Generally, skin lesions will return to normal 6 weeks after medication.

It is also believed that topical application of testosterone propionate is the standard method for treating lichen sclerosus, but its efficacy varies from person to person. Some atrophic skin can basically return to normal, some lesions can improve, but there is no obvious effect in some cases. Apply 2% testosterone propionate ointment (200 mg of testosterone propionate added to 10 g of vaseline ointment) and massage slightly. Apply 3 to 4 times a day at first, then change to once a day after 3 weeks of continuous use. Continue to use for 3 weeks, then apply a maintenance dose, once a day or once every 2 days. Generally, treatment should be continued for 3 to 6 months. Within 1 to 2 years after the itching symptoms disappear, the number of medications can be gradually reduced until the maintenance dose is 1 to 2 times a week. If the itching symptoms are more severe, the above-mentioned testosterone propionate preparation can also be mixed with 1% or 2.5% hydrocortisone ointment for application. After the itching is relieved, the itching can be gradually reduced and finally the hydrocortisone ointment can be discontinued. During the treatment, the side effects of testosterone propionate should be closely observed. If masculinization effects such as increased hair growth or clitorise enlargement occur or if the therapeutic effect is poor, the drug should be discontinued and 0.3% progesterone ointment (100 mg of progesterone oil added to 30 g of vaseline ointment) can be used instead, applied 3 times a day. You can also use 0.05% clobetasol ointment, applied twice a day for the first month, then once a day for 2 months, and finally twice a week for 3 months, with a total treatment time of 6 months.

3. Subcutaneous injection: For patients with stubborn itching and ineffective topical medication, triamcinolone acetonide suspension can be injected subcutaneously. After diluting 5 mg of triamcinolone acetonide suspension with 2 ml of normal saline, take a spinal anesthesia puncture needle and inject it subcutaneously below the pubic symphysis, pass through the subcutaneous part of the labia majora to the perineum, slowly withdraw the needle, and inject the suspension into the subcutaneous tissue. The contralateral side is treated in the same way. After injection, massage gently to disperse the suspension. If this method does not achieve the treatment goal and the patient still has itching, he or she can be admitted to the hospital for treatment: pure alcohol is injected subcutaneously under regional anesthesia. This method is to first make vertical and horizontal straight marks every 1 cm on the vulva, and then inject 0.1 to 0.2 ml of pure alcohol subcutaneously at each intersection of the vertical and horizontal lines. After injection, gently massage to diffuse the liquid, but be careful not to inject alcohol into the skin, otherwise it will cause skin necrosis. Although subcutaneous injection of alcohol can completely relieve itching, it cannot relieve the burning sensation of the vulvar skin.