How to treat vulvar leukoplakia?

Generally, patients with vulvar leukoplakia often experience increased vaginal discharge and unbearable pain. In severe cases, the vulva may even harden, atrophy, and proliferate, which have a certain impact on sexual life and pregnancy. So what are the treatments?

1. Drug treatment: Hormone treatment mainly achieves the purpose of relieving itching and thinning the skin through anti-inflammation, inhibiting connective tissue proliferation, and enhancing skin protein decomposition. Commonly used are glucocorticoid ointments or creams, and androgens or progestins can also be applied topically. Hormone treatment lasts a long time, symptom control is poor, relapse is easy after stopping the drug, and frequent repeated use of the drug is required, and patient compliance is poor. This is one of the treatments for vulvar leukoplakia.

2. Surgical treatment: In the past, it was believed that vulvar white lesions had a 10 to 15 percent malignancy rate, and surgical removal was often recommended. However, the postoperative recurrence rate is as high as 50%, and there is a possibility of recurrence after another surgery. After the operation, scars are easily formed on the diseased vulva, leading to difficulty in sexual intercourse and a decline in the quality of sexual life. Recent studies have also found that the cancer rate of this disease is actually less than 5%. Therefore, surgical treatment is not recommended to be expanded. It is recommended that surgery be limited to patients with severe disease, atypical hyperplasia that is not responsive to drug treatment, or patients with the possibility of malignancy. This is also the treatment for vulvar leukoplakia.

3. Treatment with traditional Chinese medicine: mainly uses external application and flushing of traditional Chinese medicines such as clearing away heat and detoxifying, removing wind and dampness, and promoting blood circulation and removing blood stasis. There are many reports on this type of treatment, but there is still a lack of objective evaluation indicators and long-term follow-up, and the reports on efficacy are inconsistent.