PRP Treatments for Lichen sclerosus
Lichen sclerosus is relatively rare skin condition of the external genitals (vulva) of women that can create uncomfortable patchy, white skin that may be thinner than normal and can potentially tear, bleed and cause much discomfort. Lichen Sclerosus causes vulvar itching, pain, and burning as well as scarring of the vulva, which can cause extreme pain and sexual dysfunction. It usually affects the genitals and anus in people with the condition. Between 4 to 6% of all women diagnosed with Lichen Sclerosus will develop cancer of the vulva, so this is a serious condition. Postmenopausal women are at the highest risk, yet anyone can be diagnosed.
Most doctors will suggest treatments of the area with creams and ointments which could help return the skin to a more normal appearance and may help reduce the tendency for scarification of the area. This condition tends to recur which results in the need for long term treatment plans and follow-up care. Unfortunately, lichen sclerosus usually does not improve without medical intervention. Clinical trials are starting to show that Platelet Rich Plasma injections for lichen sclerosus can help reduce the unwanted signs and symptoms of the disease and allow women to live a normal life again. At NovaGenix in Jupiter, Florida we can help patients suffering from Lichen Sclerosus with regenerative medicine treatments like PRP and Stem Cell therapy.
Platelet-rich plasma (PRP) injections for lichens sclerosus
PRP or platelet rich plasma, is a platelet concentrate above normal baseline levels that can help speed up tissue and cellular healing, without the risks of serious side effects due to the fact that a patient is using their own blood. It’s currently being successfully implemented in a very wide variety of medical conditions such as chronic knee pain and acute injuries, muscle injuries, ligament and tendon injuries, as well as in a variety of cosmetic procedures such as facial rejuvenation and PRP for hair loss. The reason that PRP works is because of its high concentration of platelets, growth factors and cytokines, which are the bodies proteins and regenerative healing cells that help with wound healing. It’s also important to note that the majority of published studies have shown that PRP injections pose minimal risks of any scar tissue formation or negative side effects, making it not only highly effective, but the safest treatment option as well.
There have been several clinical studies performed and all have shown excellent results with using platelet-rich plasma (PRP) injections to treat lichen sclerosus. In one study, a 38-year-old premenopausal woman had received PRP injections for lichen sclerosus and was almost completely symptom-free in just one month after the injections. The diagnosis of lichens sclerosus had been confirmed histologically and her symptoms had been documented by using the ICIQ-VS, known as the ICIQ Vaginal Symptoms Questionnaire as well as the (FSFI) or Female Sexual Function Index questionnaire. The platelet rich plasma was prepared from the patient’s own blood and was administered twice over a two-month period. A physical exam of the affected area had shown that the epidermis was nearly normal after only one injection and the “upper dermal cellularity had been restored”. The patient was symptom-free and both her ICIQ-VS and her FSFI scores had improved significantly.
The PRP Procedure for Lichen Sclerosus
At NovaGenix we use blood concentrating devices and PRP kits to ensure the maximum number of platelets that we can harvest from a sample. We take approximately 50 to 100 cc’s of autologous blood from a venous sample from the patient depending on the total amount of PRP needed for the patient. Before injecting the PRP, a numbing cream may be applied to the vulva, or another form of local anesthesia may be administered, typically lidocaine. After the patient is comfortable the PRP will be injected sub-dermally with a 27-30-gauge needle in the affected area. Often, we administer PRP in an area surrounding the affected region as well to ensure maximum coverage and benefits. Some patients will even opt to use stem cell injections as well, which are more expensive but highly effective when used with PRP.
Therapy is recommended to be repeated two months after the 1st procedure. Studies have shown that a second treatment will not only alleviate the symptoms but prevent them from reoccurring. In previous medical studies and clinical trials, vulvar appearance and function will dramatically improve after just one treatment. In trials performed, patients receiving PRP injections for lichen sclerosus had shown that the skin was nearly normal and “upper dermal cellularity had been restored” within weeks of platelet rich plasma treatment. The patient no longer had the discomfort and pain associated with lichen sclerosus and were symptom-free. Patients report that their sex drive returned after PRP, and their quality of life increased dramatically. In clinical studies this has been confirmed by measuring pre and post ICIQ-VS scores, sexual matters scores and quality-of-life scores.
How Long Does the Procedure Take?
PRP for Lichen Sclerosus is a relatively easy procedure that should take about an hour to an hour and a half to perform. This includes, drawing the blood, preparing the patient and administering the PRP injections. The patient will be able to drive home afterwards with little to no discomfort and will be able to resume normal activities almost immediately after the visit.
To learn more about treatment options, please call 561-277-8260 to speak to one of our medical professionals and to schedule a consultation at our clinic located at 609 North Hepburn Ave Suite 106, Jupiter, Florida 33458 or email us at [email protected]
Symptoms of Lichen sclerosus
In some cases, people with mild lichen sclerosus might experience few or no signs or symptoms. For people experiencing symptoms of lichen sclerosus, it usually affects their skin in and around their genital and anal region but may it could in some cases also affect skin on their upper body, arms and breasts.
Some symptoms of Lichen sclerosus may include:
- Redness in the area
- Pruritus or Itching, which often may be severe
- Pain and discomfort
- White patches on your skin that appear smooth
- Wrinkled and blotchy patches in the area
- The skin may easily tear and bleed
- In some more severe cases, heavier bleeding, blister formations and development of ulcerated sores
- Sex becomes painful
When you should see your doctor
If you have signs and symptoms similar to that of lichen sclerosus, you should visit your doctor for diagnosis. Unfortunately, there are not many physicians who are knowledgeable in this area, so finding a physician who can help may be difficult and frustrating. For patients who have been diagnosed with lichen sclerosus, it’s important to regularly see your doctor every six to 12 months and be checked for any changes or side effects from medication of treatments. The good news is that there are few, if any potential side effects to platelet rich plasma therapy, as you are utilizing your own blood for therapy. There are very few doctors who perform PRP for Lichen Sclerosus so finding a physician experienced with treating this condition may be difficult, which is why traveling may be beneficial to receive proper medical care.
Causes of lichen sclerosus
There is no known cause of lichen sclerosus. Hormonal imbalances or an overactive immune system are suspected causes but there is no certainty. Areas on the skin that had suffered damage may be more susceptible to the signs and symptoms of lichens at that particular spot. The good news is that Lichen sclerosus is not contagious and won’t be spread to a partner through sexual contact.
Lichen sclerosus frequently occurs in postmenopausal women which is why hormone imbalance may be a suspected cause, but it can also in men and children which is what makes pinpointing the exact cause so frustrating. In women, lichen sclerosus typically involves the vulva and surrounding vaginal area. In males, those who are uncircumcised are at a much higher risk, because Lichens usually affects the foreskin.
For patients who suffer from lichen sclerosus, there are many complications which often include urinary retention, painful sexual intercourse and an increased risk of squamous cell carcinoma in the area affected by the disease.
Diagnosis of Lichen Sclerosus
Lichen sclerosus diagnosis from a physician is usually based on a few factors:
- The doctor’s physical examination of the area
- A biopsy for examination under a microscope. This is where they remove a small portion of the affected tissue for analysis.
Because the condition is something most PCP’s are unfamiliar with, they may refer you to a dermatologist or an OBGYN who may have more familiarity with the condition.
Treatment of lichen sclerosus
Treatment of lichen sclerosus may help reduce the itching as well as improve the appearance of the skin and hopefully decrease scarring and tissue disfigurement. Because recurrence is extremely common with lichen sclerosus, treatment may be ongoing as it typically will not go away on its own. There are many options that a physician may try to help with the condition. As PRP is a relatively new treatment option for Lichen, many medical professionals are not familiar with or capable of utilizing this option. The method that most doctors will resort to using is steroid creams and gels to treat the disease, but this is not always effective. Many patients will confirm that they experience little to no relief on these medications.
Corticosteroids for Lichen Sclerosus
Commonly prescribed for lichen sclerosus, corticosteroid ointments, gels or creams may help reduce the inflammation and help alleviate symptoms. Often, cortisone creams or ointments will be applied to the affected area twice daily. After a few weeks, the physician will most likely recommend that you reduce application of the medications to bi-weekly week to prevent any future recurrence. Corticosteroids may work well for some patients and not at all for others. One of the potential side effects is further thinning of the skin which is a problem that limits these medications as a long-term solution. As well as the thinning of the skin, corticosteroid creams can also lead to fungal infections, and lowering of the immune system, so this treatment is not always the best solution. Because of the efficacy and safety of PRP, it’s a much better option that corticosteroids.