CO 2 Laser Therapy for Treating Lichen Sclerosus: A Prospective Case Series

Abstract

Abstract

Objective:

The goal of this research was to determine the efficacy of fractionated carbon dioxide (CO₂) laser therapy for reducing symptoms of vulvar lichen sclerosus (LS).

Materials and Methods:

This was a prospective case series. The study participants were 23 women with active vulvar LS, confirmed via biopsy, who were abstaining from topical and systemic treatments for at least 4 weeks before enrollment. Subjects received 3–5 treatments with the CO₂ laser, based on symptom improvements. The primary endpoint was a reduction by >50%, as shown by a composite examination-based and symptom-based score at 6 months post-treatment. A secondary endpoint was changes in the Vulvar Quality of Life Questionnaire and patient-supplied Patient Global Impression of Improvement (PGI) scores. A t-test was used to contrast pre-treatment and post-treatment changes in symptoms

Results:

From 2015 to 2020, 23 women participated in the study. The primary endpoint of >50% reduction in the composite symptom score was not significant; p = 0.08, although a reduction was significant at that time point; p = < 0.01. At 12 months a >50% reduction was significant; p = 0.03. Secondary outcomes were remarkable for significant reductions in symptoms that did not meet the >50% threshold at 6 and at 12 months. Mean satisfaction was 2.47 ± 0.61 on a 3-point scale and significantly positive PGI scores through the post-treatment follow-up time point.

Conclusions:

Exploration of fractionated CO ₂ for treating vulvar LS should be continued. (J GYNECOL SURG 39:295)