Re-surfacing and other vulvar uses for Laser

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Modest Vaginal tightening

Long-term non-hormonal therapy for vaginal atrophic changes

Intimate Vulvar and peri-anal color bleaching

Intimate vulvar tissue shrinkage

FINALLY: a possibility for real help for Lichen Sclerosis sufferers


Candidates for “Pixillated Fractional CO2 Laser intimate re-surfacing therapy:”

1.      Women who wish to lighten skin color (“bleach”) intimate vulvar and peri-anal skin

2.      Women who wish to re-surface and/or “tighten” lax skin of intimate areas.

3.      Chronic lichen sclerosis sufferers (possibly—not yet evidence-based)

4.      Women who wish modest vaginal tightening

5.      Women who wish non-surgical therapy of mild urinary stress incontinence.


Laser Technology and how it is applied for intimate shrinkage and de-coloration (“bleaching”)

LASER stands for” light amplification by stimulated emission of radiation.” In this specific case, a hand piece connected to the laser generator, sized ~ ¾ inch at the tip, is applied to external skin to be “shrunk,” “bleached,” or “rejuvenated,” and laser emissions penetrate and stimulate the skin to, depending on the power settings in watts and joules, cause shrinkage, “peel” off the surface layer to allow lighter-colored skin to form underneath, or penetrate into the dermis, the deep layer if the skin, to change the collagen and elastin content of this lower layer, resulting in greater resiliency, stretch-ability, or shrinkage, depending on wavelength and power setting.

With a different probe (cigar-shaped “vagina friendly…”), the inside of the vagina may be re-surfaced to stimulate the basal layers of the vaginal mucosa to form more collagen and elastin fibers, allowing it to “stretch” better for women with atrophic changes, to provide a more “trampoline-like” effect for support of the bladder, and provide more “springiness” to help with intra-vaginal tone.

The laser, in a different power-setting mode, may be utilized to treat tissues of the vulvar vestibule, including the inner surfaces of the vulvar vestibule, labial and clitoral hood skin, and potentially the anterior and posterior fourchette in women with lichen sclerosis. In this application, PRP (“platelet-rich plasma”) is sometimes utilized, to provide for a greater chance of successful re-surfacing. This latter use is not yet evidence-based, although initial trials by individual cutting-edge practitioners is promising.

Candidates for Pixillated Fractional CO2 Laser Intimate Resurfacing Therapy:

1.      Women with modest “sagging” and redundancy of the outer lips (labia majora) and perineum. (Women with significant “camel-toe) and significant skin redundancy are probably better candidate for surgical removal of redundant skin…)

2.      Women with localized darkening of “sex skin” (specifically of the vulva/labia majora, perineum, peri-anal areas, where this darkening is of significant “bother” to them.

3.      Possibly women with late-stage lichen sclerosis, who have had little or no success with traditional clobetasol and hormone-based therapies.

4.      Women requesting modest tightening of the vaginal walls and/or non-surgical relief from modest “genuine stress” urinary incontinence. This therapy is perfect for a woman requesting modest tightening as she is now with a partner with a smaller penis, or in-between childbirths, awaiting a surgical repair after her final childbirth.

5.      For women having a surgical tightening procedure (i.e. perineoplasty/vaginoplasty (aka “vaginal rejuvenation”) who also have modest urinary incontinence. In our office, a FemiLift laser bladder support procedure can be added to an in-office surgical perineplasty/vaginoplasty performed under “local” anesthesia to non-invasively treat minimal/modest urinary incontinence at the same sitting.

Article by
Davis OB/GYN