What procedures is best for lichen sclerosis? Vaginal rejuvenation procedure that is? Is Morpheus 8-V a choice?

Question

I am 53, healthy and 3 years into menopause. I am looking to treat the VLS but don’t want to pick the wrong treatment.

Anna Chacon, MD, FAAD · Answer

Lichen sclerosus is a chronic inflammatory skin condition, and while it's understandable to look for procedures that may improve symptoms, it's important to know that vaginal rejuvenation procedures are not considered first-line treatment for this condition.

The treatment with the strongest medical evidence remains high-potency topical corticosteroids, such as clobetasol ointment. These medications help reduce inflammation, relieve itching, minimize scarring, and lower the risk of long-term complications. Many women also benefit from regular use of moisturizers or barrier ointments to help protect the delicate vulvar skin.

Regarding Morpheus8 V, there is currently limited scientific evidence supporting its use specifically for lichen sclerosus. While radiofrequency microneedling is designed to stimulate collagen remodeling and improve tissue quality, lichen sclerosus is an autoimmune inflammatory disorder rather than simply an issue of aging or skin laxity. For that reason, Morpheus8 V should not replace established medical therapy.

Some energy-based devices—including fractional CO₂ lasers and radiofrequency treatments—have shown promising early results in small studies for selected patients with persistent symptoms. However, the available research is still limited, and these procedures are generally considered adjunctive or investigational rather than standard treatment. More long-term studies are needed to determine their safety and effectiveness in managing lichen sclerosus.

Because you are 53 years old and three years into menopause, it's also possible that genitourinary syndrome of menopause (GSM) is contributing to symptoms such as dryness, irritation, discomfort, or painful intercourse. In some women, treating menopausal changes with localized vaginal estrogen (when appropriate) can significantly improve tissue health, although it does not treat the underlying lichen sclerosus itself.

If your lichen sclerosus is well controlled with medical therapy but you're interested in improving tissue quality or symptoms that persist despite treatment, discussing energy-based procedures with a clinician who has specific experience managing vulvar disorders may be worthwhile. The key is to ensure the underlying inflammation is controlled first before considering any procedural intervention.

Overall, I would not consider Morpheus8 V the primary treatment for lichen sclerosus. The best outcomes are generally achieved by controlling the disease with proven medical therapy first, then considering carefully selected adjunctive treatments if symptoms remain despite appropriate management.

Burcak Tok, MD · Answer

According to my treatment experience in my own clinic, the best vulvar lichen sclerosis treatment is with sessions where Monalisa laser and PRP treatment are applied together.

Sue Kafali, MD · Answer

Lichen sclerosis is a chronic skin condition without a known cure. However, there are some effective treatments available that can slow its progression and reduce symptoms, allowing individuals to continue with their daily activities more comfortably. I often recommend treatments like PRP (Platelet-Rich Plasma) therapy, CO2 laser therapy, and Morpheus 8V, can help strengthen and rejuvenate the affected skin. Additionally, the daily application of a hyaluronic acid moisturizer can also help maintain skin hydration and elasticity. The frequency of these treatments may vary based on the condition's severity and the individual's age. Estrogen therapy could also help. Hope this helps and best of luck!

Gary J. Alter, MD · Answer

There are many treatments such as laser and now stem cell injections including nonfat. Fat has a lot of healing stem cells. With nanofat, fat is liposuctioned then liquified, which saves the stem cells. The liquid fat with stem cells is the injected into the areas of LS. This can result is significant improvement in the LS.

Gary J. Alter, M.D.

Beverly HIlls, CA - Manhattan, NY

Gary J. Alter, M.D.

Beverly HIlls, CA -  Manhattan, NY

Oscar A. Aguirre, MD, FPMRS · Answer

At 53 and postmenopausal for 3 years the Morpheus 8V could be used within your vagina to help with vaginal dryness/sexual discomfort, but also on the vulva affected by your Lichen Sclerosus. This is a great option for your situation. You should have a consultation with a gynecologist experienced in vulvar and vaginal rejuvenation. Unfortunately, the steroid medical treatments for Lichen only help with initial symptoms but do NOT mitigate the disease process. Bipolar radiofrequency and microneedling with Morpheus in combination with PRP actually modify the condition and hopefully reverse the morphologic changes that have occurred.
Go to the link below to see hundreds of before and after photos where you will find many examples that may be similar to you. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your anatomy, expectations and concerns. Women from all over the world travel to my Center for their Intimate Makeover.
Best of luck,

Magnus Murphy, MD · Answer

There are many studies showing that CO2 laser as well as Erbium laser give excellent results. There are no good scientific studies on Morpheus that I'm aware of regarding Lichen Sclerosis. I searched the most widely used medical scientific database (Pubmed) for LS and Morpheus and came up empty, which is usually a good indication of where the evidence lies, or is lacking. In contrast, the search for laser, yielded a ton of studies. In my clinic we've had excellent results using a combination of Erbium and NDYag laser, as well as PRP. The treatment is well tolerated and takes about an hour. An average of three sessions are necessary to start, and then maintenance is planned around 6-12 months.

Cynthia McNally, MD · Answer

I am a gynecologist and I have been doing the Mona LIsa Touch for my patients with Lichen Sclerosis for 3 years. I was hoping it would replace topical steroids (the gold standard) and it does not. However, the combination of the MLT with topical steroids seems to work better than steroids alone. I have had seen good results.

What procedures is best for lichen sclerosis? Vaginal rejuvenation procedure that is? Is Morpheus 8-V a choice?

Answers (7)

More Vaginal Rejuvenation Questions

Can I have femilift or thermiva treatment done as a virgin?

Will having vaginal rejuvenation surgery actually change how the vagina feels inside during sex?

How to clear up bikini area from shaving breakout? (Photo)

Failed vaginal rejuvenation. Is a further reduction more risky than the original op?

RF or CO2 - which procedure would deliver results and target vaginal laxity, decreased sensation and early posterior prolapse?

Age 22, what are some options for tightening my vagina? (Photos)

WE SEND PRETTY
EMAILS