Microablative fractional radiofrequency as a therapeutic option for vulvar lichen sclerosus: a pilot study

Abstract

OBJECTIVES: To assess the clinical response to and the histomorphometric effects of microablative fractional radiofrequency (MFR) in women with symptomatic vulvar lichen sclerosus (VLS). METHODS: This was a pilot study on the use of MFR for the treatment of VLS. Upon recruitment and at each treatment session, all participants were examined and each of their symptoms were rated on a visual analog scale. After the procedure, the participants completed a satisfaction questionnaire. We compared the morphometric findings of vulvar biopsies performed at enrollment and after the last treatment session. The participants were divided into three groups according to previous treatment with corticosteroids: G1, no previous treatment; G2, treated for up to 5 years; and G3, treated for >5 years. RESULTS: This study included 26 women. After two to three sessions, most participants in all groups became either “asymptomatic” or “much better” than before treatment and were “very satisfied” or “satisfied” with the intervention. Pruritus and burning sensation were the most frequently reported symptoms. Nearly 40% of the participants in all groups reported complete remission of symptoms. The improvement was rated as moderate or higher by 80%, 76%, and 66% of the women in groups 1, 2, and 3, respectively. The improvement of symptoms persisted for 11 months (range, 7-16 months), on average, after the treatment. Type III collagen concentration significantly increased and was associated with important symptom improvement. Tissue trophism and vascularization also increased but did not reach statistical significance, probably because of the small number of cases. CONCLUSIONS: MFR may be an effective and safe treatment for symptomatic VLS.

Clinical study on multi-focused laser in the treatment of vulvar lichen sclerosus

“…Radiofrequency is a type of high-frequency electromagnetic wave that has been widely used to treat tumors in the brain, liver, breast, thyroid, and other tissues in clinical practice. In recent years, its use in the of uterine leiomyomas of less than 5 cm has received satisfactory results ( 13 ). Electromagnetic waves act on the dermis and exert a thermal effect, resulting in vasodilation, accelerating blood flow, and increasing the permeability of the vascular endothelial cell membrane, improving the nutritional status of microvessels and nerve endings in the dermis so that the nerve terminals are no longer abnormally excited, and pruritus symptoms do not appear in the vulva.…”

Use of radiofrequency for the treatment of urinary incontinence in women: a systematic review

“…RF therapy has been widely used to treat dermatological and gynecological conditions. The microablative fractional-type RF, which is used to improve skin, vaginal, and vulvar mucosal trophism 19 , results in promising responses in neocollagenesis and neoelastinogenesis 20,21 , consequently leading to clinical improvement. Thus, it is observed that this therapy provides a less invasive treatment for women with SUI and MUI [11][12][13][14][15][16] .…”

Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects

“…The potential benefits of micro-ablative fractional radiofrequency (MFR) on epithelial trophism and symptom improvement have been assessed in VLS patients [217]. After two to three sessions of MFR, most participants reported an improvement in symptoms, which persisted for about 11 months (range: 7-16 months) after the treatment.…”