7.1.4 Lichen sclerosus

ChoiceDrugDosage
1st choiceRegular emollient use

See section 13.2.1

Clobetasol propionate ointment 0.05% (Dermovate®)Dose: Apply once daily, at night, for 4 weeks, then on alternate nights for 4 weeks, and then twice weekly for a further 4 weeks, before review

Prescribing Notes

  • If symptoms recur when the frequency of steroid application is reduced, advise the patient to use the treatment more often until the symptoms resolve. They can then try to reduce the frequency again.
  • A 30g tube of Dermovate® should last at least 12 weeks.
  • About 60% of patients experience complete remission of their symptoms. Others will continue to have flares and should use Dermovate® as required. Most patients with ongoing disease require 30-60g of Dermovate® annually.
  • Moisturisers are helpful for softening and protecting the skin. Ointments are preferred to creams on ano-genital skin. Dermol® may be useful as a soap substitute. Lubricants may also be beneficial if sexual intercourse is painful.