ArticleLasers in medical science2026
Use of fractional and microablative CO2 laser in cases of vulvar lichen sclerosus: a clinical-histological analysis.
Article in Lasers in medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the clinical and histological response of patients with vulvar lichen sclerosus (VLS) following fractional and microablative CO₂ laser treatment.
methodsThis interventional clinical study included 14 patients diagnosed with VLS. The participants underwent three CO₂ laser sessions with a monthly interval. Clinical assessments and biopsies were performed at baseline and six weeks after the final session. Primary outcomes were improvement in symptoms (Visual Analog Scale - VAS) and clinical signs (Global Aesthetic Improvement Scale - GAIS), associated with histological regression. Secondary outcomes included quality of life (Skindex-29) and specific histological parameters, such as hyperkeratosis, dermal elastic fibers, and type I/III collagen ratio.
resultsAll patients reported vulvar pruritus at baseline. After treatment, 50% became asymptomatic (p = 0.016), with a reduction in mean VAS score from 8 to 1 (p = 0.016). Burning sensation, present in 71.4% at baseline, decreased to 28.5% at follow-up (p = 0.031), with VAS scores declining from 6 to 0 (p = 0.008). Clinical improvement assessed by GAIS was observed in up to 64.3% of patients, with high inter-rater agreement (ICC = 0.855). Histological regression occurred in 42.9% of cases (p = 0.031). Quality of life significantly improved across all Skindex-29 domains (p < 0.05). There was a reduction in hyperkeratosis (p = 0.032) and in type I/III collagen ratio (p = 0.022), along with reappearance of dermal elastic fibers (p = 0.024).
conclusionCO₂ laser therapy reduced symptoms and improved clinical, histological, and quality-of-life outcomes, suggesting therapeutic potential for VLS. Larger controlled studies are warranted.
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