Vulvar lichen sclerosus (VLS) is a chronic, progressive inflammatory condition with significant functional, anatomical, and quality-of-life implications. Although high-potency topical corticosteroids remain the evidence-based cornerstone of treatment, a subset of patients experience persistent symptoms, progressive atrophy, scarring, or intolerance to long-term steroid therapy. In recent years, increasing clinical interest has focused on adjunctive and regenerative approaches aimed not only at symptom control but also at tissue restoration and disease modulation.

This ISAPS Patient Safety Update reviews the current state of the art in the management of VLS, with particular emphasis on regenerative therapies including platelet-rich plasma, adipose-derived treatments (microfat, nanofat, stromal vascular fraction), and energy-based devices.