Emerging treatments
Fractional carbon dioxide laser
Some small case reports show promise for the use of fractional carbon dioxide laser in certain patients with lichen sclerosus (LS) as an adjunct therapy.[97][98] One study found that patients treated with fractionated carbon dioxide laser monotherapy showed significant improvement in subjective symptoms and objective measures compared with patients treated with topical clobetasol, without serious safety or adverse events at 6 months.[99] However, one randomized controlled trial did not show a statistically significant difference in effectiveness of fractional carbon dioxide as a monotherapy compared with placebo.[100]
Fat grafting
One prospective cohort study of 33 women showed that fat grafting via lipotransfer may improve fibrosis and scarring associated with LS.[101]
Topical Janus kinase (JAK) inhibitors
Topical JAK inhibitors are approved for use in several countries to treat inflammatory dermatologic conditions (e.g., atopic dermatitis, vitiligo, alopecia areata). Ongoing trials are evaluating topical JAK inhibitors as a potential therapy for LS. One study of 10 patients with LS treated with topical abrocitinib for 4 months reported disease control in all patients.[102]
Adalimumab
Adalimumab, a systemic tumor necrosis factor (TNF)-alpha inhibitor, has been used with success in two cases of severe LS; one participant showed modest clinical improvement with no significant improvement in quality-of-life measures, and the second showed a significant improvement in both clinical and quality-of-life measures.[103]
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