Red Light Therapy and Vulvar Lichen Sclerosus
What is Vulvar Lichen Sclerosus?
If you’ve never heard of vulvar lichen sclerosus (VLS), consider yourself fortunate.
And if you have heard of it, or you're living with it, you know it’s so much more than a ‘skin condition.’
VLS is a chronic, inflammatory disease that affects the vulva and sometimes even the skin around the anus. It’s often itchy, painful, and, honestly, life-altering. It can also result in fusion or adhesions that can occur when areas of the vulva, such as the labia minora (inner lips), stick to the labia majora (outer lips) and it can impact the clitoral hood.
It can cause burning, pain with intimacy, skin changes, and deep emotional distress. If you have been diagnosed with this condition I’m sorry you’re feeling so miserable - for too long, treatment options have been limited to steroid creams and crossing your fingers. VLS tends to show up most often early in life (before puberty) and later in life (after menopause). It’s less common during the reproductive years (teenagers through about mid-40s) so it seems likely there’s a hormonal aspect to it.
But here’s the good news - and you know I love bringing you good news.
Photobiomodulation (PBM) — also known as low-level laser therapy (LLLT) or red light therapy is showing serious promise as a way for women to get natural relief for vulvar lichen sclerosus in a non-invasive way to help manage the symptoms of vulvar lichen sclerosus. The research is exciting, but as usual we need a LOT more focus on women's health, especially this debilitating condition.
(My recommended Red Light Products for women’s health - hand held laser for VLS
Image credit - Volodymyr Bushmelov - Solasta handheld laser for vulvar lichen sclerosus photobiomodulation therapy."
How Photobiomodulation (PBM) Helps LS at a Cellular Level
In this case PBM uses red and near-infrared light to stimulate cellular within the tissues. We start at the tiniest common denominator - your cells, and when we give them more energy for healing and reducing inflammation the tissues of the vulva can heal. It's like giving your cells a little TLC to help them reduce inflammation, soothe pain, and start the repair process. This is NOT a CO2 laser - there is no burning, no cutting, no downtime - just gentle light on your bits for a few minutes a week for several weeks. The Solasta Laser can be used to reduce discomfort and improve collagen production in the area.
Solasta handheld laser for vulvar lichen sclerosus photobiomodulation therapy.
How Photobiomodulation (PBM) Targets VLS at the Source
Unlike traditional CO2 lasers that resurface skin through heat, PBM uses red and near-infrared light to "recharge" your cells. Think of it as cellular TLC. By increasing mitochondrial function within the epithelial cells, we:
Reduce inflammation and oxidative stress.
Decrease pain by calming TRPV channels.
Boost collagen to help with tissue elasticity and adhesions.
Blue Light: A New Player in the LS Light Therapy Toolkit?
While we often talk about Red and Near-Infrared light, there is a newer option gaining attention: Blue Light therapy. You might have heard of blue light for treating acne, but early clinical research shows it could have a special place in managing VLS symptoms, too.
Studies using medical-grade blue light have found that it can help reduce itching and pain, while also calming redness and helping those painful "fissures" (small skin tears) heal.
How Blue Light Works Differently
Think of Red light as the "deep healer" and Blue light as the "surface specialist."
Surface Relief: Blue light stays very superficial. It doesn't penetrate deep like infrared light; instead, it focuses its energy on the very top layers of your skin.
Targeting the Itch: Because much of the intense burning and itching of VLS is felt right on the surface, blue light can help calm that inflammation exactly where it’s happening.
The "Sweet Spot": Why More is Not Better
With blue light, there is a very important rule: A little goes a long way. In moderate doses, blue light is a "healing support." However, science shows that at very high doses, blue light (specifically in the 400 - 420 nm range) can actually flip and become an irritant, potentially damaging skin cells or collagen.
If you are experimenting with a device like the Fringe Wand - which includes a 415 nm blue light setting - safety is the priority and we’ll work together with very low conservative dosing to begin with.
Blue wavelenghts can be helpful for itching but not tissue atrophy and pain - that’s where red light excells.
The Denmark Study: Real Relief for Chronic Symptoms
A recent study followed 94 women who didn't find enough relief from steroid creams alone. After ten sessions of 808 nm low-level laser therapy, the results were life-changing:
Dramatic drop in pain levels.
Improved sleep and energy.
Significant boost in emotional well-being.
And the best part - no serious side effects.
Brazilian Pilot Study
We know that the "gold standard" for Lichen Sclerosus (VLS) has always been high-potency steroid creams. But if you’ve used them, you know they come with a catch. A fascinating pilot study out of Brazil recently put steroids head-to-head with red light therapy (Photobiomodulation), and the results give us a very clear picture of the Sprint vs. The Marathon in LS healing.
Here is the breakdown of what they found and why it matters for your treatment plan.
The Study: Steroids vs. Light
Researchers followed 20 women with confirmed VLS. They split them into two groups for a 4-week trial:
Group A (The Steroid Group): Used Clobetasol once a day.
Group B (The Light Group): Received red light therapy (PBM) laser just once a week.
The Results: A Tale of Two Timelines
1. The "Itch" Factor (The Sprint)
If you need immediate relief from a brutal flare-up, steroids are the fast lane.
Steroids: Reduced itching by 84%
Light Therapy: Reduced itching by 50%
Steroids are faster at calming that initial, maddening itch.
2. Skin Health (The Long Game)
This is where the study gets really interesting. LS already makes the skin thin and fragile, and we know that long-term steroid use can make that worse.
Steroids: Skin thickness decreased by 27.5%. The cream helped the itch, but it thinned the skin further.
Light Therapy: Skin thickness increased by 49%.
PBM actually helped rebuild and "plump up" the tissue, making the skin healthier and more resilient.
3. How long did the relief last?
The researchers checked back in several months after the treatments stopped to see when the symptoms returned.
Steroids: Symptoms started coming back after about 2 months.
Light Therapy: Symptoms stayed away for about 4 months.
Even though the light therapy took longer to get started, the relief lasted twice as long as the steroids.
What does this mean for you?
It’s not necessarily about choosing one or the other; it’s about using the right tool for the job and many women continue to use both while getting inflammation under control.
For a Crisis: If you are in a massive flare, steroids are excellent for putting out the fire quickly.
For Long-Term Health: If you want to stop the cycle of thinning skin and frequent relapses, Photobiomodulation (PBM) is the marathon runner. It supports the skin’s structure and keeps you in the clear for much longer.
This study was small, but it's quite heartening. It suggests that red light therapy is a powerful way to support or even reduce the need for steroids, giving your "bits" a chance to actually heal and thicken rather than just being "numbed" to the pain.
Beyond Steroids: Why Having More LS Treatment Options Matters
VLS can steal so much, confidence, comfort, sleep and intimacy. Having more tools like red light therapy in our healing toolkit means women aren’t stuck choosing between suffering or relying 100% on steroids (especially if steroids haven’t helped).
And you deserve options. You deserve to feel good in your body.
Period.
Red light therapy reduces inflammation and oxidative stress at the source by increasing mitochondrial functioning within the epithelial cells. Photobiomodulation increases anti-inflammatory cytokines and reduces pain through TRPV channels.
If you’re using my home laser I’ll write a personalised protocol for you to replicate the most effective research protocols as closely as possible.
Frequently Asked Questions About Red Light Therapy for Lichen Sclerosus
These are the "hard truths" that often get missed in general red light therapy discussions. When it comes to a condition as specific and localized as Vulvar Lichen Sclerosus (VLS), the delivery of the light is just as important as the light itself.
Can I use red light therapy at home for LS?
Yes - but with a major caveat. Home treatment is only effective if you use a targeted, handheld device designed for close-contact or direct-skin use. Because VLS affects the delicate, recessed tissues of the vulva, generic wellness devices often fail to deliver the energy where it's actually needed. Home low level laser PBM is a fantastic way to maintain the results of any clinical treatments, but it requires the right tool and a consistent protocol.
Is PBM the same as a "laser" treatment?
This is where the terminology gets confusing.
Surgical/Ablative Lasers (like CO2 or MonaLisa Touch): These use heat to create "micro-injuries" in the skin to force it to heal. They can be effective but involve "downtime" and can be painful.
Photobiomodulation (PBM): This is often called "Cold Laser" or Low-Level Laser Therapy (LLLT). It does not use heat. Instead of injuring the tissue to trigger a response, it simply feeds the cells the energy (photons) they need to reduce inflammation and repair themselves.
The takeaway: PBM is non-invasive, painless, and has no downtime. It’s "cellular fuel," not a "cellular burn.
Why a Red Light Panel won't help LS
Many people buy a large wall panel thinking "more light is better," but for VLS, a panel is almost entirely ineffective. Here is the science of why:
The Inverse Square Law (Distance Matters)
In physics, the intensity of light drops off dramatically the further you are from the source. With a panel, you are usually sitting several inches or even feet away. By the time that light reaches your skin, the power density (irradiance) has plummeted. For VLS, we need a high enough "dose" to trigger cellular change, which a distant panel simply cannot provide.
Anatomical "Shadowing" and Scatter
The vulva is not a flat surface. It has folds, curves, recessed areas, and is tucked away anatomically.
The Shadow Effect: Light from a panel travels in a straight line. It cannot "curve" into the folds of the labia or reach the clitoral hood effectively.
Light Scattering: When light travels through the air from a panel, it hits dust and air molecules, scattering the photons. When you use a contact device (like a handheld laser or a specialized wand), the photons are delivered directly into the tissue without losing energy to the environment.
Tissue Compression
Clinical PBM often uses the "contact technique." By pressing the device gently against the skin, you temporarily displace blood and compress the tissue, allowing the light to penetrate deeper into the layers affected by Lichen Sclerosus. You can't do this with a panel.
Is there any risk of burning or damaging delicate tissue?
No. This is one of the most common concerns, and it’s important to distinguish PBM from "thermal" or surgical lasers. PBM is often called "cold laser" because it does not produce heat. There is no burning, no cutting, and no trauma to the skin. It is a gentle, biostimulating light that encourages your cells to heal themselves. Most women feel a gentle warmth as blood flow to the area starts to improve. I start with very conservative dosing so as not to aggravate already sensitive tissues and you’ll track your progress along the way.
How soon will I start to feel a difference?
While everyone’s body responds differently, many women in clinical settings report a reduction in itching and "stinging" sensations within the first 3 to 4 sessions. However, for deeper tissue repair and long-term relief, a consistent protocol (usually 10 sessions over several weeks) is recommended to feel the full benefit.
Can I use red light therapy alongside my steroid creams?
Yes. PBM is highly complementary. Many women use it as a supportive tool to help heal the skin while continuing their prescribed steroid regimen. Over time, as the inflammation stays under control and the skin becomes more resilient, some women find they can reduce their reliance on steroids, but you should always coordinate those changes with your specialist.
Why is the specific wavelength of light so important?
Not all "red lights" are created equal. For LS, we look for specific wavelengths that can penetrate the skin effectively. Red light (around 630nm - 660 nm) is excellent for surface-level healing, while Near-Infrared light (around 808 nm) reaches deeper tissues where chronic inflammation lives. Using the wrong wavelength is like trying to tune into a radio station with the wrong frequency - you won't get the "signal" or the results you need.
What about vaginal wands?
As this issue impacts the vulva and usually not inside the vaginal canal I prefer to use a tool I know can deliver the correct amount of energy especially when treating sensitive tissues with LS. My Solasta laser fulfills those requirements. I am a big fan of the Fringe Wand for lubrication, atrophy and collagen improvements and it includes blue wavelengths that can be turned on or off based on how you are tolerating it. I tend to see more noticeable improvements in clients using my Solasta laser than the Fringe wand.
Is PBM a permanent cure for Lichen Sclerosus?
Currently, there is no known permanent cure for LS. However, PBM is a powerful management tool. Think of it like a "rechargeable battery" for your skin’s health. While it can lead to long periods of being symptom-free, most researchers and clinicians recommend occasional "maintenance" sessions to keep inflammation at bay and prevent future flare-ups.
Tracy
Resources:
2024 Study - Journal of Obstetrics and Gynecology
https://www.tandfonline.com/doi/full/10.1080/01443615.2024.2349965#abstract
2017 - Brazil - https://pmc.ncbi.nlm.nih.gov/articles/PMC5550930/
https://doaj.org/article/a272603d01a54d37898e50a490eb6386
