PRP in Gynecology: New Solutions for Lichen, Vulvovaginal Atrophy, Recurrent Pregnancy Loss, and Scarring
Regenerative medicine now offers innovative treatments for various gynecological conditions. In particular, PRP (Platelet-Rich Plasma) together with exosomes is emerging as a promising method for treating difficult conditions such as vulvar lichen sclerosus, vulvovaginal atrophy, thin endometrium associated with recurrent pregnancy loss, and vulvar or vaginal scarring.
Below, we explore each of these conditions in detail, explaining how PRP can help regenerate tissue and improve patients’ quality of life.
Vulvar Lichen Sclerosus: PRP as a Regenerative Treatment
Vulvar Lichen Sclerosus (sometimes simply called “vulvar lichen”) is a chronic inflammatory condition, probably autoimmune, that affects the skin and mucous membranes of the vulva. The symptoms can be very debilitating, typically including persistent and intense itching, burning, pain during sexual intercourse (dyspareunia), vulvovaginal dryness, and sometimes fissures or small cuts in the vulvar and perianal area. If not properly treated, lichen can lead to tissue changes (such as scarring and reduced elasticity) and, in some patients, may increase the long-term risk of vulvar cancer.
Currently, the first-line therapy for vulvar lichen consists of prolonged use of high-potency topical corticosteroids (e.g., clobetasol ointment) combined with protective emollient creams. This treatment is often effective in controlling inflammation and alleviating the main symptoms, preventing or delaying the anatomical changes caused by the disease. However, some issues such as loss of skin elasticity and dryness may persist despite steroid therapy, causing pain and discomfort during intercourse. It is precisely in these cases that an additional regenerative approach can make the difference.
PRP is a concentrate of growth factors obtained from the patient’s own blood. It is prepared by collecting a small amount of blood, which is then centrifuged to isolate and concentrate the platelets in a reduced volume of plasma. Platelets contain numerous growth factors and cytokines that stimulate cell regeneration and the formation of new blood vessels (angiogenesis) in the targeted tissues. In gynecology, the idea is to harness these properties in order to repair vulvar tissue damaged by lichen, improving its trophism, vascularization and elasticity.
Local injections of PRP into the vulvar area affected by lichen sclerosus have proven to be a promising complement to conventional therapy. A pilot study on patients already receiving corticosteroid treatment at the Policlinico of Milan showed that injections with autologous PRP led to further relief in itching and burning symptoms, a significant improvement in sexual function and psychological wellbeing, and an overall positive impact on quality of life. In practice, thanks to PRP, patients reported less local discomfort and greater comfort during intercourse, indicating improved elasticity and healthier treated tissues. Other studies also confirm that vulvar PRP can reduce local inflammation and increase tissue elasticity, offering a more comprehensive approach to the management of lichen sclerosus. This regenerative method is now considered one of the most innovative complementary treatments for vulvar lichen, although further confirmation from larger studies is awaited.
The treatment is minimally invasive and performed as an outpatient procedure. After preparing the PRP from the patient’s own blood, the gynecologist administers micro-injections of the platelet concentrate directly into the vulvar dermis and vaginal mucosa of the areas affected by the lesions. Fine needles are used; if necessary, a topical anesthetic cream is applied beforehand to minimize discomfort. Several sessions are usually required: an initial treatment cycle often involves approximately two injections, spaced 3-4 weeks apart (the protocol may vary depending on the severity of the case). Each session lasts only a few minutes, and once the procedure is completed, patients can immediately resume their normal daily activities. The only precaution is to avoid sexual intercourse for 48 hours to allow the tissues to begin the healing process. Being autologous, PRP is very safe well tolerated: it has virtually no significant side effects and does not cause rejection or allergic reactions. Mild burning or temporary swelling in the treated area may occur, but this typically resolves within a few days.
Expected Results
Just a few weeks after the injections, many patients suffering from lichen sclerosus report that the vulvar area feels less fragile and more elastic, with a reduction in itching, fissures, and pain. Preliminary studies indicate that PRP can promote measurable tissue regeneration (increasing thickness and improving vascularization of the vulvar tissue) leading to a significant relief of symptoms. It is important to emphasize that, to date, PRP is not a definitive cure for lichen sclerosus, which remains a chronic condition that must be kept under control. However, it represents an additional therapeutic option that can help improve quality of life and limit disease-related damage. Standard corticosteroid therapy should still be continued according to medical advice, while PRP can be repeated periodically (e.g., annually or as needed) to maintain the achieved benefits.
PRP offers additional hope for women affected by vulvar lichen sclerosus who do not find complete relief with conventional therapies. It is a safe and relatively simple regenerative treatment that aims not only to control inflammation but also to repair intimate tissues damaged by the disease. Initial results are encouraging: many patients report improvements in symptoms and regain a more comfortable and fulfilling intimate life. It is always essential to consult qualified centers and specialists to assess suitability for treatment and appropriately integrate it into the patient’s treatment plan.
FAQ – Lichen Sclerosus and PRP Therapy
Vulvar lichen sclerosus is a chronic inflammatory condition affecting the skin and genital mucosa, likely of autoimmune origin. It primarily involves the vulva (and occasionally the anal area), causing symptoms such as intense itching, burning, dryness, pain during intercourse, and fragile skin prone to fissures. The condition is neither contagious nor caused by infections and usually follows a long-term course with periods of flare-ups.
Currently, there is no definitive cure for lichen sclerosus. It is a chronic condition that is managed with treatments aimed at controlling symptoms and preventing complications. High-potency topical corticosteroids are very effective in reducing inflammation and itching, but they need to be used long-term under medical supervision. PRP and other regenerative therapies are being investigated to further improve tissue quality, although they may require periodic sessions. With proper care, however, most people can keep lichen sclerosus well controlled and lead a normal life.
PRP (Platelet-Rich Plasma) is derived from the patient’s own blood and contains powerful growth factors that promote natural tissue regeneration. When injected into the vulvar areas affected by lichen sclerosus, PRP helps repair damaged skin, stimulate new blood vessel formation, and boost collagen production. In other words, it promotes a better recovery of the vulvar tissue, increasing thickness, elasticity, and lubrication. This can reduce symptoms such as itching, burning, and pain, improving sexual function and restoring everyday comfort.
Not at the moment. PRP should be considered an additional, complementary treatment, and not a substitute for corticosteroids. Standard corticosteroid therapy remains essential for controlling active lichen inflammation, especially in its early stages or during flare-ups. PRP can be introduced later, once the condition is more stable, to help regenerate tissue and address symptoms such as dryness, reduced elasticity, and small fissures – issues that corticosteroids alone often cannot fully resolve. Looking ahead, as more evidence becomes available, PRP may become a key part of lichen sclerosus treatment. For now, however, it should be considered a supplementary option, evaluated on a case-by-case basis.
There is no fixed number that applies to everyone. In many experimental protocols, two initial sessions are performed 3-4 weeks apart. Some patients notice improvements after just one session, but completing two sessions allows for a full assessment of the tissue response. After this initial treatment cycle, the need for additional sessions depends on the evolution of symptoms: some patients undergo periodic maintenance sessions (e.g., one session every 6-12 months) to maintain the benefits. The gynecologist will determine the most appropriate plan based on the severity of lichen sclerosus and the patient’s response.
The procedure is generally well tolerated. Before the injections, a topical anesthetic cream is applied to numb the area and minimize discomfort. The injections are performed with very fine needles, producing a sensation of small infiltrations under the skin that is usually perceived as slight discomfort rather than pain. Most patients report the sensation as tolerable, and those who wish may take a mild painkiller before the session. After the treatment, some burning or swelling may occur for 24–48 hours, but these symptoms usually resolve on their own without the need for any significant analgesia
Since PRP is derived from the patient’s own centrifuged blood, it is 100% biocompatible, with no risk of allergies or adverse immune reactions. Side effects are minimal and may include slight pain at the injection site, mild swelling, or temporary redness, all of which usually resolve within a few days. It is essential that the procedure is performed in a sterile environment by qualified personnel to minimize the risk of infection. Even small hematomas in the vulvar area are rare, thanks to the use of a fine needle and very superficial injections. Overall, PRP is considered safe, but it should be avoided in specific cases, such as patients with serious blood disorders or active local infections – conditions that will be carefully assessed by the specialist before proceeding with the treatment.
PRP may be considered for patients with lichen sclerosus who, despite standard therapy, continue to experience bothersome symptoms (such as itching, pain, or dryness) or who already present tissue changes (very thin, inelastic, or cracked skin). It is particularly recommended when corticosteroid treatments control inflammation but do not improve the quality of the skin or mucosa. Even patients who cannot use high doses of corticosteroids due to side effects or contraindications may also consider alternative approaches such as PRP. The gynecologist will determine the indication on a case-by-case basis. PRP should be postponed in cases of pregnancy or active local infections.
Book an appointment
If you are experiencing symptoms consistent with lichen sclerosus, or have already been diagnosed and are interested in vulvar PRP therapy, book an appointment with Dr. Giovanni Buzzaccarini. During the consultation, you will receive personalized treatment options and have the chance to get answers to all your questions.