Topical corticosteroids (TCS) for vulval lichen sclerosus should be continued even when patients are asymptomatic, and follow-up should be maintained “indefinitely”, new clinical management advice states.

The panel of 22 doctors from Australia and New Zealand who developed the advice said studies had shown that such long-term therapy improved function and relieved symptoms as well as minimising scarring and carcinoma of the vulva.

“In contrast to European and British guidelines, which recommend treating only active lichen sclerosus during maintenance therapy, an Australian study has shown that regular, long-term, preventive treatment with TCS which achieve objective normality of skin leads to better disease outcomes,” they wrote.

The team, led by Dr Janice Yeon of the Skin Hospital in Sydney, comprised 16 dermatologists, five gynaecologists and a paediatrician who carried out a Delphi process to develop the consensus statement, published in the Australasian Journal of Dermatology.