Can immunosuppressive drugs treat lichen sclerosus?
Immunosuppressive drugs, such as topical tacrolimus or pimecrolimus, may be used in certain cases of lichen sclerosus when steroids are not suitable. Systemic immunosuppressants are rarely required.
Detailed Medical Explanation
Topical immunosuppressants like tacrolimus and pimecrolimus work by inhibiting T-cell activation and reducing local inflammation. These are sometimes used for recalcitrant or steroid-intolerant lichen sclerosus. Systemic immunosuppressive drugs (such as methotrexate or ciclosporin) are reserved for rare, severe, and resistant cases due to higher risk profiles. The majority of patients respond well to topical therapy alone. More information at NICE BNF and British Association of Dermatologists.
Clinical Context
Specialist review is required before considering immunosuppressive therapy. Our clinic can advise on complex or resistant cases and arrange further investigations: Vulval Skin Conditions Clinic.
Evidence-Based Approaches
Use of immunosuppressive agents should be reserved for carefully selected patients with expert monitoring. Further reading at NICE BNF.