What lifestyle modifications or supportive measures can I suggest to patients with vulval lichen sclerosus to alleviate symptoms?

Lifestyle modifications and supportive measures for patients with vulval lichen sclerosus to alleviate symptoms include:

• Advise gentle vulval hygiene by showering rather than bathing, and cleaning the vulval area no more than once daily using a simple, unscented emollient as a soap substitute to avoid aggravating symptoms.
• After washing, gently dab the vulval area dry with a soft towel or use a cool setting on a hairdryer held at a distance to prevent irritation.
• Encourage keeping nails short to minimize skin damage from scratching and explain the itch-scratch cycle to reduce scratching behavior.
• Use cooling measures such as a cool flannel or cool gel packs to help manage itching.
• Avoid irritants that can worsen symptoms, including soaps, perfumed products, shampoos, bubble baths, wet wipes, scented sanitary products, sponges or flannels, antiseptics, tight or synthetic clothing, fabric conditioners, fragranced washing powders, spermicidally-lubricated condoms, coloured or scented toilet paper, nail varnish on fingernails if scratching, and shaving pubic hair.
• Offer symptomatic treatment with emollients to restore the skin barrier and reduce inflammation.
• Refer to secondary care for confirmation of diagnosis and initiation of potent topical corticosteroids as needed.

These measures aim to reduce irritation, break the itch-scratch cycle, and maintain skin integrity, thereby alleviating symptoms of vulval lichen sclerosus.

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