Research Article
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Published Online: 1 December 2016

Fractional CO2 Laser Treatment for Vaginal Atrophy and Vulvar Lichen Sclerosus

Publication: Journal of Gynecologic Surgery
Volume 32, Issue Number 6


Objectives: The aim of this research was to assess the efficacy of fractional CO2 laser energy for treating vaginal atrophy and lichen sclerosus.
Materials and Methods: The first study population was 23 postmenopausal women diagnosed with vaginal atrophy via microscopic evaluation and who were symptomatic. The second study population was 27 postmenopausal women diagnosed with lichen sclerosus by biopsy and who were symptomatic. Patients with vaginal atrophy had 3 treatment sessions spaced at 4–6 weeks between each session. Laser settings for this group were: power: Watts, 30; time, 1000 microseconds; and spacing, 1000 micrometers. For the lichen sclerosus group, the power was set at 20 Watts and 3–4 treatments were given at 4–6-week intervals.
Results: In the vaginal atrophy cohort, 22/23 women who previously complained of dryness and discomfort had these symptoms alleviated and vaginal microscopic exam showed significant changes in color, elasticity, and wetness following 3 courses of CO2 laser fractional treatment; additionally 20/23 women had elimination of urinary frequency and urgency, 18/21 women had alleviation of dyspareunia. In the lichen sclerosus cohort 24/27 patients who had laser treatment reported cessation of itching and pain/discomfort; and 26/27 women demonstrated visible improvement of skin color, elasticity, vascularity following 3-4 laser treatments. All examinations were performed with the operating microscope.
Conclusions: The fractional CO2 laser beam is useful for treating vaginal atrophy and lichen sclerosus. This new technique represents a significant divergence from estrogenic-, steroid- and corticosteroid-bulwark dependence. All treatments were performed in an office setting and were associated with either no pain or, at the most, minimal and temporary discomfort. This new use of the CO2 laser is an excellent alternative for managing these two troublesome problems, particularly in postmenopausal women. (J GYNECOL SURG 32:309)

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Published In

cover image Journal of Gynecologic Surgery
Journal of Gynecologic Surgery
Volume 32Issue Number 6December 2016
Pages: 309 - 317


Published in print: December 2016
Published online: 1 December 2016
Published ahead of print: 21 November 2016


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Michael S. Baggish
St. Helena Hospital, St. Helena, CA, and Department of Obstetrics and Gynecology, University of California—San Francisco, San Francisco, CA.


Address correspondence to:Michael S. Baggish, MD1576 Voorhees CircleSt. Helena, CA 94574E-mail: [email protected]

Author Disclosure Statement

No financial conflicts exist.

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