Jill M Krapf, 1, 2 Leia Mitchell, 2 Michelle A Holton, 3 Andrew T Goldstein 1, 2 1The George Washington University, Washington, DC, USA; 2The Centers for Vulvovaginal Disorders, Washington, DC, USA; 3Department of Emergency Medicine, Baystate Medical Center, Springfield, MA, USACorrespondence: Andrew T GoldsteinThe Center for Vulvovaginal Disorders, 3 Washington Circle NW, Suite 205, Washington, DC 20037, USATel +1 202- 887-0568Email obstetrics@yahoo.comAbstract: Vulvar lichen sclerosus (LS) is a chronic, inflammatory dermatosis that may lead to scarring of the vulva and sexual dysfunction. LS affects women of all ages and often goes unrecognized and underreported. Uncertainty continues to exist around its pathogenesis, histologic diagnosis, and treatment. However, there have been great advances in our understanding of autoimmunogenic targets in disease formation and progression. In addition, there has been recent investigation of potential non-steroid-based treatments, including platelet-rich plasma therapy and energy-based modalities such as the fractional CO 2 laser, photodynamic therapy, and high intensity focused ultrasound. Refinement of surgical techniques for restoring vulvar anatomy and treating clitoral phimosis, introital stenosis, and vulvar granuloma fissuratum is leading to improved patient outcomes. This review summarizes current perspectives on the pathogenesis, symptomatology, diagnosis, and treatment for vulvar lichen sclerosus.Keywords: lichen sclerosus, clitoral phimosis, vulvar granuloma fissuratum, corticosteroids, fractional CO 2 laser, lysis of vulvar adhesions