Lichen Sclerosus (LS) is a chronic inflammatory disease of genital and extra-genital muco-cutaneous districts, presenting a double pick of incidence in pre-puberty and peri-post menopausal women. The pathognomonic symptomatology is represented by itch, but also pain, dysuria, restriction of micturition and entry dyspareunia. If not treated, it might cause a significant and permanent subversion of vulvar anatomy with scarring of the clitoral hood, stenosis, and disappearance of skin reliefs. Uncertainty exists around its pathogenesis, however, there are important hypotheses involving an autoimmune target for its formation and progression. The gold standard in treatment is topical steroids. Second line treatment includes calcineurin inhibitors, phototherapy, plated-rich plasma therapy, fractional Co2 laser. Surgery is reserved only for the treatment of obliterative complications such as introital stenosis. Patient education and long follow up have primary importance.