Fractional CO ₂ Laser Combined With Topical Corticosteroids for Vulvar Lichen Simplex Chronicus: An Observational Study From an 8‐Year Single‐Center Experience

ABSTRACT Background Vulvar lichen simplex chronicus (VLSC) is a chronic inflammatory dermatosis that remains difficult to manage long term. Fractional CO 2 laser (FxCO 2 ) combined with topical corticosteroids (TCs) has emerged as a potential therapeutic strategy; however, high‐quality long‐term evidence remains limited. Objective To evaluate the long‐term efficacy and safety of FxCO 2 combined with TC in patients with VLSC. Study Design This retrospective single‐center study included 172 patients with biopsy‐confirmed VLSC treated between 2016 and 2024. All patients received at least one FxCO 2 + TC treatment session. Primary outcomes included pruritus improvement, recurrence, and subjective symptom relief. Secondary outcomes assessed patient satisfaction, treatment adherence, and adverse events. Results FxCO 2 combined with TC treatment was effective, achieving an initial pruritus improvement rate of 90.12% (155/172). Subjective symptom improvement was reported by 91.86% (158/172) of patients, and patient satisfaction was 88.95% (153/172). Among those who improved, 50.58% (80/155) achieved improvement after 3 treatments, and the median duration of improvement was 18.0 months (range, 12–54 months). The recurrence rate was 14.84% (23/155), with a median time to recurrence of 36.0 months (range, 12–60 months). Adverse events occurred in 15.70% (27/172) of patients, with dryness being the most common (6.40%, 11/172). No clinical signs of deterioration or atypical progression were noted throughout the follow‐up. Conclusion FxCO 2 combined with TC treatment is effective and well tolerated in women with VLSC, providing long‐term symptom relief with low recurrence and acceptable safety. This combined approach may represent a promising therapeutic option for managing intense pruritus associated with VLSC.