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Vulvar Lichen Sclerosus in Darker Skin Types

Vulvar Lichen Sclerosus in Darker Skin Types


In today's video, we are joined by Dr. Akinshemoyin Vaughn to discuss vulvar lichen sclerosus (VLS) in darker skin types. We talk about misdiagnoses, how VLS presents in folks of darker skin types, and how lichen simplex chronicus and erosive lichen planus present in folks of darker skin types. We chat about so much, including cultural and ethnic backgrounds and how they influence diagnosis, treatment, and management, taboo & stigma in certain communities, and so much more.

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This video is for educational and entertainment purposes only. Please consult with your medical provider before making any changes to your health plan. Importantly, what I share is my interpretation of the science.

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Dr. Akinshemoyin Vaughn's Bio

For those who do not know her, Olushola Akinshemoyin Vaughn, MD, is an Assistant Professor of Dermatology at the Medical College of Wisconsin. She grew up in Milwaukee, attended Harvard University, played in bands in Los Angeles for 10 years, and then returned to Wisconsin to attend medical school in Madison. After graduation, she returned to Milwaukee to serve her community as an academic dermatologist. Her areas of interest are vulvar dermatoses, transgender skin concerns, and global health.⁠

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Dr. Akinshemoyin Vaughn's website

Dr. Nina Madnani's Altas of Vulvovaginal Disease in Darker Skin Types

Timestamps For Vulvar Lichen Sclerosus in Darker Skin Types

0:00 – Introduction

3:15 – Misdiagnoses in folks with darker skin types

8:32 What does VLS look like in darker skin types – signs and symptoms

12:30 – Vitiligo and VLS in vulvas of color

16:18 – Is there a difference in the way that symptoms are experienced?

17:58 – Cultural and ethnic differences and VLS

27:59 – Stigma and shame around genitals

36:00 – Skin color and identity in people of color

38:08 – Will your skin color return?

43:00 – Treatment, efficacy, and absorption in folks with richly pigmented skin

46:46 – What does steroid overuse look like in darker skin types

52:22 – Advice for patient advocates

57:59 – Coles notes: How lichen simplex chronicus and erosive lichen planus present in darker skin types

01:00:47 – Summary and Outro


In sum, it's important that healthcare providers familiarize themselves with photos of vulvar dermatoses in darker skin types and remember to look beyond pigment only–scarring and anatomical changes can provide helpful clues for a VLS diagnosis.

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Email: jaclyn@lostlabia.com or DM me @thelostlabiachronicles on Instagram, Facebook, & TikTok


  • Iris johnson

    I have had various symptoms sunce 2012. Two Male dermatologists treated me somewhat hesitantly, told me I was misdiagnosed. New diagnosis from them said “reverse psoriasis,” so they said follow up with GYN, and I no longer needed to come to them.
    My GYN then confoirmed tge original diagnosis using lab tests as LS.
    Since the last two months I have been sent to female dermatologist with specialty in female issues. Today I will see a PA dermatologist at UT SW in Dallas. Her specialty is vulvar dermatology.
    I seek help in understanding what, if anything, I can do proactively, and what is my long term prognosis.

    • Jaclyn Lanthier

      We are so sorry to hear about all the misdiagnoses; it’s awful how you were dismissed and treated. We hope you have found a better care team since. Long prognosis varies per individual; everyone is different, but in general, VLS is a manageable condition. With consistent, proper, and regular evidence-based treatments, emollients, stress reduction, etc., you will hopefully be able to get in remission. With love, Jaclyn

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