The treatment of vulvar lichen sclerosus is generally quite challenging. However, symptoms can be alleviated by some symptomatic treatments. Firstly, it is important to keep the affected area clean and dry. Attention should be paid to avoid spicy and allergenic foods, and not to wash the vulva with irritating drugs or soaps. Wearing non-breathable synthetic underwear should be avoided. Additionally, topical corticosteroid medications can be used to control itching. However, it takes a long time for the affected skin to show significant improvement or return to normal. If medication treatment is not sustainable or effective, local physical therapy can be recommended. This involves removing abnormal epithelial tissues locally and destroying nerve endings in the dermis, thus interrupting the vicious cycle caused by itching and scratching. For patients who do not respond to medication or physical therapy, or those with atypical hyperplasia or potential malignant changes, surgical treatment can be recommended. However, surgery is generally considered a last resort due to the possibility of long-term recurrence and significant trauma, affecting both the appearance and function of the vulva.