Despite evidence of autoimmune etiology in genetically predisposed patients, the cause of Lichen Sclerosus remains unknown. Infectious causes such as B. Brudorferi is still unproven and hormonal influence seem unlikely. Lichen Sclerosus may lead to scarring, distortion and disruption of the vulvar architecture and in a large proportion of affected individuals may cause sexual dysfunction. The diagnosis of LS is usually clinical but in clinically unclear cases a histological examination is required. Topical corticosteroids are highly effective, and remain the first – line of therapy and they often give symptom relief in the first few days. Emollients are recommended as supportive therapy. TCI is utilized in cases which are unresponsive to corticosteroids and may require 24 weeks to obtain an optimal response. Surgery should be limited to those conditions associated with malignancy or for patients who have severe scarring restricting micturition or sexual function. New modalities such as radiofrequency and Hyaluronic acid or PRP have shown to be both safe and effective in patients who are not responding to topical agents.