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Following 6 months treatment skin looks healthy (according to consultant) with no significant signs of inflammation. However, burning, stinging, pinching and sensitivity persist. Is this active LS that needs ongoing intensive treatment or could there be something else going on? What investigations or additional treatment options could be considered?

Thank you for your post. If your consultant feels that the LS is in remission, it is likely that these symptoms are due to something else. The inflammation from LS can sometimes lead to an irritation of the nerves in the skin. We call this vulvodynia. Vulvodynia can also develop out of the blue, without pre-existing Vulval disease. It can often cause burning and stinging and pain. The skin looks normal in these cases. Usually a tablet for the nerves such as amitriptiline or gabapentin can help, or a topical anaesthetic such as 5% lidocaine ointment can be used. Sometimes, lack of oestrogen can lead to strophic vaginitis where the vaginal skin becomes inflamed and thin and replacing the oestrogen with a cream or pessary can treat the burning sensation. Please see your doctor.