Last week on our blog, one of our patients shared her experience with Lichen Sclerosus and how we have been helping her on her journey to recovery (see “Recovering from Lichen: A Case Study — Part One”).

Janet reported that her symptoms had started 10 years before she visited our Tampa functional medicine clinic, and she was diagnosed three years prior to consulting us. In all that time — despite consulting several doctors — the recommended treatments provided little to no relief.

As part of her intake here at PROVOKE Health, she reported a possible past exposure to mold, so we ordered a mold toxin antibody test, which confirmed the exposure. The positive result led us to understand that mold was aggravating her immune system causing dysregulation and contributing to hormonal imbalances. It’s likely that the problem of Lichen Sclerosus was not solely due to the mold exposure; however, we know it was a contributing factor.

Lichen Sclerosus photograph

Although Janet reported symptoms of Lichen Sclerosus dating back a decade, upon further discussion, we came to find out that she had suffered from itching for nearly 18 years. This led us to an understanding that mast cells were involved. When mast cells are activated, they secrete histamine along with other inflammatory chemicals called cytokines.

We tested for mast cell activation syndrome (MCAS). She did not test positive for MCAS, but it is a complex illness. Most conditions in conventional medicine are either positive or negative. However, we suspect that MCAS may exist more on a spectrum. Janet could have been experiencing symptoms of MCAS without reaching the threshold of testing positive for it. We find this quite common in our patient population.

This is the nuance of functional medicine. A willingness and readiness to practice in areas that require flexibility and open-mindedness. The question we faced was determining what was continually aggravating those mast cells? In Janet’s case, mold was a contributing factor. For others, it can be a food sensitivity or allergy, another environmental allergy, stress levels, infections, physical exertion, or even a commonly prescribed medication (antibiotic or steroid).

Calming the Mast Cells

Because mast cell reactivity was playing a key role in producing symptoms, we had to calm those cells — make them less reactive. This was a two-step process:

  1. Eliminate mold exposure through mold remediation.
  2. Use antihistamines and a low-histamine diet to calm the mast cells.

Janet hired a mold remediation service to address the mold issues in her residence, but mast cells often remain in reactive state even after what triggered their reactivity is removed. This is, in part, why many people develop food allergies after being exposed to mold. You don’t want to leave mast cells turned on. Starting with an antihistamine is one way to calm the histamine secreting mast cells, which is why we recommended over-the-counter antihistamines. Certain phytonutrients, such as quercetin and peptides — including KPV — can also calm overactive mast cells. We also instructed Janet to follow a low-histamine diet, avoiding foods that tend to release excess histamine such as pickles, avocados, gluten, and alcohol.

Healing the Damaged Skin

After years of pain and symptoms, Janet’s vaginal tissue was not healing appropriately. Following the mold remediation, she needed a treatment plan to address the years of immune dysregulation and tissue damage.

To restore skin health, we used specific peptides including glycyl-l-histidyl-l-lysine (GHK), which supports healthy collagen remodeling. GHK has multiple biological actions that, according to our current knowledge, appear to be health positive. It stimulates blood vessels and nerve outgrowth and increases collagen, elastin, and glycosaminoglycan synthesis. GHK demonstrates beneficial effects on skin fibroblasts, which are considered key cells in the skin regeneration process.

Fibroblasts not only synthesize structural elements of the dermal matrix but also produce a wide range of growth factors essential for skin repair.

Restoring Hormone Balance

Vaginal tissue is sensitive to hormones, and most 20-year-olds have more robust hormones than do 30- or 40-year-olds. Janet was 20 years past her 20s and had been on hormonal birth control for a number of years, so we knew that hormone therapy would play a key role in her recovery and specifically in healing her damaged skin.

Hormones aid in moisturizing, supporting skin health, and improving resiliency of the vaginal tissue and skin. We used low-dose hormones to increase healing. This proved to be helpful for her skin. Additionally, she reported an increase in energy when we added a low dose of testosterone support.

Many doctors and women don’t realize that testosterone is just as important to females as it is males, although females require a lower dose. At the age of 30, testosterone is depleted in many women. Recall that Janet was on hormonal birth control for many years, which reduces testosterone and estrogen prematurely. Since starting therapy, she has had other positive benefits, including an end to hot flashes and improved sleep.

Addressing Nutrient Deficiencies

When battling chronic health conditions, the body burns through more nutrients and can often have difficulty absorbing certain nutrients. Two common vitamin deficiencies are Vitamins D and B12. In this case, Janet had numbness and tingling in her arms, following COVID, along with a worsening of her skin condition. She also had ringing in her ears.

Following a lab evaluation for signs of vitamin deficiency, we started her on eight weeks of Vitamin D, B12, B complex, and Vitamin C injections. Injections were well tolerated, and after the second B12 injection she reported the numbness and tingling in her arms had resolved after being present for two years. With completion of treatment, the ringing in her ears also resolved.

Treating Yeast/Fungi Overgrowth

Due to the mold exposure, Janet’s digestive system was reacting to an overgrowth of yeast and fungal colonies. For years, other providers had tried to treat this with antifungals, only to fail because of mold exposure and, I believe, the lowered hormone levels. In her case, the antifungal is now an opportunity to restore good digestive health and reduce the likeliness of future flareups.

Restoring Health and Building Resilience in Patients with Lichen Sclerosus

As you can see in this patient’s journey to improve quality of life, it was imperative that we help to build more resilience. Janet had a long history of birth control impacting normal hormonal production (very common for today’s women) and antibiotics impacting her gut microbiome and causing yeast overgrowth. And it all seemed to worsen once she lost more resilience with COVID. Her body’s natural healing capabilities had been exhausted and depleted. We needed to eliminate the root cause of the problem and then restore what had been depleted and re-establish balance.

What we love about the functional medicine approach to healthcare is that Janet is doing better with her main concern — itching, pain with intercourse, and an inability be intimate with her partner. In addition, she is sleeping better, has more energy, her neurological symptoms have subsided, and her body composition has improved. This is what happens when the body is restored to a better level of resiliency using an integrative approach.

If you are suffering from Lichen Sclerosus or a long-term health condition and have “tried everything” without receiving a diagnosis that makes sense to you or effective treatment, we strongly recommend that you consult with a functional medicine-focused healthcare practitioner. Better yet, if you are in or near Tampa, Florida, contact us to schedule your consultation. And if you’re not located in our area but might be interested in a telehealth consultation, we’d be happy to help.

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About the Author: Dr. Matt Lewis, D.C., DACBN, CFMP®, specializes in diagnosing and treating the underlying causes of the symptoms related to chronic and unexplained illness through nutrition, lifestyle, chiropractic, and other natural approaches to whole-health healing at PROVOKE Health in Tampa, Fla. Dr. Lewis has 20 years of experience practicing nutritional and holistic medicine. He earned his B.S. in Biology from Shenandoah University, his Doctorate in Chiropractic from Life University, his Diplomate status in Clinical Nutrition from the American Clinical Board of Nutrition, his CFMP from Functional Medicine University, and his certification as a Digestive Health Specialist (DHS) through the Food Enzyme Institute. Dr. Lewis’ passion for health and wellness stems from his own personal experience. With a family history of autoimmune conditions and diabetes, and his own lab tests showing his genetic susceptibility to Hashimoto’s thyroiditis (autoimmune thyroid), Dr. Lewis has learned how to restore his own health and vigor to prevent the onset of these and other illnesses and live an incredibly active life. Through this process, he acquired a deeper understanding of health and wellness, which he now offers his patients in Tampa and elsewhere.

Disclaimer: The information in this blog post about Lichen Sclerosus is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this blog post should be construed as medical advice from Dr. Matthew Lewis, Functional Healthcare Group, PLLC, or PROVOKE Health, nor is this blog post intended to be a substitute for medical counsel on any subject matter. No reader of this blog post should act or refrain from acting on the basis of any information included in, or accessible through, this blog post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.