In severe cases of lichen sclerosus, treatment with immune-modulating medications may be advised. These included medications like ciclosporin and methotrexate, which can help to stop symptoms. Because it is an autoimmune disorder rather than an infection, these drugs can help to suppress the immune system and stop it from triggering flare-ups and symptoms. However, there are serious side effects that occur when using immune-modulating medications, including an increased risk of contracting infections and illnesses. As a result, many physicians will only prescribe drugs that impact the immune system if other, safer options like corticosteroids have failed to work.

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