Does Low Dose Naltrexone (LDN) help improve symptoms of vulvar lichen sclerosis and in what doses/formats? Thank you. I would say I've had maybe five or six patients and they have certainly benefited from LDN. The dose would normally be starting about 1.5 but I would say I think most of these are about 3.5, the doses because they're one core patient that is not common with us but we do see it but I do follow them up because it's a very interesting set of symptoms that they have. Yes, I would certainly see it's worth trying the LDN and also try and cut down on your sugar and dairy and gluten as well. But sugar primarily, I would see first. And it takes a long time. Lichen sclerosis is a long treatment, like nine months. A lot of times I see them see benefits. You gotta ride it out. Also, check for your estrogen levels too and check for any type of lubricant that might have preservatives in it that you actually think might be helping but in actual fact, it's maybe causing it to be more irritated than before. I do a lot of topical I would say for like in sclerosis but like I said it's normally these patients who are treated for nine months to a year before they really start seeing benefit.