Lichen sclerosus is a non-contagious, chronic skin condition, most often affecting the female genital area, but men and children can also be affected. You’ll find all details in our guide Lichen sclerosus – symptoms and treatment. Here we explain how to use FMS dilators for self-care in lichen sclerosus.

Why FMS dilators for lichen sclerosus?

Treatment with FMS dilators for lichen sclerosus offers effective, gentle support, because stretching is not achieved by simple spreading as with traditional dilators, but through the gentle massage effect of the elliptical heads. For this, the dilator does not need to be fully inserted; only the elliptical head is alternately inserted and withdrawn, so uninvolved areas are spared. In addition, extremely smooth borosilicate glass glides with virtually no friction. These factors allow the many desired repetitions that keep tissue flexible and activate cellular metabolism without irritating sensitive skin.
FMS dilators come in 27 sizes starting from 14 mm in diameter. If sizes below 14 mm are required at the beginning, the FMS principle (flexibilisation via massage effect) would no longer be effective because the difference between head and shaft would be too small. For such cases, we recommend our bougie dilators made of implant steel: the polished, pore-free surface glides very well and is highly hygienic; implant steel is 100 % biocompatible and suitable even with nickel allergy. With only 1 mm increments over more than 100 mm length, they dilate extremely gently until treatment with FMS dilators from 14 mm can be continued.

One dilator or a set?

In the early stage of lichen sclerosus, regular massage with a single FMS dilator can already help prevent narrowing of the vaginal entrance due to tissue hardening. Choosing the right size is crucial: a glass dilator that is too small provides little to no massage effect; one that is too large causes pain and is therefore unsuitable. A set is always recommended, as this lets you adjust the size daily to how you feel and to current symptom severity – and increase if you wish.

If consequences have already appeared due to the condition, treatment with a dilator set is necessary in any case, because affected areas first need to be flexibilised very gradually. With a set you can start small and gradually increase size over the course of treatment.

The right size

There is no universal statement about the optimal size of a single dilator or a set, because vaginal capacity varies greatly and there are very different severities and symptoms.

A standard set for every woman and every condition cannot be optimal; that’s why we offer 27 sizes and recommend various sets. You can also assemble your own individual set. 

The first step for the best chance of healing is to determine the right starting size, ideally through self-assessment. We provide tips on finding the right size.

Mental preparation

A pleasant, calm atmosphere is important to make treatment as comfortable as possible. Erotic stimulation can additionally help, as can looking forward to pain-free sex. Imagination and anticipation are powerful boosters for healing.

What else do I need for use?

For optimal treatment, temperature conditioning the dilator can be helpful: intense warmth relaxes tissue; cool glass soothes acute burning and relieves pain. Therefore, prepare a vessel with cold or hot water. After conditioning, briefly dry the glass dilators so the lubricant is not diluted. Larger FMS dilators from approx. 26 mm can even be temperature-conditioned sustainably thanks to their filling; details can be found in the instructions for use. 

FMS dilators have excellent glide. Nevertheless, a high-quality hypoallergenic lubricant is required to create a non-irritating lubricating film. 

Also have a towel ready for drying after the water bath and for placing used dilators on, plus another to clean your fingers after applying lubricant, so you can carry out your session calmly without interruption.

The key point: gentle massage 

Ideally, a half-seated, reclined position with legs open and slightly angled works best. If necessary, treatment can also be done standing with one foot placed on a stool or chair.

Start with a size you can insert comfortably. Then move the dilator gently back and forth for a light massage. The most important thing with lichen sclerosus is to alternately insert and withdraw the head of the dilator completely. This mobilises the mainly affected skin areas around the vaginal entrance and makes them flexible, because symptoms concentrate on the front part of the vulva. For this, it’s sufficient to move only the head of the dilator in and out (i.e. back and forth). Please respect your pain threshold and don’t overdo it. Patience is important here.

Only FMS dilators enable this type of application, because the thicker part is at the front and not at the back as with conical dilators. And above all because they work in both directions: the tissue always moves around the elliptical heads and “flows” – inspired by nature. 

Gradually increase speed to improve efficiency. This massage and the mobilisation of hardened tissue are more decisive for success than maximum stretch or insertion depth.

When to increase size?

If moving a dilator causes no pain or discomfort, you can continue treatment with the next size. This may happen during the first session, but in severe cases may take several sessions. Don’t pressure yourself. What matters is accepting your current state and needs. With sets that have the smallest size steps of 1 mm (up to size 19) and 2 mm (from size 20), success usually comes faster; sets with larger steps of 2 mm (up to size 19) and 4 mm (from size 20) require a bit more patience. Your well-being during use alone determines progress and pace.

Frequency and duration 

Duration and frequency always depend on the current stage of the condition. During an acute flare, use is usually limited to what’s necessary to maintain status and counteract deterioration. Between flares, you should check for changes and take countermeasures if needed. Avoid long breaks between sessions, as hardening of tissue can also progress gradually. As someone affected, you are the best expert on your body. Keep at it!

Free therapeutic advice

Under “Frequently asked questions about FMS dilators” you’ll find further info, and our guides cover additional specialist topics. I’m happy to answer customer questions about using our products for individual concerns.

Contact: hsw@theros.de

Hera Schulte Westenberg