Use of Theros® FMS Dilators for Lichen Sclerosus

 
Lichen sclerosus is a non-contagious, chronic skin condition that most commonly affects the genital area of women, although men and children can also be affected. You can find full details in our guide Lichen Sclerosus: Symptoms and Treatment. Here we explain how to use Theros® FMS dilators for self-treatment of lichen sclerosus.

Why Use FMS Dilators for Lichen Sclerosus?

The use of FMS dilators for lichen sclerosus offers effective and gentle support: stretching is not achieved by simply forcing tissue apart, as with traditional dilators, but through the gentle massage effect of the elliptical heads. For this reason, the dilator does not need to be inserted fully – only the elliptical head is repeatedly inserted and withdrawn. Unaffected areas remain protected. In addition, the extremely smooth borosilicate glass glides with virtually no friction. These factors allow many beneficial repetitions of the massage, help maintain tissue flexibility and stimulate cellular metabolism – without irritating sensitive skin.
FMS dilators are available in 27 sizes starting from 14 mm in diameter. If sizes below 14 mm are required at the beginning of treatment, the FMS principle (stretching through massage action) is no longer effective because the difference between the head and shaft becomes too small. In such cases, we recommend our Theros® Bougie Dilators made from implant-grade steel: the polished, pore-free surface glides exceptionally well and is extremely hygienic, while implant-grade steel is 100% biocompatible and suitable even for people with nickel allergies. With an increase of only 1 mm over a length of more than 100 mm, they provide exceptionally gentle stretching until treatment can continue with FMS dilators from 14 mm onwards.

A Single Dilator or a Dilator Set?

In the early stages of lichen sclerosus, regular massage with a single FMS dilator can help prevent narrowing of the vaginal opening caused by hardening of the tissue. Choosing the correct size is essential: a dilator that is too small produces insufficient massage, while one that is too large causes pain or cannot be inserted at all. A dilator set is always recommended because it allows you to adapt the size daily according to your condition and the current severity of symptoms – and increase it when necessary.

If consequences of the condition have already developed, treatment with a dilator set is essential because affected areas must be gradually made flexible again. A set allows you to begin with smaller sizes and increase gradually as treatment progresses.

The Right Size

A universal recommendation regarding the ideal size of a single dilator or a dilator set is not possible because vaginal capacity varies greatly and the severity and symptoms of lichen sclerosus differ significantly from one person to another.

A standard set suitable for every woman and every situation therefore cannot be optimal. This is why we offer 27 sizes and recommend different sets. You can also create your own customised set.

The first step towards the best possible chance of recovery is determining the correct starting size, ideally through self-examination. We provide tips on how to determine the right size.

Mental Preparation

Creating a pleasant, calm atmosphere is important so that treatment can be carried out as comfortably and relaxed as possible. Erotic stimulation may also be helpful, as can looking forward to pain-free sex. Imagination and anticipation are powerful allies in the healing process.

What Else Do I Need?

For optimal treatment, temperature adjustment of the dilator can be beneficial: intense warmth relaxes the tissue, while cool glass can reduce acute burning sensations and relieve pain. Therefore, prepare a container with either hot or cold water. After adjusting the temperature, dry the glass dilators briefly so that the lubricant is not diluted. Larger FMS dilators from approximately 26 mm onwards can even retain temperature sustainably when filled; details can be found in the instructions for use.

FMS dilators offer excellent glide. Nevertheless, a high-quality medical lubricant is essential to create a smooth, irritation-free lubricating film.

You should also have a towel ready for drying the dilators after the water bath and placing used dilators on during treatment, as well as another towel for cleaning your fingers after applying lubricant. This allows you to carry out your treatment calmly and without interruption.

The Most Important Thing: Gentle Massage

The ideal position is semi-reclined, leaning back with your legs bent and comfortably apart. If necessary, however, treatment can also be performed while standing with one foot placed on a stool or chair.

Begin with a size that you can insert comfortably. Then move the dilator gently back and forth to create a light massage. The most important aspect of treatment for lichen sclerosus is to insert and withdraw the head of the dilator completely with each movement. This mobilises the skin around the vaginal opening – the area most commonly affected – and gradually restores flexibility. Because symptoms are concentrated in the front part of the vulva, it is sufficient to move only the head of the dilator in and out or gently back and forth. Respect your pain threshold and do not push yourself too hard. Patience is essential.

Only FMS dilators make this type of treatment possible, because the wider section is at the front rather than the rear, unlike conical dilators. Most importantly, they work in both directions: the tissue continually moves around the elliptical heads and “flows” – following the principles of nature itself.

Gradually increase the speed of the movement to improve effectiveness. This massage and mobilisation of hardened tissue are more important for treatment success than achieving maximum stretching or insertion depth.

When Should I Increase the Size?

Once movement of a dilator no longer causes pain or discomfort, you can continue treatment with the next size. This may happen during the very first session, but in severe cases it may take several sessions. Do not put yourself under pressure. What matters is accepting your current condition and your own needs. Sets with the smallest size increments of 1 mm (up to size 19) and 2 mm (from size 20 onwards) generally lead to faster progress, while sets with larger increments of 2 mm (up to size 19) and 4 mm (from size 20 onwards) require a little more patience. Only you determine the pace of progress – according to your comfort during treatment.

Frequency and Duration of Treatment

The duration and frequency of treatment always depend on the current stage of the condition. During an acute flare-up, treatment is usually reduced to the minimum required to maintain the current situation and prevent further deterioration. Between flare-ups, you should regularly assess any changes and take action if necessary. Avoid excessively long breaks, as tissue hardening can also develop gradually and unnoticed. As someone affected, you are the best expert on your own body. Trust yourself, stay consistent and keep going – it is worth it.