Use of Theros® FMS Dilators for Lichen Sclerosus

 
Lichen sclerosus is a non-contagious, chronic skin condition – most commonly affecting the genital area in women; however, men and children can also be affected. You can find all details in our guide Lichen Sclerosus – Symptoms and Treatment. Here we explain the use of Theros® FMS dilators for self-treatment in lichen sclerosus.

Why Use FMS Dilators for Lichen Sclerosus?

The treatment with FMS dilators in lichen sclerosus provides effective and gentle support: The dilation does not occur through simple stretching 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 moved in and out alternately, while unaffected areas remain protected. In addition, the extremely smooth borosilicate glass glides with virtually no friction. These factors allow many repeated massage movements, keep the tissue flexible and activate cellular metabolism – without irritating sensitive skin areas.
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 (dilation through massage effect) would no longer be effective due to the minimal difference between head and shaft. For these cases, we recommend our Theros® Bougie dilators made of implant-grade steel: The polished, non-porous surface glides very well and is extremely hygienic, implant-grade steel is 100% biocompatible and suitable even for nickel allergies. With only 1 mm increments over a length of more than 100 mm, they allow very gentle dilation until treatment with FMS dilators from 14 mm can be continued.

One Dilator or a 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 tissue hardening. The correct size is crucial: a dilator that is too small has insufficient massage effect, while one that is too large causes pain or cannot be inserted at all. A dilator set is always recommended, as it allows you to adapt the size daily to your condition and the current severity of symptoms – and increase it if needed.

If symptoms have already developed, treatment with a dilator set is essential, as affected areas must be gradually restored in flexibility. With a set, you can start small and increase the size step by step over the course of treatment.

The Right Size

There is no general answer regarding the optimal size of a single dilator or a set, as vaginal capacity varies greatly and symptoms differ significantly in severity.

A standard set for every woman and every condition cannot be optimal – therefore, we offer 27 sizes and provide recommendations for different sets. You can also create your own individual set.

The first step for the best chances of recovery is determining the correct starting size, ideally through self-examination. We provide tips for finding the right size.

Mental Preparation

A calm, pleasant atmosphere is essential to ensure the treatment is as relaxed as possible. Erotic stimulation may also help – as can anticipation of pain-free intercourse. Imagination and positive expectation are powerful contributors to recovery.

What Else Do I Need?

For optimal treatment, temperature adjustment of the dilator can be helpful: warmth relaxes the tissue, while cool glass can reduce burning sensations and relieve pain. Therefore, prepare a container with cold or hot water. After tempering, dry the dilators briefly so the lubricant is not diluted. Larger FMS dilators (approx. 26 mm and above) can even maintain temperature sustainably through filling; details can be found in the instructions for use.

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

Also prepare a towel to dry the dilators after the water bath and to place used dilators on, as well as another towel to clean your fingers after applying the lubricant – so you can carry out your treatment without interruption.

The Most Important Thing: Gentle Massage

A semi-reclined position with bent, open legs is ideal. If necessary, the treatment can also be performed standing with one foot placed on a stool or chair.

Start with a size that you can comfortably insert. Then gently move the dilator back and forth for light massage. The most important aspect in lichen sclerosus is to alternately fully insert and withdraw the head of the dilator. This mobilizes the affected tissue around the vaginal entrance and increases flexibility – as symptoms mainly occur in the front area of the vulva. It is sufficient to move only the head in and out. Always respect your pain threshold and do not overstrain yourself. Patience is key.

Only FMS dilators allow this type of application, as the thicker part is at the front rather than at the back as with conical dilators. Most importantly, they work in both directions: the tissue moves around the elliptical heads and “flows” – following the model of nature.

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

When to Increase Size?

If the movement of a dilator causes no pain or discomfort, you can proceed with the next size. This may happen during the first session or may take several sessions in more severe cases. Do not put pressure on yourself. What matters is acceptance of your condition and needs. Sets with smaller increments of 1 mm (up to size 19) and 2 mm (from size 20) allow faster progress; larger increments require more patience. Progress is determined solely by your comfort.

Frequency and Duration

Duration and frequency always depend on the current state of the condition. During acute phases, application is often limited to maintaining the current status and preventing further deterioration. Between flare-ups, changes should be monitored and addressed if necessary. Avoid long breaks, as tissue hardening can occur gradually. As someone affected, you are the best expert on your own body. Trust yourself and stay consistent – it is worth it.