The untapped potential of oral vitamin E in lichen sclerosus: from immunobiology to real-life clinical experience
6 affiliations
- 1Laboratory of Experimental Immunology, Istituto Dermopatico dell’Immacolata, IDI-IRCCS
- 2Bioinformatic Unit, Istituto Dermopatico dell’Immacolata, IDI-IRCCS
- 3UniCamillus, Saint Camillus University of Rome
- 4Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza
- 5Center for Regenerative Dermatology and Immune-Mediated Skin Diseases, Istituto Dermopatico dell’Immacolata, IDI-IRCCS
- 6Department of Life Sciences, Health, and Health Professions, Link Campus University
Abstract
Lichen sclerosus (LS) is a chronic dermatosis characterized by persistent inflammation, progressive fibrosis, and an elevated risk of vulvar squamous cell carcinoma. While ultra-potent topical corticosteroids remain the gold standard of care, the necessity for long-term maintenance therapy raises concerns regarding cumulative toxicity, underscoring the critical need for adjunctive therapies that target underlying pathogenic mechanisms. Vitamin E, traditionally recognized for its antioxidant and membrane-protective properties, has emerged as a promising candidate due to its broad immunomodulatory effects, including its regulatory impact on innate and adaptive immunity and its anti-inflammasome activity. However, the available clinical evidence remains limited to topical formulations, and corresponding efficacy data are scarce. In this Perspective article, we critically analyze the current clinical evidence on oral vitamin E in LS, delineate its immunological mechanisms, and incorporate insights from real-world clinical practice at a tertiary referral center, which should be interpreted as hypothesis-generating given the observational, uncontrolled design. Furthermore, we explore the potential of oral vitamin E formulations, address the pharmacokinetic challenges associated with conventional delivery, and propose future research avenues—such as optimized delivery systems and active metabolite formulations—to fully elucidate the therapeutic role of oral vitamin E in LS management.
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BibTeX
@article{scala2026untapped,
title = {{The untapped potential of oral vitamin E in lichen sclerosus: from immunobiology to real-life clinical experience}},
author = {Emanuele Scala and Giovanni Luca Scaglione and Lavinia Zozi and Chiara Assorgi and Laura Colonna and Cristina Albanesi and Mauro Picardo and Alessia Paganelli},
journal = {Frontiers in Pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1945302},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1945302/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The untapped potential of oral vitamin E in lichen sclerosus: from immunobiology to real-life clinical experience
AU - Emanuele Scala
AU - Giovanni Luca Scaglione
AU - Lavinia Zozi
AU - Chiara Assorgi
AU - Laura Colonna
AU - Cristina Albanesi
AU - Mauro Picardo
AU - Alessia Paganelli
PY - 2026
DA - 2026/10/07
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1945302
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1945302/full
AB - Lichen sclerosus (LS) is a chronic dermatosis characterized by persistent inflammation, progressive fibrosis, and an elevated risk of vulvar squamous cell carcinoma. While ultra-potent topical corticosteroids remain the gold standard of care, the necessity for long-term maintenance therapy raises concerns regarding cumulative toxicity, underscoring the critical need for adjunctive therapies that target underlying pathogenic mechanisms. Vitamin E, traditionally recognized for its antioxidant and membrane-protective properties, has emerged as a promising candidate due to its broad immunomodulatory effects, including its regulatory impact on innate and adaptive immunity and its anti-inflammasome activity. However, the available clinical evidence remains limited to topical formulations, and corresponding efficacy data are scarce. In this Perspective article, we critically analyze the current clinical evidence on oral vitamin E in LS, delineate its immunological mechanisms, and incorporate insights from real-world clinical practice at a tertiary referral center, which should be interpreted as hypothesis-generating given the observational, uncontrolled design. Furthermore, we explore the potential of oral vitamin E formulations, address the pharmacokinetic challenges associated with conventional delivery, and propose future research avenues—such as optimized delivery systems and active metabolite formulations—to fully elucidate the therapeutic role of oral vitamin E in LS management.
SN - 1663-9812
ER -