To describe the etiology, clinical manifestations, assessment, and management of vulvar lichen sclerosus (LS) in women. Selected research and clinical articles in professional journals and online websites, peer review, educational technical bulletin from professional organization and the authors' professional clinical experiences. Vulvar LS can manifest with varied symptoms that may mimic other common vulvar disorders such as infections. Careful assessment of the vulva and biopsy of any suspicious skin changes are needed for diagnosis and management of vulvar LS. Treatment with high-potency topical corticosteroids may alleviate uncomfortable symptoms and reduce physical changes. Follow-up management is essential to check for progressing problems such as introital stenosis and to assess for skin changes that may indicate vulvar squamous cell carcinoma. Accurate diagnosis and successful management of vulvar LS requires thorough assessment of the genitalia, knowledge of the disorder and appropriate treatment and follow-up management.