Presented is a case of a 6-year-old girl with biopsyproved lichen sclerosus et atrophicus (LSA) localized to the anogenital region. She was seen approximately 3 months after the development of vulvar pruritus and burning on micturition. Following vulvar biopsies the patient was treated with hydrocortisone cream. Four months postbiopsy the patient is asymptomatic but with the coalesced white plaques remaining. Although cases benefiting from such various regimens as estrogen creams have been reported in the literature, the major benefit of therapy is relief of symptoms. This may be more safely accomplished with treatment of any vaginal discharge and the use of topical hydrocortisone cream. In children with regression of lichen sclerosus, complete resolution is common. No definite relationship to the menarche is documented.