Lichen sclerosus (LS) is a chronic condition affecting the anogenital region in women. Symptoms range from none at all to severe pruritus. While most LS is atrophic and culminates in scarring, there is a less common variant that is hyperkeratotic. This presentation is typically refractory to standard-of-care super-potent topical steroids, likely owing to decreased penetration. On rare occasions, if left partially or completely untreated, LS can progress to squamous cell carcinoma, highlighting the importance of monitoring and treating this condition.1 We report 2 cases women with hyperkeratotic LS refractory to conventional treatment with super-potent topical steroids that was successfully treated with fractionally ablative laser therapy (Er:YAG; erbium-doped yttrium aluminium garnet).