What is the worst progression of lichen sclerosus?

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I have seen the pictures (attachment removed to protect patient identity), and nothing looks abnormal.

If you have itching only, then you can use candid cream (Clotrimazole) locally. It will be more helpful if you have a fungal infection. Drink more water as the urine should be transparent. If dark spots are increasing and symptomatic than you can send a small biopsy to rule out any pathology. And if anything found then you can go for treatment accordingly. Right now if sexual health tests comes normal then do not worry.

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Normally black discoloration can be due to friction, and age-related and it does not look like anything abnormal. That is why I asked, if it is increasing in size or symptoms are there like pain or redness. Actually, the photo is slightly blurred. But it looks like mucosal blackening. Do drink more water. Wash the area with vaginal wash like solution two times a week. Change pads during menses more frequently.