Lichen Planus Treatment

We provide lichen planus treatment and care at Vujevich Dermatology Associates.

What is lichen planus?

Lichen planus is a skin condition that can affect multiple areas of the body, including the skin, hair, nails, and mucous membranes. Because of the vast difference in areas affected, lichen planus treatment for each area differs. Before identifying a lichen planus treatment plan, you need to learn what causes lichen planus and how to identify the symptoms.

Lichen planus causes swelling and irritation in the affected areas. How this swelling and irritation presents differs based on the affected area. When the skin is affected by lichen planus, common symptoms include purplish, flat bumps that often occur around the ankle, wrist, or inner forearm. These bumps are often itchy. Blisters that form scabs or crusts are also common.

When lichen planus affects mucous membranes, such as the mouth, symptoms include painful sores. Lacy white patches can also form in the mouth or on the lips that can cause a burning sensation. A form of lichen planus, lichen planopilaris, often results in the destruction of hair follicles, which leads to alopecia. This can also change the color of your scalp.

Is Lichen Planus Contagious?

No, lichen planus is not contagious. However, it is a chronic skin condition, and lichen planus symptoms can last from six months to over a year. Understanding the causes and triggers of lichen planus can help you and your dermatologist create a lichen planus treatment plan that can help manage symptoms and outbreaks.

What triggers lichen planus?

While there are no specific lichen planus causes known, it is connected to your immune system and there are many factors that are thought to trigger this condition. Immune responses to triggers such as stress, viral infections, or allergens may cause this rash. Genetics can also play a factor in lichen planus symptoms.

Other common triggers include certain medications, such as medication for high blood pressure or pain relievers, including Advil and Aleve. Certain pigments, metals, and chemicals sometimes cause flare ups. Identifying which pigments, metals, or chemicals can be a trial-and-error process, but knowing what triggers your condition is important to your lichen planus treatment plan. A Hepatitis C infection or the flu vaccine has also been linked to lichen planus.

Lichen planus is thought to affect less than 1% of the world’s population. However, it can occur in anyone, and lichen planus that affects the skin often affects men and women equally. Oral lichen planus is diagnosed in women twice as often as men. It is most often diagnosed in middle-aged people and rarely affects very young children or the elderly.

Are there complications caused by lichen planus?

Most mild cases of lichen planus can be treated at home and often without medical care. If significant pain or itching occurs, dermatological care can be helpful in managing your symptoms.

During an oral lichen planus breakout, it can be difficult to eat. Oral lichen planus also increases your risk of being diagnosed with oral cancer. If lichen planus affects the ear canal, and is left untreated, this can eventually lead to hearing loss. Darkening of the skin can occur, even after the rash has cleared. This occurs more often in darker skin tones.

If you have other concerns, please speak with your dermatologist.

How is lichen planus diagnosed?

Dermatologists can often diagnosis lichen planus by a physical examination. At times, additional testing is required for a diagnosis. You may have a biopsy, which is an analysis of skin cells, to identify if cell patterns match those of lichen planus.

A Hepatitis C test may be conducted, as this is often a trigger of lichen planus. Allergy tests may also be used to identify if the rash is an allergic reaction or if the allergic reaction may be triggering lichen planus. Once you have a confirmed diagnosis of the condition, your dermatologist can create a lichen planus treatment plan tailored to you.

What is the best treatment for lichen planus?

There are different types of lichen planus treatment based on the affected area. In general, if you know your triggers, attempt to avoid them as much as possible. If stress is often a trigger, explore new ways to manage your stress. Some recommendations include meditation, short walks, or crafting.

When affecting the skin, lichen planus treatment may include light therapy. Ultraviolet B light is  commonly used to treat lichen planus. To be effective, you may need light therapy two to three times a week for several weeks. Medications are often prescribed for treatment, including corticosteroids, oral anti-infection medications, immune response medicines, antihistamines, and retinoids.

Corticosteroids can be prescribed as a topical ointment, pill, or injection based on how large the affected area is. Oral anti-infection medications that may be prescribed based on your symptoms include hydroxychloroquine and metronidazole. If your lichen planus symptoms are severe, an autoimmune suppressant may be prescribed to alleviate symptoms. And, if the above treatments do not work, your dermatologist may prescribe retinoids in pill form.

If lichen planus has caused hair loss, alopecia treatment options are often considered to manage this hair loss. This often includes hair loss medication, which includes corticosteroids, minoxidil, anthralin, and diphencyprone (DPCP). Treatment of lichen planopilaris aims at managing the spread of the symptoms to prevent additional hair loss.

While you can treat most cases of lichen planus at home, confirming a diagnosis can help manage this chronic skin condition efficiently. Contact us to schedule an appointment with one of our expert dermatologists to discuss your lichen planus treatment options.