If you've recently been diagnosed with lichen planus, you're already familiar with the discomfort it can cause. Your skin itches, you have a rash or even sores and lesions. Lichen planus can be physically painful and emotionally disturbing. However, it usually resolves with treatment, most of which you can manage at home.
What is Lichen Planus?
Lichen planus is a condition causing targeted inflammation of the skin and mucous membranes. It is caused by the immune system mistakenly targeting healthy tissue. The result is an itching rash in the mouth, on hands and feet, nail beds, or genitals.
Lichen planus is not a dangerous condition, but it can disrupt daily life. With genital lichen planus, your skin may develop sores that can be extremely painful. Depending on their location, they may cause complications with sex, hygiene, and other activities.
The good news is that lichen planus can be treated, usually at home. Most cases clear up with the right treatment, and the vast majority are gone within 18 months. Some people do have recurrent flare-ups of the condition.
What Are The Symptoms of Lichen Planus?
Lichen planus can affect various parts of the body in different ways. On the hands and legs — particularly the forearms, wrists, and ankles — it usually manifests as flat, itchy bumps that may be purplish. These develop over weeks and can range from mildly to debilitatingly itchy.
The condition also commonly affects the nails, leading to scarring or discoloration. Some people may lose one or more of their nails altogether, though they will grow back without issue. Although less common, lichen planus can also develop on the scalp, which may cause hair loss.
Lichen planus affecting the mucous membranes can be more serious, painful, and distressing. That's because these mucous membranes are found in the mouth and the genitals, including the vagina, vulva, and penis.
On these parts of the body, the condition appears as a lacy white pattern. While it doesn’t itch, it may develop into painful sores that can become infected if left untreated.
Not everyone who has the condition affecting their skin will have oral lichen planus. It is also important to know that it is not contagious, and it is not a sexually transmitted disease. You cannot spread lichen planus to someone by sharing a living space, eating utensils, or having sex.
Other symptoms of the condition may include dry mouth or a metallic taste in the mouth.
What Causes Lichen Planus?
The short answer is -- we're not entirely sure. Lichen planus is not considered an autoimmune disorder, but it works so similarly to one that it is often put in that category.
Medical experts have several theories about the cause of lichen planus. These include:
- Allergic reactions to medication
- Genetics
- Exposure to certain chemicals or dyes
- Diseases such as hepatitis C
To diagnose your symptoms, your doctor will likely ask you about your medical history. That includes what medications you take and what health concerns you've had in the past. If your condition is related to a certain drug, it will likely resolve as soon as you stop taking it.
How do Doctors Diagnose Lichen Planus?
If you notice an itchy, raised, or discolored rash on your arms, hands, legs, or feet -- especially one that affects your nails -- you should visit your dermatologist as soon as possible. Lichen planus of the skin isn't deadly, but it can cause significant discomfort in your daily life.
Physical Examination
During the examination, your doctor will look for the six characteristics of a lichen planus rash, sometimes called the "six Ps":
- Itchiness (pruritis)
- Angular (polygonal)
- Flat (planar)
- Discolored (purple)
- Bumpy (papules)
- Patches (plaque)
Skin Biopsy
A skin biopsy is usually performed to confirm the diagnosis. In this procedure, your doctor may use a small razor to gently scrape a bit of skin off the affected area. This is then sent off to a lab to be tested.
Allergy Test
Some doctors may recommend an allergy test. This will help target possible lichen planus causes, such as a reaction to medication. By pinpointing the cause, you can more effectively treat the symptoms. If your condition is caused by an allergen, reducing or eliminating the allergen usually stops the symptoms in a few days or weeks.
Blood Test
Sometimes blood tests are conducted to support the diagnosis. Lichen planus is not directly caused by hepatitis C, and most people who have one don't have the other. But there is a correlation between the two issues. If a blood test indicates you have been infected with hepatitis C, it may draw a clearer picture of why you've developed lichen planus and how to treat it.
How do You Treat Lichen Planus?
The treatment for lichen planus depends on several factors. Mild lichen planus may not need treatment and often resolves on its own. However, severe cases can seriously disrupt your daily life.
Treatment also varies depending on what part of the body is affected.
Treating Lichen Planus of The Skin
There are a few standard treatments for lichen planus breakouts on the skin. These include:
- Topical corticosteroid creams and ointments. Your doctor may also prescribe an oral corticosteroid.
- Immunosuppressants
- Oral medications to fight infection
- Antihistamines to combat allergic reactions
- Phototherapy
- Home remedies such as aloe vera, oatmeal baths, and over-the-counter medicines
- Retinoid medications -- these stimulate the production of blood vessels and collagen. However, they are not safe if you are pregnant or nursing, as they can cause birth defects and other health problems.
- Avoiding triggers and reducing stress, which can lead to breakouts
Treating Lichen Planus of The Mouth
The treatment for oral lichen planus is fairly straightforward. In addition to corticosteroids, you can reduce your symptoms with:
- Good oral hygiene
- Avoiding injury to the mouth when possible
- Avoiding acidic foods like hot peppers and citrus
- Eliminating alcohol and tobacco
- Replacing dental fillings if they are the source of irritation. In some rare cases, certain dental compounds can cause allergic reactions.
Treating Genital Lichen Planus
For genital lichen planus, treatment usually involves topical steroids and soothing compresses to reduce pain. Your doctor may also recommend applying petroleum jelly to any lesions for an extra layer of protection.
How Dermeleve Can Help Soothe Lichen Planus
When it comes to conditions like lichen planus, finding the right topical treatment can spell the difference in finding relief. Corticosteroids are often used to treat this skin condition, but overusing them can lead to other serious health conditions.
That's why Dermeleve offers steroid-free, highly effective relief from skin irritation. You can feel safe knowing that there are no side effects or long-term complications. Dermeleve's quick-acting formula reduces your symptoms quickly, bringing you peace of mind. To learn more, visit this link.
Dr. Neal Bhatia is a board-certified dermatologist based in San Diego, California. He serves as the Director of Clinical Dermatology at Therapeutics Clinical Research and is the Chief Medical Editor for Practical Dermatology. Additionally, he is an Associate Clinical Professor at Harbor-UCLA Medical Center in Los Angeles, CA. With a background in immunology, Dr. Bhatia has a special interest in mechanisms of therapy, skin cancer, and medical dermatology.
Learn more about Dr. Bhatia and our Medical Advisory Board