Treatment of lichen planus is essential for alleviating symptoms and improving quality of life, especially for individuals experiencing persistent discomfort or visible skin lesions.
Because symptoms vary in severity, place, and type, doctors adjust treatment plans for each person. While some mild cases clear up on their own, many people need medicine to ease pain, calm inflammation, and stop flare-ups.
Lichen planus causes inflammation and can affect the skin, mouth, scalp, or nails. Experts aren’t sure what causes it, but it likely involves the immune system not working properly. So, most treatments aim to calm the immune system, reduce inflammation, and relieve itching and soreness. While there’s no full cure, many treatments can control the condition well.
First Steps in the Treatment of Lichen Planus
Doctors usually start with topical corticosteroids. These creams or ointments go straight onto the rash and help reduce redness and itching. In tough cases, stronger steroids like clobetasol propionate might be needed.
If steroids thin the skin or can’t be used for long, other creams like tacrolimus or pimecrolimus may help. These non-steroid options act on immune cells and work well for delicate areas like the mouth and genitals.
Soothing moisturisers and emollients also play a role. They calm dry, itchy skin and form a shield to protect it. They work even better when used with other topical treatments.
Moving to Oral Medications
When the condition spreads or becomes severe, pills may be needed. Doctors often give short-term oral steroids like prednisone to calm symptoms fast. These lower inflammation across the body by calming the immune system.
Other strong medications like azathioprine, methotrexate, and cyclosporine help when steroids don’t work or cause too many side effects. Doctors save these for harder cases. Retinoids like acitretin, made from vitamin A, are another option. These can help with stubborn skin lesions, but they’re unsafe during pregnancy due to the risk of birth defects.
Sometimes, people deal with severe itching that affects sleep or mood. Antihistamines help ease the itch. While they don’t fix the disease, they do make life more comfortable.
Phototherapy as an Alternative Treatment of Lichen Planus
When creams and pills don’t work well enough, light therapy can help. This method, called phototherapy, is useful for people with wide-spread or stubborn skin issues. One popular option is narrowband ultraviolet B (NB-UVB) therapy. It uses special light to slow skin growth and ease inflammation.
PUVA, another light therapy that uses UVA light with a medicine called psoralen, may also help. However, PUVA has more side effects than NB-UVB. Light therapy usually takes place at a clinic, two to three times a week, for several weeks or even months. A skin specialist carefully supervises this process.
Special Care for Oral and Genital Lichen Planus
When lichen planus affects the mouth or genitals, treatment needs to be more specific. Doctors often give steroid gels or ointments. These may be used with custom dental trays to keep medicine in place on the mouth’s lining. For painful or ulcerated areas, pills may be needed.
Managing pain is very important. Oral lichen planus can make eating, drinking, or speaking hard. Numbing mouth rinses with lidocaine can ease pain during meals. For the genitals, keeping clean, avoiding irritants, and using creams like steroids or tacrolimus helps manage the condition.
Nail and Scalp Problems
When it affects nails, lichen planus can cause lines, splits, or even lead to nail loss. To stop this, doctors may inject steroids directly into the nail area. While this may hurt, it can help save the nail and ease swelling.
On the scalp, the condition is called lichen planopilaris. It can cause scarring and hair loss if untreated. To prevent this, doctors may use steroid creams, scalp injections, or pills like hydroxychloroquine or isotretinoin. These medicines aim to protect hair roots and stop damage from spreading.
Lifestyle Tips to Support Treatment of Lichen Planus
Medical treatment works best when paired with healthy habits. Avoiding known triggers like certain drugs, stress, or allergens may reduce flare-ups. Eating well, staying hydrated, and lowering stress through yoga or meditation can help the immune system stay balanced.
Taking gentle care of the skin is also key. Use soft, fragrance-free soaps and moisturisers. For oral care, avoid spicy or sour foods, and brush with a soft toothbrush. Alcohol-free mouthwashes are gentler and help keep the mouth clean without irritation.
Importance of Monitoring and Long-Term Care
Regular check-ups are very important, especially for those with oral or genital lichen planus. These forms may carry a small risk of turning into cancer. Seeing your doctor regularly helps check how well treatments are working and if anything needs to change.
If lesions don’t get better or seem unusual, a doctor might take a small sample (biopsy) to check for cancer. Catching problems early means better and quicker treatment.
Conclusion
The treatment of lichen planus takes a mix of approaches and depends on each person’s needs. It may include creams, pills, light therapy, and changes in daily habits. Acting early and staying on top of treatment can improve symptoms and life quality. Although it may come back now and then, many people do well with the right care and enjoy long periods without symptoms.
