Lichen Planus

Lichen Planus. it’s Time for Relief. Treatment for Rashes & Dental Pain

Updated: 9/28/23

If you’re looking for ways to obtain relief from the painful and irritating symptoms of Lichen Planus, then you’ve come to the right place. Lichen Planus can cause itchy rashes on your skin or inside your mouth along with dental pain; but thankfully, fast and effective treatments are available so that you can get back to feeling like yourself again. In this blog post, we will discuss various treatment methods that have been proven beneficial in offering relief from the physical discomfort caused by Lichen Planus.

What is Lichen Planus?

Lichen Planus is a relatively uncommon skin disease that affects about 2 percent of people. It can affect several different parts of the body including arms, legs, scalp, nails, genitals and mouth. In cases where only the mouth is affected, it is often referred to as oral lichen planus.

Lichen planus is not an infectious disease and it is not caused by lifestyle choices. For those who have symptoms presenting in the genital region, it can be mistaken for an STI. However, it is not transmitted by sexual contact, and should not cause shame or worry.

If the condition is limited to your skin then it will usually clear up within nine months. Until then, it is a matter of managing the symptoms. Oral lichen planus may never go away. If it does, it can take years to do so. Once the condition has cleared up, it is very unlikely to return.

You are more likely to develop lichen planus once you are over the age of 40. The skin condition equally affects men and women, though oral lichen planus is more common in women.

For many, the symptoms or lichen planus are mild and there is no need for treatment. Only in cases where the rash causes pain will treatment be suggested. In a very small number of cases, the condition is classed as erosive lichen planus. In this case, along with the rash, painful ulcers can form in the mouth and on the genitals.

Lichen Planus Symptoms

Skin Irregularities

The most common lichen planus symptom is a skin rash. It can appear as a cluster of small, flat-topped bumps that are shiny and reddish-purple in color. The rash can appear anywhere on the body, but it is most commonly found on the wrists, ankles, lower back, and neck. The bumps may also be scaly and have a white streak running through them. The bumps can be between 3-5 mm in diameter. Along with these bumps, there may also be some white streaks. These irregular white streaks are known as Wickham’s streaks.

These purple bumps are most often observed on the wrists and forearms, but can appear anywhere on the body. When seen on the ankles, the rash is often thicker and scaly in texture.

These bumps will appear and disappear over time, with new ones appearing as older bumps fade. Once the bumps do fade, they will often leave the skin discolored for some time.

Itching

The rash associated with lichen planus can be very itchy. The intensity of the sensation varies from patient to patient. The itching can be unbearable at times, making it difficult to sleep and focus on daily activities.

Blisters and Ulcers

Blistering or the formation of ulcers can occur with lichen planus. However, it is a very rare form of lichen planus that causes this. Erosive lichen planus leads to the rash being far itchier than normal. It will also cause the formation of blisters and ulcers located in either the mouth or on the genitals.

For men, the ulcers are less likely to form on their genitals and may just be limited to the mouth.

White Patches in the Mouth

The hallmark of oral lichen planus is the appearance of white patches in the mouth. The white patches often form on the cheeks, tongue, and gums. In mild cases these white patches are painless. In some cases, though they may be sensitive to hot or spicy foods.

Nail Damage

Lichen planus can also cause nail changes, such as thickening, grooving, ridges, or splitting. The nails can become discolored and even detach from the nail bed. These nail changes can be very painful, and they can also make it difficult to perform daily activities. In a small number of cases, the nails may stop growing or even fall out. This is a rare occurrence.

Hair Loss

Patches of red skin rash can form on the scalp. The hair that is surrounded by these rashes will often fall out. The hair loss can be patchy, and it can occur on the scalp or other parts of the body. In a small number of cases, this hair loss is permanent.

Genital Rashes

For men, the purple bumps seen on the wrists can form in rings on the tip of the penis. The bumps are shiny and flat-topped and can be either red or purple in color. The penile rash is usually not itchy.

For women, the genital rash is much more severe. The rash can form on the vulva or inside the vagina. The rash is often white streaked and the bumps range from red to pink in color. The appearance of the rash coincides with soreness and burning sensations. If the rash forms inside the vagina it can cause narrowing which makes sex painful. Disruption of the rash can lead to a bloodstained discharged. The more severe symptoms are due to the fact the in women the genital symptoms are most often caused by erosive lichen planus.

Lichen Planus and Hair Loss

In some cases, lichen planus can lead to scarring alopecia, a type of hair loss that results in permanent hair loss. Scarring alopecia occurs when hair follicles are destroyed by inflammation and replaced with scar tissue. The scars make it difficult or impossible for hair to grow in the affected areas. Scarring alopecia can occur on the scalp or other parts of the body, and it can be a devastating consequence of lichen planus.

Is Lichen Planus an Autoimmune Disease?

Lichen planus is an autoimmune response. Although the exact causes are unknown, the condition occurs when the immune system mistakenly attacks the skin, mucous membranes, and nails. As the immune systems attack, it removes the protective tissues, leading to inflammation.

Is Lichen Planus Cancerous?

Lichen planus is typically not cancerous. Research indicates that it is an autoimmune condition, which means that the body’s immune system attacks its own tissues by mistake. Lichen planus affects the skin, oral mucosa, and/or genitals, causing rashes, bumps, and dryness. While cancerous changes are not common in this condition, a few studies suggest that lichen planus can increase the risk of certain cancers, particularly of the oral cavity, esophagus, and genitals. However, more research is needed to understand the potential link between lichen planus and cancer.

 

Lichen Planus Symptoms

Causes of Lichen Planus

Though the exact cause of Lichen Planus is unknown, various environmental and genetic factors trigger this chronic skin disease. However, several factors could play a role in its development.

Immune System

Lichen planus is an autoimmune disorder, which means that the immune system attacks healthy tissue, causing inflammation and pain. It usually occurs when the immune cells attack skin cells, which leads to the formation of purple, scaly patches on the skin. Certain viral infections, such as hepatitis C, can trigger Lichen Planus by activating the immune system. Similarly, some medications and chemicals can also trigger the immune system and lead to developing it.

Virus or Infection

It is thought that lichen planus can be caused by an external factor such as exposure to an bacteria or a virus. It has been noted that sufferers of it are also more likely than normal to be positive for hepatitis C.

Allergies

Allergies are another potential trigger for Lichen Planus. Exposure to various allergens, such as chemicals, metals, or drugs, can cause adverse reactions in the body, leading to skin inflammation and rashes. If you suspect that you may have an allergy-related Lichen Planus, it is crucial to get tested by an allergist to identify the allergen and avoid it.

Genetics

Lichen Planus is a genetically inherited condition that often runs in families. If someone in your family has it, you have a higher risk of developing this condition. Medical researchers have identified several genes that are associated with it. However, it is still unclear how these genes cause this skin disorder.

Medications

It has been observed to be caused by some medications. Medicines have links to the onset of lichen planus include some anti-rheumatic injections that contain gold. These injections are to relieve the pain of arthritis or painful joints. Some anti-malarial tablets have also have links to it. The side effect is rare with these drugs and in the case of combating malaria, most people agree that it is worth the small risk.

Emotional and Physical Stress

It is worth noting that emotional and physical stress can also contribute to the development of it. When people experience extreme stress or anxiety, their bodies release stress hormones that can weaken the immune system, leading to many health problems, including Lichen Planus. Therefore, it is crucial to control stress levels through relaxation techniques, such as yoga, meditation, and therapy.

Managing Lichen Planus Symptoms

There are several ways to manage the symptoms of it. Some of these are:

  • Use of topical corticosteroids, either alone or in combination with a topical immunomodulator.
  • Oral antihistamines and other drugs that can help reduce itching, inflammation, and pain.
  • Stress reduction techniques such as yoga, meditation, and deep breathing exercises.
  • Avoiding exposure to chemicals and allergens that can cause irritation.
  • Applying cold compresses or soaking the affected area in cold water.
  • Maintaining a balanced diet with plenty of vitamins and antioxidants.

How to Remove Lichen Planus Pigmentation

Topical Treatments

The most common treatment for lichen planus pigmentation is topical corticosteroids, applying directly to the area of affection. These medications are reduce inflammation, itchiness, and redness from lichen planus pigmentation. In addition to steroids, other topical treatments include calcineurin inhibitors, retinoids, and hydroquinone. Your dermatologist will determine the right medication according to the severity of your condition.

Laser Therapy

Another treatment option for lichen planus pigmentation is laser therapy, which involves using high-intensity light beams to break down the pigments in the affected areas. This procedure  requires a dermatologist for several sessions for visible results. Laser therapy is an ideal option for patients who don’t respond to topical treatments or have severe pigmentation.

Chemical Peels

Chemical peels are an effective treatment for lichen planus pigmentation that involves applying a chemical solution to the affected skin. This solution exfoliates the outer layer of the skin, stimulating the growth of new, pigmentation-free skin. Chemical peels are available in different strengths and be of use in-office or at home.

Lichen Planus Treatment

There are also specific treatments available to help provide relief from Lichen Planus depending on the severity of the condition. Let us take a look at some of these:

Phototherapy

This is a treatment that uses UV light to reduce itching and inflammation. It is often used in combination with other treatments.

Oral Medication

If the symptoms of the swelling are severe or widespread, oral medication may be necessary to reduce inflammation. Your doctor may recommend the use of topical or oral medications, such as corticosteroids, retinoids, and antihistamines, to reduce inflammation and itching. They may also prescribe antibiotics or antifungal medications to treat any secondary infections. These treatments work by reducing inflammation and suppressing the immune response that is causing the condition.

Laser Therapy

This treatment can help reduce the appearance of scars and lesions, and it may also create a protective barrier to keep the affected area from becoming infected.

Cryotherapy

This is a treatment that involves the use of cold temperatures to destroy abnormal tissue, especially in cases of in the mouth.

Lichen Planus vs Psoriasis

Lichen planus and psoriasis are both two chronic skin conditions that can cause discomfort and affect an individual’s quality of life. While they can share similar symptoms, it’s clear the difference between the two lies in their causes, symptoms, and how they present. Effective treatment plans are also available to manage the symptoms of it and psoriasis.

Lichen Planus Remedies and Supplements

Aloe Vera

Aloe vera has long been used for its soothing effect on the skin. It is also known to have antiseptic and anti-inflammatory properties as well as being an excellent moisturizer. The best way to reduce the symptoms of it is to keep the skin with moisturizer on it.  Therefore, for those who are looking to speed up the healing process of it, topical application of aloe vera gel can be an effective method of treatment.

It is very easy to add aloe vera into your diet as you can take about ½ teaspoon per day dissolved into a drink of your choice. You may want to talk to your doctor before adding it to your diet if you have any digestive problems, and it should not be taken orally by pregnant or breastfeeding women.

Coconut Powder

If you receive a diagnosis with lichen planus to reconsider your use of skin products with care. Don’t use any harsh soaps or cleaning products. This makes it difficult to find effective cleaning products, especially for removing makeup. A natural alternative is to use coconut water for cleaning your skin. It is can remove dirt and makeup without removing the protective oils on your skin. The end result is clean and moisturized skin. You can easily make a batch as needed by dissolving coconut powder in water.

Coconut and Skin

Though coconut water can be used to remove makeup it is NOT recommended that you use coconut oil as a cleanser. Coconut oil is highly comedogenic, which means that it will clog your pores.

Keeping yourself well hydrated is an excellent way to keep your skin moisturized, which is one of the key recommendations for anyone suffering from lichen planus. A lot of us are very bad at drinking enough water to stay properly hydrated, so it might be helpful to know that coconut water is actually better at hydrating the body than plain water. This means that you can have a tastier and effective way to keep yourself well hydrated by adding a tablespoon of coconut powder to any drink to get a boost in hydration.

Vitamin D

The sunlight is a great source of Vitamin D. However, taking Vitamin D supplements can also help strengthen the body’s immune system. Together with a healthy diet and a reasonable amount of sun exposure, Vitamin D can help improve your skin’s health through time.

Turmeric

One of the best drugs in alleviating inflammation, turmeric, can help reduce the effects of Lichen Planus. Apart from relieving inflammation, turmeric also assists in reducing scarring. The use of turmeric as an anti-inflammatory agent traces back to ancient Ayurvedic medicine. Taking turmeric in capsule or powder form is a safe method.

A recent study looked into the effects of turmeric for the treatment of oral lichen planus. It showed extremely positive effects when the turmeric was added to an oral ointment. This is still an early study so it is no recommendation to try this yourself, however, it is something worth talking to your doctor about with more research.

Zinc

Zinc is one of the micronutrients that many people lack in their diet. Lichen Planus can be treated with Zinc supplements as it enhances the body’s immune system. Zinc supplements also assist in treating the symptoms associated with the disease.

The Bottom Line

Lichen planus is a chronic, noninfectious, inflammatory condition. It mostly causes rashes on the skin and inside the mouth but can affect other areas of the body. There is no cure for this condition and the only option is to treat the symptoms. 

While Lichen Planus can be a frustrating condition to deal with, there are plenty of treatment options available that can help alleviate symptoms. Depending on the severity of the condition and the location of the rashes or sores, your doctor may recommend topical or oral medications, phototherapy, lifestyle changes, or holistic treatments to help manage your symptoms. Whatever approach you choose, make sure to work closely with your healthcare provider to find the best treatment plan for your unique needs. With the right combination of therapies, it is possible to find fast relief from the discomfort of Lichen Planus.

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease

Author: Ryan Quigley
Graduate of Longwood University in Virginia. Part-time sports journalist covering the Vegas Golden Knights.