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Lichen Planus: Treatment, Procedure, Cost and Side Effects

Last Updated: Dec 10, 2021

What is the treatment?

Lichen Planus is a type of rash that occurs on your skin and is commonly caused due to a deficiency in your autoimmune system. The actual cause for this disease to occur is unknown, however, there are a ton of known treatments that doctors can recommend for you. Lichen Planus can occur anywhere in the body, though it often occurs on the ankles, wrists, joints, and genital tissues.

This disease usually clears up on its own within a few weeks or months, though you can turn to medical treatments to speed up the process of getting rid of it. There are many different treatments to choose from and your doctor will recommend one on the basis of your medical history. You won’t really need additional treatment for very mild versions of this disease as it clears up on its own, however, since it causes itching, burning, and general discomfort, seeking treatment can help you gain relief.

Some of the commonly used treatments types include antihistamines (which can help reduce inflammation and work very well if your rash has occurred due to an allergen), retinoids (which provide vitamin A and can either be applied topically or taken orally), corticosteroids, nonsteroidal creams, and even light therapy.

Summary:You may be given one form of treatment or multiple forms, depending on what works on you and what doesn’t. Sometimes, finding the ideal and most effective treatment for your body can be a bit of a hit-and-miss procedure so you must be patient while your doctor recommends different treatments.

What autoimmune disease causes Lichen Planus?

Mutation in T cell-mediated cells can be one of the causes of Lichen Planus. It develops an autoimmune reaction against your basal epithelial keratinocytes causing skin lesions in different places. This can only be caused if a person is born with this kind of genetic abnormality.

Summary: Autoimmune disease is the root cause of Lichen Planus. Mutation in the T cell-mediated cells causes skin lesions.

How is the treatment done?

Your doctor will run a series of tests to first diagnose lichen planus. Some of these tests include biopsies (during which your doctor will extract a piece of tissue from the infected areas on your body and have a look under a microscope to determine what is wrong), a test for hepatitis C (as lichen planus is often related to hepatitis C, this test will be performed to determine whether you have this disease), and finally a few allergy tests (sometimes, lichen planus is triggered by allergies and you may have to find out what you are allergic to so that you can avoid it in the future).

Once lichen planus is diagnosed, you will be given the appropriate treatment. If you have been prescribed retinoids, you will have to apply the cream topically or ingest a pill. If you have been given corticosteroids or nonsteroidal creams, you will have to apply them on your rashes as many times as you have been asked to. Corticosteroids are also available in the form of a pill and can be ingested.

Summary:Light therapy involves the flashing of certain types of light at a certain frequency to get rid of the rash. Since Lichen Planus is a known disease with a known cure, one of the treatments is bound to work and therefore, it is important not to lose heart if you have already tried a few treatments and are not seeing any results. Immune reactive drugs are also often a part of the treatment and can be taken orally.

Who is eligible for the treatment? (When is the treatment done?)

Any person who has been diagnosed with Lichen Planus is eligible to get the treatment. Usually, the treatment follows a specific order so you will first be eligible only for the corticosteroids, then light treatment if that doesn’t work, then retinoids, and so on. Your doctor can recommend the right order of the treatments on the basis of your medical history.

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Who is not eligible for the treatment?

Any person who is not suffering from lichen planus is not eligible for the treatment. If you have a random rash that itches or burns, it does not mean that the treatments mentioned above will provide you with any relief. Using the wrong treatment can often aggravate your symptoms or cause more problems.

Are there any side effects?

Some of the treatments mentioned above come with their own list of side effects. For instance, using corticosteroids can make your skin thinner in the areas where it is applied, skin irritations, an upset stomach or oral thrush. Similarly, the side effects of using light therapy is getting a sun burn. It also has a long term risk of getting skin cancer and cataracts. The side effects of using retinoids include birth defects, which is why pregnant women should strictly stay away from them. Breastfeeding women should also avoid using retinoids. If you have any allergies, it is better to let your doctor know immediately so that he or she can prescribe the right treatments accordingly.

What are the post-treatment guidelines?

Since the actual cause of lichen planus is unknown, there are no specific post-treatment guidelines regarding your lifestyle that can help prevent the reoccurrence of this disease. If you have oral lichen planus, however, you will be asked to make certain changes like avoiding spicy food, smoking and drinking alcohol as they all function as mild irritants and can lead to a rash or the reoccurrence of the disease.

For people for whom the disease is caused due to an allergy, the only post-treatment guideline is to stay away from the items that lead to allergic reactions. Having said that, all patients are different, and based on your medical history, your doctor may suggest some additional guidelines pertaining to your body. Always follow post-treatment guidelines with care.

How long does it take to recover?

When lichen planus is left on its own, it can resolve itself in a matter of weeks or even months. It goes away as randomly as it occurs. However, if you are seeking additional treatment, then the recovery time depends on the treatment that you are using. On an average, however, it can take up to 2-3 weeks for the condition to disappear completely. This does not include the time it takes to find the treatment type that is the most effective for you.

Is Lichen Planus a serious disease?

Yes, it is considered a serious medical condition under certain conditions. Even though it goes on its own in many cases, some may come back or escalate within.

For instance, untreated oral Lichen Planus is a known sign of oral cancer. It is advised to visit an oral specialist twice a year, in case it's coming back does not go away very easily.

Summary: Yes, it is considered a serious medical condition under certain conditions. Even though it goes on its own in many cases, some may come back or escalate within.

What happens if Lichen Planus goes untreated?

If left untreated it can be problematic in the future. It can be hard to manage, especially in the oral or genital area. It can also leave scars and cause darkening of skin if left for too long. Further damages will include sexual dysfunction and difficulty in eating or speaking.

Summary: If left untreated it can cause serious skin lesions all over your body. They can be very painful in your oral or genital area if not treated on time.

What is the price of the treatment in India?

Most over the counter creams and ointments in India cost between Rs 150 – Rs 300, depending on the ointment, brand, and the strength of dosage. Pills, on the other hand, cost anywhere between Rs 50- Rs 150, again depending on the brand and the strength of the dosage.

Are the results of the treatment permanent?

The results of the treatment are usually permanent. The only case in which they are not permanent is if they are related to allergies, in which case you must always take care to avoid triggering the disease once more with the allergen.

What are the alternatives to the treatment?

There are many alternative treatments as well as home remedies that can be considered to treat this disease. You must take care of yourself at home in order to gain some relief from the symptoms of lichens planus like itching and burning. Soaking in a hot tub usually helps. As an additional (and optional) step, you can always add an essential oil that is known for its anti-inflammatory properties to the bath to further reduce the inflammation and itching on your skin.

Lavender essential oil is a good option for this. You can also indulge in soaking in the tub along with oat meal as it can help subside the itching. Once the bath is over, applying a lotion to your skin, particularly lotions that contain aloe vera, can help with the symptoms of Lichens planus. Often, cool compresses also help with itching and inflammation. Using over the counter hydrocortisone cream (which has at least 1% of hydrocortisone in it) can also help with the rash. Finally, you can also avoid scratching the rashes as this can prevent it from spreading further, thereby preventing more pain and itching.

What foods should I avoid with Lichen Planus?

During Lichen Planus, the body generates a lot of oxalate during the damage, if your diet is low in oxalate it will help you with the treatment and prevention from any relapse:

  • Fruits: Canned pineapple, dried fruits.
  • Veggies: Spinach, potato, turnips, beets.
  • Cereals and bread: Rice, bran, soy, brown rice.
  • Nuts and seeds: Almonds, peanuts, coconut.
  • Other products to consume: Chocolate, rhubarb, buckwheat groats.
Summary: Foods are the necessity of life, it can help you maintain or eliminate certain diseases. Avoiding some fruits, veggies, nuts, cereals or other products will help you decrease the damage caused by Lichen Planus.

What foods are good for Lichen Planus?

Since the level of oxalate is already high during Lichen Planus, one eats foods that are low or don't have oxalate to speed up the recovery process.

Here is the list of consumables that you can opt for in case of Lichen Planus:

  1. Vegan options:
    • Fruits: Avocados, apples, melons, grapes, peaches, plums.
    • Veggies: Broccoli, asparagus, cauliflower, lettuce, green peas.
    • Oils: Olive oil, vegetable oil.
    • Seasoning and spices: White pepper, salt, basil, cilantro.
    • Drinks and sweets: Beer, coffee, green tea, white chocolate.
  2. Nonvegan options:
    • Dairy: Cows and goat milk and its by-products.
    • Nonveg: Poultry, fish, beef.
Summary: Even though Lichen Planus is an autoimmune disease, certain foods can help you calm your skin and manage your skin lesions.
Summary: Lichen Planus refers to a skin condition that causes irritation and swelling in the skin and mucous membranes. Sings can be identical to purplish, flat bumps ( on the skin) or white patches ( on mucus membranes). In most cases it will fade away with some home remedies, others may need to see a doctor as it can be a sign of early-stage skin cancer.

References

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Written ByDr. Deepa Kadam MD - AyurvedaDermatology
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