Lichen planus is an inflammatory skin condition, characterized by an itchy, non-infectious rash of small, polygonal (many sided) flat-topped pink or purple lesions (bumps) on the arms and legs. Other parts of the body may also be affected, including the mouth, nails, scalp, vulva, vagina, and penis. Involvement in the scalp can result in hair loss – sometimes permanent.
Cause of Lichen Planus
Nobody knows what the exact causes of lichen planus are. We know it can be triggered by taking certain medications, including thiazide diuretics, antimalarials and phenothiazines (a group of tranquilizing drugs with antipsychotic actions). A significant number of skin specialist doctors (dermatologists) believe it might be classified as an autoimmune disease. A higher-than-normal percentage of people with hepatitis C and some other liver diseases have lichen planus.
Oral lichen planus is more common in women than in men. Skin lichen planus affects both sexes equally. It typically occurs in people over 30 years of age. About half of all affected people have oral lichen planus (symptoms in the inner surface of the mouth). Oral lichen planus typically occurs inside the cheeks, but may also affect the lips, gums and tongue.
What are the signs and symptoms of lichen planus?
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign. Lichen planus of the skin:
- The rash appears abruptly, and usually lasts for several months
- There are clumps or patterns of shiny, raised, red/pink/purple, flat-topped papules (bumps)
- Papules are approximately 3mm to 5mm in diameter
- Sometimes there may be white streaks on the papules, called Wickham’s striae
- Intense itching, especially at night
- Most affected areas are the wrists, elbows, ankles, and lower back. However, other parts of the body may be affected. The shins may be affected by hypertrophic (thickened) lichen planus, while the armpits may have annular (ring-shaped) lichen planus.
The first attack may continue for weeks, and even months, while recurrences can go on for years – recurrences are more common in cases of oral lichen planus. When symptoms are gone there may be dark brown or gray spots on the skin, which are more noticeable if the patient has dark skin.
Oral lichen planus (affects the mouth):
- White streaks on the inside of the cheeks. The gums, tongue and lips may also be affected.
- The streaks are not usually painful or itchy
- The white streaks are persistent (they do not go away)
- Possible redness and blistering of the gums
- Sore mouth ulcers can develop, and recur (erosive lichen planus)
- The patient’s sense of taste may become blunted. Some experience a metallic taste
- Dry mouth
- Spicy foods, crispy foods, and tomato products can exacerbate symptoms
Penile lichen planus (lichen planus of the penis):
- Purple/white ring-shaped patches appear around the glans (head of the penis)
- They are not usually itchy
- Symptoms are similar to thrush, and often mistaken for thrush
Lichen planus of the vagina and vulva:
- Vulva – white streaks develop, similar to those that appear in the mouth. They are usually not itchy or painful. The skin may be red. Erosive lichen planus may affect the inner lips (labia minora) and the entrance to the vagina (introitus) – the affected mucous membrane is bright red and raw. The labia minora may shrink and stick to each other or to the labia majora (outer lips).
- Vagina – may be red. Scar tissue may distort the shape of the vagina. Lichen planus may affect deeper within the vagina, causing desquamative vaginitis. A mucky discharge appears when the surface cells in the vagina peel off. The eroded vagina may easily bleed when touched. Sexual intercourse may become difficult or impossible.
Lichen planus follicaris (lichen planopilaris) – this affects hairy areas, such as the scalp. There may be redness and irritation. Sometimes there is hair loss, which may be permanent.
Other areas – lichen planus of the anus, ear canal, eyelids and esophagus (all extremely rare).
Treatment for Lichen Planus – Mild Lichen planus can be relieved at your home itself.
Self-help
Below is some general self-help advice that you can follow to help ease your symptoms and prevent them from getting worse.
Lichen planus of the skin
- avoid washing with soap or bubble bath – use plain warm water instead
- wash your hair over a basin to stop affected areas of skin coming into contact with shampoo
- use an emollient to moisturise your skin
Lichen planus of the mouth (oral lichen planus)
- avoid eating spicy foods and anything acidic, such as fruit juice, as they can irritate oral lichen planus
- avoid eating sharp food, such as crusty bread
- avoid drinking alcohol, particularly spirits
- if areas of your mouth are painful, stick to soft, bland foods, such as mashed potatoes and porridge
- if possible, continue to use your usual toothpaste
- avoid using mouthwashes that contain alcohol as they may be too strong, and keep your mouth as clean as possible
- visit your dentist regularly to help keep your gums and teeth healthy
Lichen planus of the genitals
- avoid washing with soap or bubble bath – use plain warm water or a soap substitute instead, such as aqueous cream
- use an emollient, such as petroleum jelly, before and after urinating
- applying ice packs to the affected areas may soothe itching and swelling (never apply an ice pack directly to your skin – wrap it in a clean tea towel before placing it on your body)
- women should avoid wearing tights
If it doesn’t settle within a week or two, Welling Homeopathy Skin Protocol can help you get rid of Lichen. Planus permanently. Welling Homeopathy offers option to visit us personally at our state of art clinic in the heart of Mumbai city in India, or you can take help of our Online treatment platform, where our dedicated homeopathic consultants are available for online consultation and treatment anywhere in the world.
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