On regular skin, lichen planus may last from a few months to several years and spontaneously clear on its own. If it affects your mucous membranes, the disease may be more resistant to treatment and prone to recur. Medications and other treatments help relieve itching and promote healing.
Corticosteroids may reduce inflammation associated with lichen planus. The side effects of corticosteroids vary depending on how you take them — as ointment applied to the skin, as a pill or as an injection. Corticosteroids are considered safe when taken as directed and for short-term use. Common side effects of topical corticosteroids may include skin problems, such as burning, reddening or thinning of the skin at the application site. When taken orally or as an injection, side effects may include high blood pressure, elevation of blood glucose and osteoporosis.
Retinoids are synthetic versions of vitamin A that can be applied topically or taken orally for treatment. Retinoids may be an effective treatment, but they can cause bothersome skin irritations, such as severe dryness, redness and peeling. Oral retinoids can harm unborn babies, so these medications are not recommended for women who are pregnant or may become pregnant. If you're pregnant or nursing, your doctor may advise you to delay topical retinoid therapy or choose an alternative treatment.
Nonsteroidal creams or ointments
Topical calcineurin inhibitors reduce immune-system activity involved in lichen planus and appear to be particularly helpful in managing lichen planus of mucous membranes. Examples of these topical medications include tacrolimus (Protopic) and pimecrolimus (Elidel).
Antihistamines act against a protein called histamine that is involved in inflammation. An oral or topical antihistamine may relieve itching or pain associated with lichen planus.
Light therapy, or phototherapy, may help clear up lichen planus affecting the skin. The most common phototherapy for lichen planus uses ultraviolet B (UVB) light, which penetrates only the upper layer of skin (epidermis). There is some risk of "sunburn" with this treatment. Phototherapy using ultraviolet A (UVA) light in combination with the medication psoralen also may be effective, though it carries a small long-term risk of skin cancer and cataracts.
If your doctor suspects that lichen planus may be related to hepatitis C infection, an allergen or a drug you take, he or she will recommend steps to address the trigger, such as trying a different medication and avoiding offending allergens. You may be referred for further treatment to an allergist or, in the case of a hepatitis C infection, to a specialist in liver disease (hepatologist).
Feb. 22, 2013
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- Ferri FF. Ferri's Clinical Advisor 2013: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-08373-7..00002-9&isbn=978-0-323-08373-7&about=true&uniqId=343863096-23. Accessed Dec. 28, 2012.
- Bradford J, et al. Management of vulvovaginal lichen planus: A new approach. Journal of Lower Genital Tract Disease. 2013;17:28.
- Parashar P. Oral lichen planus. Otolaryngologic Clinics of North America. 2011;44:89.
- Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, U.K.; New York, N.Y.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7234-3541-9..X0001-6--TOP&isbn=978-0-7234-3541-9&uniqId=230100505-57. Accessed Dec.28, 2012.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 10, 2013.
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