Your doctor or dermatologist makes a diagnosis of lichen nitidus or another skin condition based on the information you provide about the symptoms and a careful examination of the skin abnormality.
Your doctor may use a magnifying glass to look at your skin. Or he or she may take a small sample of tissue (biopsy) and look at it under a microscope.
For most people, lichen nitidus lasts for a few months to a year. The condition usually clears up on its own without treatment. After it clears up, the appearance of the skin is usually normal with no scarring or permanent change to skin color.
If lichen nitidus causes itching or if you have concerns about your appearance or your child's appearance, your doctor may prescribe one of the following treatments:
- Corticosteroids may reduce inflammation associated with lichen nitidus. The side effects vary depending on whether it's used as an ointment applied directly to the skin (topical) or taken as a pill (oral). Long-term use of topical corticosteroids can cause thinning of the skin, a lessening of the treatment effect and other skin problems. Long-term use of oral corticosteroids can cause weakening of the bones (osteoporosis), diabetes, high blood pressure and high cholesterol levels.
Retinoid is a synthetic version of vitamin A that can be a topical or oral treatment. The topical treatment doesn't cause the side effects associated with corticosteroids, but it may irritate the skin.
Because retinoid can cause birth defects, it shouldn't be used by women who are pregnant or who might become pregnant. Your doctor can advise you on necessary precautions.
- Other topical medications. A topical drug called tacrolimus (Protopic) helps to suppress the immune response and may be helpful for lichen nitidus. Possible side effects include stinging, burning and itching at the site where the medication is applied. This medication can't be used in conjunction with phototherapy. Limit sun exposure while using tacrolimus and don't use tanning beds during treatment.
- Antihistamines act against a protein called histamine that is involved in inflammatory activity. An oral or topical antihistamine may relieve itching associated with lichen nitidus.
- Phototherapy, a type of light therapy, may help clear up lichen nitidus. One type uses ultraviolet A (UVA) light, which penetrates deep into the skin. This therapy is usually used in combination with a drug that makes the skin more sensitive to UVA light. Another type uses narrow band ultraviolet B (UVB) light. It's important to avoid sun exposure for a couple of days after having phototherapy. Also, you need to wear special UV-absorbing sunglasses for a couple of days to protect your eyes.
Preparing for your appointment
You'll likely start by seeing your child's pediatrician or your primary care doctor if your child or you are experiencing a skin condition. You may then be referred to a specialist in skin conditions (dermatologist).
Here's some information to help you get ready for your appointment.
What you can do
Before your appointment make a list of:
- Symptoms you or your child have been having, including any that may seem unrelated to the reason for which you scheduled the appointment
- All medications, vitamins and supplements that you or your child takes
- Questions to ask your doctor
For lichen nitidus, some basic questions to ask your doctor include:
- What's the most likely cause of my symptoms?
- Do I need any tests?
- How long can I expect this condition to last?
- What treatments are available, and which do you recommend?
- What side effects can I expect from treatment?
- Are there any restrictions on what types of products I use on my skin?
- Is there a generic alternative to the medicine you're prescribing me?
- Do you have any brochures or other printed materials I can take with me? What websites do you recommend visiting?
What to expect from your doctor
Your doctor is likely ask you a number of questions, such as:
- When did you first notice the appearance of the tiny bumps?
- Where are the patches of bumps located?
- Have the patches of bumps changed in appearance over time?
- Do the bumps itch? How much or how often?
- Does anything further irritate the site, such as certain soaps or lotions?
- Are there any known allergies?
- Do you or immediate family members have a history of atopic eczema, asthma or hay fever?
Oct. 22, 2015
- Chu J, et al. Lichen nitidus. CMAJ: Canadian Medical Association Journal. 2014;186:E688.
- Tilly JJ, et al. Lichenoid eruptions in children. Journal of the American Academy of Dermatology. 2004;51:606.
- Wright AL. Lichen nitidus. In: Treatment of Skin Disease: Comprehensive Therapeutic Strategies. Philadelphia, Pa: Elsevier Limited; 2014.
- Questions and answers about psoriasis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Psoriasis/default.asp. Accessed Sept. 1, 2015.
- Protopic (prescribing information). Deerfield, Ill.: Astellas Pharma US, Inc.; 2006. http://www.astellas.us/docs/protopic.pdf. Accessed Sept. 1, 2015.
- Solak B, et al. Narrow band ultraviolet B for the treatment of generalized lichen planus. Cutaneous and Ocular Toxicology. 2015;Early Online:1. http://www.tandfonline.com/doi/full/10.3109/15569527.2015.1074587#abstract. Accessed Oct. 7, 2015.
- Protopic. U.S. Food and Drug Administration. www.accessdata.fda.gov. Accessed Oct. 19, 2015.