Lichen Planus Overview
Lichen planus is a fairly
common skin rash that is thought to be triggered by the immune system. Exactly why
the immune response occurs is not known. There may be several contributing
factors, and each case is different. Potential causes include viral infections,
an allergen, or even stress or genetics. Sometimes lichen planus occurs along
with autoimmune disorders.
While it may be uncomfortable,
in most cases lichen planus is not a serious condition. It is not contagious. There
are some rare variations of the condition that are more serious and painful. It
can be treated by using topical and oral medications to reduce symptoms, or by
using drugs that suppress the immune system.
Who Is at Risk for Lichen Planus?
Lichen planus can occur in
anyone at any age, but there are certain factors that make some people more
likely to develop the condition. The skin form of lichen planus occurs in men
and women equally, but women are twice as likely to get the oral form. It is
very rare in young and elderly people, and most common in middle-aged people.
Other risk factors include
having other family members with lichen planus, having a viral disease like
hepatitis C, or being exposed to certain chemicals that may act as allergens.
These could be antibiotics, arsenic, gold, iodide compounds, diuretics, and
certain kinds of dyes.
Symptoms of Lichen Planus
Some of the most common
symptoms of lichen planus include the following:
lesions, or bumps, with flat tops (mostly found on the wrist, inner forearm, or
ankles, but can be anywhere)
- lesions that
develop and spread over the course of two weeks to a few months
- itching at the
site of the rash
- lesions in the
mouth, which may be painful or cause a burning sensation
- blisters, which
become scabby after bursting
- thin white lines
over the rash
The most common type of
lichen planus affects the skin. The lesions appear and spread over the course
of several weeks and usually clear up within six months to a year and a half.
Less commonly the lesions can occur on mucous membranes, genitalia, nails, and
the scalp. There are also variations of the condition that are more common in
the Middle East, Asia, Africa, and Latin America.
Diagnosis of Lichen Planus
Anytime you see or feel a
new type of rash on your skin or lesions in your mouth or on your genitals, you
should see your doctor as soon as possible. Your primary care doctor may send
you to a dermatologist if a diagnosis of lichen planus is not obvious, or if
you have more than mild, uncomfortable symptoms.
Your doctor or dermatologist
may be able to tell that you have lichen planus simply by looking at your rash.
To confirm the diagnosis, you may need further tests. These could include a
biopsy, which means taking a small sample of your skin cells to view under a
microscope, or an allergy test to find out if you are having an allergic
reaction. If your doctor suspects the underlying cause is an infection, you may
need to have a test for hepatitis C.
Treating Lichen Planus
For mild cases of lichen
planus, which usually clear up in weeks or months, you may not need any
treatment. If the symptoms are uncomfortable or severe, your doctor can
prescribe certain medications that may help. There is no cure for the
condition, but medications that treat the symptoms are helpful and some may
even be able to target a possible underlying cause. Possible medications include
one or more of the following:
Retinoids are medications that are related to vitamin A. They can be used
topically or taken orally to treat your rash.
- corticosteroids: These help to reduce the inflammation of a lichen planus rash, and can
be topical, oral, or given as an injection.
- antihistamines: These also reduce inflammation and may be particularly helpful if your
rash is triggered by an allergen.
- nonsteroidal creams: There are topical creams available that can suppress your immune
system and help clear up the rash.
- light therapy: In some cases, treating lichen planus with ultraviolet light seems to
Lichen planus is rarely
severe and, although it can be uncomfortable, is not a dangerous condition to
have. With treatment and time, your rash will clear up and you will once again
have normal skin.