Table of Contents
Lichen planus: Types, Symptoms and Causes
What is Lichen planus ?
Lichen planus is a skin problem that can affect the scalp, nails, inside the mouth and private areas. The skin usually looks like painful red bumps that appear within a few weeks.
It can cause whiteheads, lacy patches and sometimes pain in the face and private areas. If your skin rash is mild, you may not need treatment. However, if there is a lot of pain or discomfort, your doctor may need some special medication.
Symptoms
Lichen planus can cause different signs depending on where it shows up. For nails, it usually affects several at once and can cause:
a. Purple, shiny, flat bumps, often on the inner forearms, wrists, or ankles.
b. Rash lines where the skin has been scratched.
c. Lacy white patches on the tongue or inside the cheeks.
d. Itching.
e. Painful sores in the mouth or private areas.
f. Rarely, hair loss.
g. Scarring or loss of nails.
h. Dark lines from the tip of the nail to the base.
Types of Lichen Planus
Lichen planus can affect different parts of the body in different ways:
1. Skin lichen planus:
a. Caution: Purple, flat, painfully inverted.
b. Location: Usually in the wrists, ankles, or lower back.
2. Oral lichen planus:
a. Caution: Lacy white spots or sores in the mouth.
b. Location: In the cheeks, mouth, or tongue.
3. Genital Lichen Planus:
a. Decoration: White spots and bruises.
b. Location: In the genitals and vagina.
4. Nail Lichen Planus:
a. Appearance: Nail discoloration, thinning, or brittleness.
b. Location: Affects fingernails and toenails.
5. Scalp Lichen planus:
a. Caution: Tuberous, scaly patches on the scalp.
b. Location: Can cause hair loss in affected areas. Each has different symptoms and may require specific treatment.
When to See a Doctor
Visit your doctor if you notice small bumps or a rash on your skin that doesn’t come from something like poison ivy. Also, see a doctor if you have any lichen planus symptoms in your mouth, private areas, scalp, or nails.
Getting a quick and accurate diagnosis is important because other conditions can cause similar sores and pain.
Causes
Lichen planus probably happens because the immune system mistakenly attacks the skin or the inside of the mouth and other areas. It’s not clear why this happens. Lichen planus isn’t something you can catch from someone else.
Things that might trigger lichen planus include:
a. Hepatitis C infection.
b. Pain relievers and other medicines.
c. An allergic reaction to the metal in dental fillings.
Diagnosis
To figure out if you have lichen planus, your doctor will talk to you about your symptoms and medical history and do a physical exam. You might also need some tests, such as:
1. Biopsy: The doctor will take a small piece of the affected skin or tissue and send it to a lab to check if it has the patterns typical of lichen planus.
2. Blood Tests: You might need to have your blood tested to look for health issues related to lichen planus, like hepatitis C.
Treatments & Medications for Lichen Planus
1. Topical Treatments:
a. Corticosteroid Creams: Reduce skin inflammation and itching.
b. Topical Calcineurin Inhibitors: Non-steroidal options for sensitive areas like the mouth or genitals.
2. Oral Medications:
a. Oral Corticosteroids: For severe cases affecting large areas or multiple sites.
b. Antihistamines: Help manage itching and discomfort.
3. Phototherapy:
a. Ultraviolet Light Therapy: Reduces inflammation in widespread skin cases.
4. Immunosuppressants:
a. Methotrexate or Azathioprine: For severe cases or when other treatments don’t work.
5. Mouth Rinses:
a. Steroid Rinses: Reduce inflammation and pain in oral lichen planus.
6. Lifestyle and Home Remedies:
a. Moisturizers: Alleviate dryness and itching.
b. Avoiding Triggers: Identify and avoid potential irritants or allergens.
Treatment focuses on relieving symptoms, reducing inflammation, and managing flare-ups. A healthcare provider will recommend the best approach based on the severity and type of lichen planus.
