Lichen Planus Overview


Lichen planus often infects areas such as the wrists and ankles, but it can show up anywhere on your body. See more pictures of skin problems.
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Like many other skin conditions, lichen planus is a bit of a mystery. No one knows exactly what causes it. What we do know, however, is that it's irritating, and it can also be unsightly. The disease is characterized by a rash with reddish-blue bumps that are flat on the top. It can affect any part of your body, including your genitals and sometimes even the inside of your mouth. More often than not, however, it affects the areas on the underside of your wrists or around your ankles [source: American Academy of Dermatology].

Lichen planus is fairly easy to identify because its color, often described as violet, sets it apart from similar skin conditions like eczema and psoriasis. Depending on the person affected, it might itch intensely or just a little. Unfortunately, there is no cure for the disease. There are, however, treatments that can help relieve that itching and reduce the appearance of your rash. They range from over-the-counter antihistamines to ultraviolet light therapy. In most cases, lichen planus will eventually go away on its own, but that can take anywhere from a couple of weeks to a couple of years. The good news is that, aside from the itching, it won't do you any harm [source: Berman].

There are several theories about what may cause lichen planus, but the actual reason remains unknown. There are certain medications that cause an identical rash, whereas other conditions put people at a higher risk of developing the disease. Unfortunately, neither of these clues has shed any light on the mystery surrounding lichen planus. While anyone can develop the disease, more than two thirds of those affected are middle-aged adults [source: Chuang]. Occasionally, lichen planus may affect your nails as well. It can cause grooving, splitting and in extreme cases nail loss. There's a chance that your nails could suffer permanent damage, but this is very rare [source: American Osteopathic College of Dermatology].

Keep reading to find out more about what may cause lichen planus.

Causes of Lichen Planus

The most frustrating thing about lichen planus is that no one knows exactly what causes it. The majority of medical experts who have weighed in on the subject believe it's an autoimmune disease. When a disease is autoimmune, it means the immune system malfunctions, which can cause a rash. Nobody knows exactly why this happens. It's the same type of mystery that surrounds eczema and psoriasis. There are theories that lichen planus could be related to stress, genetics and certain viruses, but none of those ideas are likely to be proven any time soon. To add to the confusion, certain medications can cause allergic reactions that appear identical to the rash caused by lichen planus [source: American Osteopathic College of Dermatology].

These medications include those used to treat high blood pressure, arthritis and heart disease [source: American Academy of Dermatology]. Anything containing gold, antibiotics, arsenic, quinine, diuretics and several other chemical compounds can have the same effect, too [source: Berman]. Lichen planus has also been linked to hepatitis C, although it's believed that any type of liver disease could put you at a higher risk of developing the disease [source: Mayo Clinic].

No one can say for certain what causes lichen planus, but we do know that it can affect anyone. It is completely blind to age and gender; although it most often affects people between the ages of 30 and 60, anyone can develop it [source: Chuang]. The disease tends to affect everyone differently, which makes treatment a little tricky as well. Luckily, the disease eventually goes away on its own.

To find out what types of treatment tend to be the most effective, keep reading.

Lichen Planus Treatments

It's pretty hard to cure something if you don't know its cause. Fortunately, lichen planus does go away on its own. On the other hand, that can take a couple of years for an outbreak on your skin and up to five years if it's inside your mouth. Just the idea of living with an itchy rash for that long would upset a lot of people. Actually having to do it is a whole other story. Thankfully, there are several treatment options available to help make living with lichen planus more bearable.

The first thing most people want to treat is the itching. Sometimes a simple antihistamine can be enough to bring relief. This is especially true when your lichen planus may be the result of an allergic reaction. If the disease is only affecting a small part of your body, a hydrocortisone cream might be effective at reducing symptoms as well. Just be careful not to apply too much. If you do, you could end up irritating the skin around the affected area as well [source: Katta]. Topical corticosteroids and oral corticosteroids can also be used to reduce inflammation and slow down your malfunctioning immune system. In extremely severe cases, corticosteroids can even be directly injected into the affected area. For oral lichen planus, you may want to try lidocaine mouth washes. They may be able to give you some temporary relief by numbing the affected area [source: Berman].

A special kind of ultraviolet A (UVA) light therapy, known as PUVA, has also been proven to help treat some cases of lichen planus. PUVA stands for "psoralen and UVA light," since people undergoing the treatment take a dose of psoralen medication before exposing themselves to UVA light. If nothing else seems to be working, a retinoid pill may help. This option, however, tends to come with quite a few negative side effects [source: Katta]. Keep in mind that each case of lichen planus is different from the next, and that means it could take a combination of treatments to see any results. You'll need to work with your doctor to find the treatments that are most effective for you.

Of course, you could always try a few home remedies as well. Keep reading to find out what your options are.

Home Remedies for Lichen Planus

Remember, there is no cure for lichen planus. The point of treatment, therefore, is to help provide you with relief from the disease until it eventually goes away on its own. If you're not comfortable using corticosteroids or ultraviolet light therapy, you still have a few options. In fact, a good bath and a few cool rags might be all you need.

One of the most popular home remedies for lichen planus is soaking in a tub with colloidal oatmeal [source: Mayo Clinic]. This form of treatment is actually useful for treating all sorts of itchy rashes, including poison ivy, chicken pox and eczema. It's best to fill the tub with lukewarm water. Using water that's too hot might irritate your skin even more and could eventually dry you out. Simply mix the oatmeal according to the directions that come with it, then sit back and relax in the tub. You can pick up colloidal oatmeal at your local drug store or supermarket.

Cool compresses can be effective as well [source: Mayo Clinic]. They can soothe even the most uncomfortable itching sensations and provide you with some relief. All you have to do is soak some washcloths in cool water and then apply them to the affected area of skin. It's not a bad idea to use some type of lotion or moisturizing cream following a cool compress, too. This will help trap in moisture and keep your skin from getting dry.

If you have oral lichen planus, there's unfortunately not a whole lot you can do. Try avoiding alcohol and tobacco, as well as spicy and acidic foods. They have a tendency to cause irritation and could even make your symptoms worse. Also, be sure to maintain good oral hygiene in an effort to reduce your chances of getting an infection [source: CNN].

See the links on the next page for lots more information on the mysterious lichen planus.

Related HowStuffWorks Articles

Sources

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  • American Osteopathic College of Dermatology. "Lichen Planus." 2009. (Oct. 13, 2009)http://www.aocd.org/skin/dermatologic_diseases/lichen_planus.html
  • Baylor College of Dentistry. "OLP Facts." 2001. (Oct. 13, 2009)http://www.tambcd.edu/lichen/olpfacts/facts/facts.html
  • Berman, Kevin MD, PhD. "Lichen planus." National Institutes of Health. Oct. 3, 2008. (Oct. 13, 2009)http://www.nlm.nih.gov/medlineplus/ency/article/000867.htm
  • Chuang, Tsu-Yi MD, MPH & Laura Stitle, MD. "Lichen Planus." eMedicine. April 18, 2008. (Oct. 13, 2009)http://emedicine.medscape.com/article/1123213-overview
  • CNN. "Oral lichen planus." Aug. 15, 2008. (Oct. 13, 2009)http://edition.cnn.com/HEALTH/library/oral-lichen-planus/DS00784.html
  • Katta, R. MD. "Lichen Planus." Family Doctor. Dec. 2006. (Oct. 13, 2009)http://familydoctor.org/online/famdocen/home/common/skin/disorders/600.html
  • Mayo Clinic. "Lichen planus: Lifestyle and home remedies." Aug. 15, 2008. (Oct. 13, 2009)http://www.mayoclinic.com/health/lichen-planus/DS00782/DSECTION=lifestyle-and-home-remedies
  • Mayo Clinic. "Lichen planus: Risk factors." Aug. 15, 2008. (Oct. 13, 2009)http://www.mayoclinic.com/health/lichen-planus/DS00782/DSECTION=risk%2Dfactors
  • MedicineNet. "Lichen Planus." July 25, 2003. (Oct. 13, 2009)http://www.medicinenet.com/lichen_planus/article.htm