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Lichen planus - Treatment

Treatment:

The goal of treatment is to reduce your symptoms and speed healing of the skin lesions. If symptoms are mild, you may not need treatment.

Treatments may include:

  • Antihistamines
  • Immune-suppressing medications, such as cyclosporine (in severe cases)
  • Lidocaine mouthwashes -- to numb the area and make eating more comfortable (for mouth lesions)
  • Topical corticosteroids (such as clobetasol) or oral corticosteroids (such as prednisone) -- to reduce swelling and suppress immune responses. Corticosteroids may be injected right into a lesion.
  • Topical retinoic acid cream (a form of vitamin A) and other ointments or creams -- to reduce itching and swelling and aid healing
  • Topical immune-suppressing medications, such as tacrolimus and pimecroliumus -- but lesions must be watched carefully for signs of cancer
  • Dressings may be placed over topical medications to protect the skin from scratching.
  • Ultraviolet light therapy may be helpful in some cases.
  • Oral retinoids (acitretin)

Expectations (prognosis):

Lichen planus is usually not harmful and may get better with treatment. It usually clears up within 18 months.

However it may last for weeks to months, and may come and go for years. It usually clears up within 18 months.

If lichen planus is caused by a medication, the rash should go away once the medicine is stopped.

Complications:

Mouth ulcers that are there for a long time may develop into oral cancer.

Calling your health care provider:

Call your health care provider if:

  • Your symptoms continue
  • The skin or mouth lesions change in appearance
  • The condition continues or worsens even with treatment
  • Your dentist recommends adjusting your medications or treating conditions that trigger the disorder
  • Reviewed last on: 10/10/2010
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Habif, Thomas P. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2009:pp 320-326.

Mirowski GW, Mark LA. Oral disease and oral-cutaneous manifestations of gastrointestinal and liver disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elseiver;2010:chap 22.

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