There is no cure for lichen planus, so treatments aim to ease the symptoms and clear the rash. Mild cases of lichen planus will not require treatment.
Below is some general self-help advice that you can follow to help ease your symptoms and prevent them from getting worse.
Lichen planus of the skin
- avoid washing with soap or bubble bath – use plain warm water instead
- wash your hair over a basin to stop affected areas of skin coming into contact with shampoo
- use an emollient to moisturise your skin
Lichen planus of the mouth (oral lichen planus)
- avoid eating spicy foods and anything acidic, such as fruit juice, as they can irritate oral lichen planus
- avoid eating sharp food, such as crusty bread
- avoid drinking alcohol, particularly spirits
- if areas of your mouth are painful, stick to soft, bland foods, such as mashed potatoes and porridge
- if possible, continue to use your usual toothpaste
- avoid using mouthwashes that contain alcohol as they may be too strong, and keep your mouth as clean as possible
- visit your dentist regularly to help keep your gums and teeth healthy
Lichen planus of the genitals
- avoid washing with soap or bubble bath – use plain warm water or a soap substitute instead, such as aqueous cream
- use an emollient, such as petroleum jelly, before and after urinating
- applying ice packs to the affected areas may soothe itching and swelling (never apply an ice pack directly to your skin – wrap it in a clean tea towel before placing it on your body)
- women should avoid wearing tights
Lichen planus of the skin, hair and nails
There are a number of medications and treatments that may be recommended for lichen planus of the skin, hair and nails.
Corticosteroid creams and ointments
Creams and ointments that contain corticosteroids (artificial hormones) are often used to treat inflammatory skin conditions. These are often described as topical corticosteroids.
Topical corticosteroids help treat the swelling (inflammation) and redness caused by lichen planus. Strong topical corticosteroids, such as clobetasol propionate, are also effective in reducing any itchiness that you may have.
Treatment is applied to the red or purple itchy spots, but should be stopped when the colour of the rash changes to brown or grey. This pigment change happens when the inflammation has settled. Continuing to apply the corticosteroid cream to the brown areas of skin will gradually cause the skin to thin.
The side effects of corticosteroids can vary depending on:
- the type and severity of treatment being used
- the amount of time the treatment is used for
- the nature of the condition being treated
Potential side effects of topical corticosteroids can include:
- redness of the skin
- burning and stinging on the skin
- skin rash
- thinning of the skin (atrophy)
- stretch marks (striae)
- contact dermatitis, a condition that causes skin inflammation
- perioral dermatitis, a condition that causes red lumps to develop on the face
- acne, a skin condition that causes spots to develop on the face
- excessive hair growth (hypertrichosis)
- lightening of the skin
You should always check the patient information leaflet that comes with your medicine to ensure that you use the correct dosage, and take note of any cautions and potential side effects.
Read about topical corticosteroids (steroid creams) for more information about this type of treatment.
Corticosteroid tablets are sometimes used to treat severe cases of lichen planus, when the symptoms are not being effectively controlled with creams or ointments.
Possible side effects of corticosteroid tablets used on a short-term basis can include:
- an increase in appetite
- weight gain
- insomnia (inability to sleep)
- fluid retention (inability to pass urine)
- mood changes, such as feeling irritable or anxious
Read more about the side effects of corticosteroids.
Other treatments that may be recommended for lichen planus of the skin are described below.
- antihistamines – this type of medication is often used to treat symptoms of allergies, such as itchy skin. If you have lichen planus of the skin that is causing itchiness, antihistamines may be prescribed to help reduce this.
- light treatment – there are two types of light treatment: ultraviolet B (UVB) and psoralen plus ultraviolet A (PUVA). UVB is the most commonly used light treatment, but PUVA may be recommended in severe or widespread cases of lichen planus that do not respond to other types of treatment. PUVA can cause side effects that your skin specialist (dermatologist) can discuss with you.
- acitretin – this medication is only prescribed by a specialist and is used to treat severe cases of lichen planus. The tablets have some associated side effects and may not mix well with other medicines. Your GP can advise you about this.
Lichen planus of the mouth (oral lichen planus)
Mild cases of lichen planus of the mouth will not need any treatment. However, in more severe cases, treatment includes:
- a mouthwash that contains an anaesthetic to temporarily numb the mouth and make eating easier
- corticosteroid sprays, mouthwashes, pastes and dissolvable lozenges
- a mouthwash or gel that contains an antiseptic to help prevent the build-up of plaque in your mouth
- corticosteroid tablets may be used on a short-term basis in more severe cases of oral lichen planus
If corticosteroids are not effective in treating your symptoms, you may be prescribed a medication that works by suppressing your immune system to try to limit the autoimmune reaction that is thought to cause lichen planus.
These types of treatments are known as immunomodulating agents. Depending on which area of your body is affected by lichen planus, treatments that may be recommended for you could include:
- topical immunomodulating agents (used to treat lichen planus of the skin) – treatments such as tacrolimus ointment and pimecrolimus cream are rubbed directly onto the skin
- immunomodulating agents (used to treat lichen planus of the mouth) – these are usually available in the form of tablets or capsules and can be used to treat severe cases of oral lichen planus