Lichen planus

Lichen planus is a skin condition where your immune system attacks your body and causes irritation of your skin, commonly your elbows, wrists, ankles, and lower back. It can also affect your scalp, nails, or the lining of your mouth or vagina. Symptoms can include flat bumps on the skin, itching, hair loss, painful sores in the mouth or on the vagina, and nail damage.

The cause is unclear, but most people will have this condition when get a cold or are infected with hepatitis C. Complications like oral cancer and deafness can occur when you do not get early treatment.

Though there is no known cure, most people can manage their symptoms with self-care. More serious conditions can be managed by a healthcare provider. Treatments include corticosteroids, antibiotics, antihistamines, retinoids and light therapy.

The most common symptoms of lichen planus are:

• Itchy skin bumps that have a flat top and are darker than the surrounding skin.
• Patches of sores (with white borders) in your mouth or vagina that are painful and itchy.
• Patches of hair loss on your scalp.
• Changes in scalp colour.
• Damaged nails.

Lichen planus does not have a known cause.

Lichen planus can affect anyone, but is more common in women between 45 and 60. You are at risk if you:

• Are middle-aged.
• Use certain medications like antimalarials, medicines for heart disease or arthritis, and ibuprofen.
• Use hair dyes that irritate your scalp.
• Have metal filling in your teeth like gold, mercury or copper.
• You have a hepatitis C infection

You should see your doctor as soon as you start to have rashes or bumps on your skin, mouth or genitals to make sure it is lichen planus and not an infectious disease.

You cannot prevent lichen planus, but you can avoid complications like oral cancer and deafness by getting treated early.

Self-care tips:

• Have warm baths without soaps or sponges.
• Apply cool compresses to the skin.
• Use mild moisturizing creams. Plain shea butter or coconut oil can help moisturize your skin safely.
• Use over-the-counter hydrocortisone cream or ointment on your skin. This can reduce the itch.
• Avoid eating very hot or spicy foods, smoking or drinking alcohol to reduce pain if you have sores in your mouth.
• Avoid wearing tight clothes and underwear if you have genital bumps.
• Avoid scratching the bumps.

Treatment options:

• Your healthcare provider may take a sample for tests.
• The first choice for treatment will usually be a course of corticosteroids cream or ointment.
• Your healthcare provider may recommend anti-infectives to treat an underlying infection, such as antimalarials or antibiotics.
• You healthcare provider may also prescribe medications such as antihistamines, immune modifying drugs and retinoids.
• Your healthcare provider may recommend light therapy to clear up skin rashes.
• If your condition is caused by hepatitis C, your healthcare provider will refer you to a specialist doctor.

The bumps and sores from lichen planus can be very uncomfortable especially due to itching and pain. You can usually manage this by using over-the-counter steroid creams. Lichen planus is not infectious and you cannot pass it to another person.