Lichen Planus treatment
Lichen planus (LP) may at times be self-limiting and can resolve within 8-12 months. Treatment to decrease or suppress itchiness may be helpful (oral or topical anti histamines). Mild cases can be treated with topical steroids. Sitz baths may also be helpful to relieve local symptoms of itchiness and burning.
More severe cases, especially those with scalp, nail, and mucous membrane involvement, require more aggressive treatment. Phototherapy may be a viable option for lichen planus of the skin.
A treatment option for lichen planus that involves the genitals includes ultra potent corticosteroids (topical ointments or pills) to reduce inflammation. Tacrolimus (Protopic ointment) and pimecrolimus (Elidel cream) may also be used. Caution should be exercised since it can be absorbed into the vaginal tissue.
In other regions, retinoids or synthetic versions of vitamin A, can be topically or locally applied as a treatment option. Retinoids have been associated with congenital birth defects, so it is critical that women of childbearing age use effective contraception. Pregnant women and those who are planning pregnancy should not use retinoids. Cyclosporine and methotrexate, drugs which may help prevent rejection of transplants, may also be effective treatment options. Treatment for diagnosed Hepatitis C should occur by an expert in liver disease.
A vaginal dilator program should be started as part of the comprehensive treatment for lichen planus. Since painful intercourse (see dyspareunia) is common, treatment should occur to prevent vaginal stenosis or narrowing. For more on treatment of painful intercourse click here.