Lichen planus is an inflammation of the skin, nails, or mucous membranes (mucosa) due to an abnormality in the immune system.This condition is not contagious like an infection, but people of all ages can experience it.
On the skin, lichen planus is characterized by the presence of scaly skin and a rash or purplish red patches. The appearance of these patches may be accompanied by itching, but it may or may not be. Meanwhile, in mucosal areas, such as the mouth or vagina, lichen planus is characterized by the appearance of white patches that are sometimes painful.
As mentioned earlier, lichen planus is not a contagious disease. This disease most often occurs in people aged 30-60 years. However, teenagers and children can also get lichen planus.
Causes of Lichen Planus
Lichen planus occurs when there is a disturbance in the immune system, so the immune system turns against healthy skin cells or mucous membranes. This is thought to be due to an autoimmune disorder.
Until now, the cause of lichen planus is still not clearly known. However, there are several factors that are known to increase a person's risk of developing lichen planus, namely:
- Infections, such as herpes zoster and hepatitis C
- Genetic or hereditary factors
- Allergic contact dermatitis
- Side effects of medications, such as non-steroidal anti-inflammatory drugs, antimalarials, blood pressure lowering drugs, diuretics, or medications for diabetes
- Exposure to metallic mercury and gold, for example in dental fillings, jewelry, or chemical liquids from photo washing equipment
- The habit of biting the tongue or the inside of the cheek
- History of organ transplant surgery
Symptoms of Lichen Planus
Symptoms of lichen planus vary, depending on the part of the body that has the condition. The following are some of the symptoms of lichen planus that can appear:
- Red-purple skin rash that protrudes from the skin
- Skin looks scaly
- Itchy skin
- White patches in the mouth or vagina that are sometimes accompanied by pain
- Dry mouth and taste bitter
- Nail damage or loss
- Baldness on the scalp
When to go to the doctor
You need to see a doctor when you experience various symptoms of planus, especially if these symptoms appear for no apparent reason. You are also advised to consult a doctor if you experience symptoms of lichen planus in the mouth or vagina.
Early examination will speed up the doctor to diagnose the condition, so that appropriate treatment can be given immediately.
Diagnosis of lichen planus
To diagnose lichen planus, the doctor will ask and answer questions about the symptoms and complaints experienced by the patient, the patient's medical history, as well as the drugs and supplements that the patient has been taking so far.
Next, the doctor will perform a physical examination, especially on the skin, mouth, or vagina, which have symptoms of lichen planus. If needed, the doctor will also run several supporting tests to confirm the diagnosis of lichen planus, such as:
- Biopsy, to detect lichen planus through tissue samples taken from the problematic skin or mucosa
- Allergy test, to determine if there is an allergic reaction that may trigger lichen planus
- Blood tests, to detect other factors that may cause lichen planus, such as hepatitis C
Lichen Planus Treatment
Lichen planus treatment aims to relieve symptoms, prevent complications, and reduce the risk of lichen planus recurrence in the future. The treatment given will be tailored to the severity of the condition and the patient's overall health.
In mild cases of lichen planus, this condition can sometimes go away on its own in a few weeks or months without treatment from a doctor. However, in severe cases of lichen planus, the patient's symptoms can get worse if left untreated. Therefore, severe lichen planus generally needs to be treated by a doctor.
Treatment of lichen planus by a doctor
Some of the treatment methods that doctors can use to treat lichen planus are:
- Administration of antihistamine drugs, in the form of oral or topical medications, to reduce itching caused by lichen planus
- Administration of corticosteroid drugs, in the form of ointments, tablets, or injections, to reduce inflammation
- Treatment with phototherapy or ultraviolet light, to get rid of lichen planus on the skin
- Administration of immunosuppressant drugs, in the form of creams or ointments, to suppress excessive immune system activity
If lichen planus does not improve with the above medications and phototherapy, your doctor may prescribe a retinoid ointment. Although effective in treating lichen planus, retinoid ointments can cause skin irritation, redness, and peeling. Retinoid ointment is also at risk of causing defects in the fetus if consumed by pregnant women.
To treat lichen planus that has been accompanied by complications such as infection, doctors can also give antibiotics or antifungals.
Handling lichen planus independently
There are several tips that patients can do at home to reduce itching and discomfort that occurs due to lichen planus on the skin, namely:
- Do not scratch the rash.
- Give a cold compress on the itchy and red skin.
- Apply a moisturizing cream to prevent dry skin.
- Use mild chemical soaps and shampoos to prevent skin irritation.
For patients with lichen planus in the mouth, some things that can be done to relieve symptoms are:
- Brush your teeth regularly, at least 2 times a day
- Replace damaged tooth fillings
- Stop smoking and drinking alcohol
- Avoid food or drinks that are too hot or cold
As for patients who experience lichen planus in the vagina, the best step that can be taken to relieve symptoms is to not wear tight clothing or pants.
Complications of Lichen Planus
Lichen planus of the vulva and vagina can cause severe pain, leave sores, and are at risk for sexual dysfunction. This disease can also increase the risk of certain types of skin cancer squamous cell carcinoma,if not treated quickly.
Lichen Planus Prevention
Lichen planus is difficult to prevent because the exact cause of this condition is not known. The best you can do is to avoid factors that can increase your risk of developing lichen planus, such as:
- Quitting smoking or drinking alcohol
- Stop the habit of biting the tongue or the inside of the cheek
- Check your teeth regularly to the dentist, especially if you have problems with your teeth
- Have regular health checkups, if you have a disease that can increase your risk of lichen planus, such as hepatitis C
- Consult with your doctor about the risk of side effects from the drugs you are taking and how to reduce these risks
