Lichen planus is a difficult and stubborn disease. It not only affects the skin, but can also affect the mouth (the inner side of the cheeks, tongue, gums, and palate i.e. roof of the mouth), scalp, nails, and the private parts (genitals). However, all the patients may not be affected in all the areas at the same time, but about 70% of people typically have lichen planus on the skin, and about 15%-20% of the patients may have lichen planus affecting their mouth which is called as oral lichen planus. 7%-10% of the patients may have genital lichen planus, 5%-7% of the affected individuals may have their nails affected with lichen planus, and around 3%-4% may have lichen planus affecting their scalp which is called as lichen planopilaris.

Homeopathic Treatment For Lichen Planus

Lichen planus is a difficult, chronic, and stubborn disease to treat, but, with homeopathy, its recovery from this skin condition is possible. Homeopathy is the first line of treatment for Lichen Planus.

Scope Of Homeopathy: The scope of homeopathy is varied in different cases of lichen planus. Homeopathy is strongly recommended for the majority of the cases of lichen planus. One should think of homeopathy when the case is recently detected and not tampered with steroids. Homeopathy is well indicated in types of oral lichen planus, lichen planopilaris, and lichen planus pigmentosa where the focus is majorly to control the disease spread with some reduction in the lesions. Since lichen planus is an autoimmune disease, which tends to spread, controlling the further spread is also a good achievement in the treatment.

How Does Homeopathy Approach Lichen planus?

Homeopathic remedies, such as Arsenic album, Sulphur, Natrum muriaticum, Apis Mellifica, Borax, Thuja occidentalis, Kali Chloratum, have been found giving great results through the internal correction of the deranged immunity, which is known to be the basic cause of the disease.

Brief indications of the mentioned homeopathic remedies in Lichen planus:

1. Arsenicum album: Arsenicum album is used in lichen planus homeopathic treatment when there is intense itching and burning, especially when the itching is intolerable and worse with cold water application and cold weather and at night causing sleep disturbances which is better by warmth. The affected lesions are red and inflamed with heat.  Individuals who require Arsenicum album are highly anxious and restless and there is a deep sense of insecurity. They have a strong fear of disease and desire for a company and reassurance.
2. Sulphur: It is the best homeopathic medicine for lichen planus for individuals who tend to have dirty and unhealthy unwashed-looking skin. It is often indicated when the lichen planus lesions have intense itching, and burning and these symptoms get worse with warmth and heat. The complaints are worse at night time and after bathing.
3. Natrum muriaticum:  Natrum muriaticum is often considered in lichen planus homeopathy treatment when one develops the same after suppressed emotions or after strong grief or from loss of loved ones or disappointment in love or strong emotional stress and are reserved by nature. There is a sense of isolation and sadness. The lichen planus eruptions are characterized by dryness, cracking, and fissures in the skin. The skin is dry and rough and the eruptions may worsen with exposure to sunlight and the skin becomes inflamed, itchy, and sensitive after going in the sun.
4. Apis mellifica: This remedy is suitable in cases of Lichen planus where the affected area appears red, hot to touch, and sensitive to touch feels sore and tender. The characteristic symptom of this medicine is burning, stinging pain which is relieved by cold application. This is often prescribed in individuals who have a lack of thirst, in spite of the presence of fever or inflammation the individual has no or little desire to drink water.
5. Borax: Borax is often used in homeopathic treatment for oral lichen planus when one has typical white lacy lesions or reticular lesions inside the cheeks or on the tongue. Individuals who need Borax experience burning and stinging pain in the oral cavity, particularly during eating and drinking hot food and drinks or spicy foods. It is suitable for individuals who are sensitive to noise and are easily startled.
6. Thuja occidentalis: Thuja is often indicated in cases of lichen planus wherein the lesions are rough, elevated, and have a cauliflower-like appearance. The itching may be worse with touch or pressure and is sensitive and painful to touch. This is suitable to individuals who have a history of recurrent infections and suppressed immune function.
7. Kali chloratum: Kali chloratum is used in lichen planus oral homeopathic treatment, suitable for oral lichen planus symptoms that worsen with the consumption of warm drinks or hot foods. Heat may exacerbate the burning or stinging sensations in the mouth. Individuals who require Kali chloratum oral lichen planus treatment homeopathy may experience soreness and burning pains in the affected areas, particularly during eating or drinking acidic or spicy foods.

Duration Of Treatment: The duration of treatment depends on the time since the patient had the disease. The more chronic the disease, the longer is the treatment required. If steroids were used for a longer period in the earlier treatment, the resultant is a complex disease that becomes a challenging condition to reverse. Skin lichen planus is relatively easier to treat than oral lichen planus and lichen planus of the scalp and genitals.

Our Experience In Treating Lichen Planus At Life Force

At Life Force, we have been treating cases of Lichen Planus for over 30 years, under the care of Dr. Rajesh Shah. We have carefully treated and documented over 5,000 cases of Lichen Planus including all varieties, such as lichen planus affecting the skin, mouth, genitals, nails, and other body parts, as well as Lichen Planus pigmentosa, Lichen planopilaris, and more.

Using homeopathy, we have observed substantial results in most cases of Lichen Planus. Cases of Lichen Planus from across the world have been under our treatment using the online model. Of course, hundreds of patients would see us in person at our centers in Mumbai.

Based on our significant experience, we strongly recommend homeopathy for the treatment of Lichen Planus.

Incidence- Lichen planus affects 1.9% of the world population. In India, about 0.5% to 2.6% of population is affected. This skin disease affects males and females equally. However, statistically, it has been seen that there is more female predisposition as far as oral lichen planus is concerned.

What Happens In Lichen Planus?

Pathogenesis

Lichen planus is a T-cell (a cell responsible to give an immune response) mediated autoimmune disease. The disease evolves by receiving an immune response from an antigen (a foreign body that induces an immune response). This triggers inflammatory processes in various parts of the body which leads to the multiplication of the skin cells (keratinocytes and melanocytes). The multiplication of keratinocytes gives rise to the features of lichen planus of the skin or oral lichen planus. And, the multiplication of melanocytes (cells responsible to give color to the skin) results in lichen planus pigmentosa.

Causes Of Lichen Planus:

The exact cause of lichen planus is not known, but it has been noted that the following factors may predominantly cause lichen planus.

1. Immunological Factors: It has been observed that there are certain immunological factors that can cause lichen planus.

2. Genetic Cause: There are also certain genetic tendencies with which some people are born. Individuals may be prone to have lichen planus, just because someone in their family has a similar autoimmune disease, unlike lichen planus.

3. Medications: Certain conventional medicines, such as NSAIDs (non-steroidal anti-inflammatory drugs) group of medicines (ibuprofen), some antibiotics, anti-hypertensive medications like beta-blockers, medicines given for gout, and some anti-malarial drugs, can be responsible for the development of lichen planus. Also, too much of PPI (proton pump inhibitors – a medicine used to treat acidity) usage may also trigger lichen planus.

4. Contraceptive Devices: In some observations and study at Life Force, we have also found that there are certain triggering factors such as some intrauterine contraceptive devices which are made up of plastic or copper which are responsible to cause lichen planus in females who are prone to have it. 

5. Trauma: Any injury or friction on the body can give a reason for lichen planus to surface on the body. This kind of tendency to have lichen planus is called as Kobner’s phenomenon in the medical term. It is important to know that certain ill-fitted metal caps on the teeth can trigger lichen planus in the mouth due to friction between the inner skin of the cheek and the cap.

6. Stress: Lichen planus is a psychosomatic (psycho - mind, soma - body) disease. Stress has been linked with lichen planus, and stress may be a possible cause in prone individuals.

Types Of Lichen Planus

1. Lichen planus pigmentosa: In this type of lichen planus, a blackish discoloration or hyperpigmentation of the skin may occur, and it can affect any part of the body. It mainly affects the exposed parts of the skin. Excessive or prolonged exposure to the sun can trigger this problem.

2. Lichen amyloidosis: It presents as grey to brown raised tiny eruptions anywhere on the body. Gradually, these coalesce to cover a large area. The most common body areas affected by lichen amyloidosis are the forearms and the lower leg (shins). The exact cause of the condition is not yet known, but it is generally associated with some existing systemic illness affecting the body. Friction is also known to cause lichen amyloidosis.

3. Lichen sclerosus: It is an uncommon type of lichen planus which presents as white and thin skin. It commonly affects the genital areas, and it has been observed that post-menopausal women are more prone to contract this condition.

4. Lichen nitidus: It is a rare variant of lichen planus. It presents as small, skin-colored shiny bumps anywhere on the skin. Lichen nitidus occurs as a result of abnormal inflammatory activity in the cells of the skin; however, the cause of inflammation is still unknown.

Symptoms Of Lichen Planus:

• Pinkish, purple, or greyish raised eruptions on the skin which have unpleasant appearance are prominent symptoms of lichen planus. It can affect the forearms, legs, abdomen, back, and, in certain uncommon cases, affects the face.
• Another common symptom is mild to severe itching on the skin lesions. There might not be any itching at all in some cases. In cases of oral lichen planus, white streaks are observed inside the cheek, tongue, gums, and palate along with severe pain and its burning in nature.
• The patients having oral lichen planus are unable to have spicy, hot food or hard food. At Life Force, we have seen some miserable cases of oral lichen planus who just cannot eat or even drink anything.
• In lichen planopilaris, that is the scalp lichen planus, the eruptions tend to form a scar after healing. This scar formation may lead to the destruction of hair roots in that area leading to patchy baldness in the scalp which may be difficult to recover in terms of hair growth.
• The genital variety of lichen planus gives rise to the eruptions which can be painful during sexual intercourse.

Diagnosis Of Lichen Planus

Usually, most of the cases of lichen planus are diagnosed clinically just by examining the lesions. But, some patients may need to undergo a biopsy to decide the treatment plan. Prompt diagnosis of lichen planus is very important. For instance, some cases of skin and oral lichen planus may resemble other skin conditions like pemphigus. Similarly, cases of lichen planus pigmentosa may look similar to what is called melasma or ashy dermatosis. A good clinician should have a keen eye and must differentiate between the cases of oral lichen planus, leukoplakia (an oral precancerous condition), and oral submucous fibrosis which may look similar on examination.

Treatment For Lichen Planus

Conventional Treatment

In the conventional or allopathic mode of treatment, dermatologists usually prescribe steroid ointments and even some steroid tablets in severe cases. Antihistamines are given to relieve you of the itching. In some extensive cases of lichen planus, which are not responding to steroid treatment, immunosuppressants, such as methotrexate, cyclosporines, and other immune-modulating medicines, are given. These drugs suppress the immunity in such a way that the body fails to show up any reaction. But, the moment they are stopped, all the symptoms return with a heightened intensity. This particular phenomenon is called the steroid withdrawal effect. These drugs give you a quick though a temporary relief. These drugs cannot be taken for a longer duration since they significant side-effects. Long-term usage of the same may damage major organs, such as the kidneys and liver. 

Supportive Measures (Diet & Home Remedies) For Lichen Planus

A. Diet To Follow When Treating Lichen Planus

Diet plays an inevitable role in treating any disease. It helps in accelerating the pace of recovery when it is combined with the medicinal treatment.

1. Foods to avoid when suffering from oral lichen planus: It is important to avoid spicy, hot foods and hard and crispy foods, as they may irritate the inner lining of the mouth. Avoid eating non-veg (more of red meat) in your diet.

2. Foods to include: Consume enough of vitamin C. Vitamin C is known to heal one’s body. Hence, include plenty of fruits and vegetables, such as lemons, amla, orange, pineapple, guava, kiwis, and spinach, in your daily diet. Increase the intake of foods rich in vitamin A, such as carrots, pumpkin, and sweet potatoes, which will help in fighting the inflammation. Healing is difficult, particularly in the cases of oral lichen planus, so including these foods in your diet would support recovery. Have soft, bland food as much as possible when suffering from oral lichen planus.

B. Home Remedies For Lichen Planus

You may find these amazing substances in your kitchen which have healing properties and can be used in recovering from nasty lichen planus lesions, particularly lichen planus affecting the mouth.

1. Turmeric (Haldi): It has known to have abilities to reduce the inflammation and soothe the pain. Researchers have proven that turmeric (Haldi) has an active substance called curcumin, which has anti-inflammatory, antibacterial, and anti-viral properties. A turmeric pack applied to the affected area on the skin will help in relieving you of the itching and discomfort. Regular drinking of turmeric decoction (Haldi powder boiled in water) will also go a long way in healing lesions of oral lichen planus.

2. Coconut Oil: This is one wonder home remedies that will help soothe the lesions in the mouth and on the skin. Applying coconut oil twice or thrice every day will help in reducing the irritation. Coconut oil pulling (1 tbsp of oil in the mouth and move it to and fro) daily reduces the pain and burning.      

Some Myths About Lichen Planus You Need To Know

1. Lichen planus does not spread by touch: Many people believe that lichen planus spreads by touch. It is important for one to know that lichen planus does not spread by touch and it is safe to live, touch, and eat with a patient having lichen planus.

2. It is safe to conceive if you have lichen planus: Some female patients ask us at the clinic whether it is safe to conceive when they have lichen planus or not. The fact is that you can conceive when you have lichen planus affecting the skin, but in some variants like genital lichen planus, it might be difficult to plan a baby.

3. Some allopathic medicines can be taken when you have lichen planus: Another myth is that no allopathic medicines can be taken when one has lichen planus. This is not correct. The fact is that some allopathic medicines like paracetamol, some antihypertensive medicines, anti-diabetic medicines, and other medicines can be taken when one has lichen planus.

4. Homeopathic medicines can be taken along with conventional medicines: Another common myth which many people believe is that homeopathy cannot be taken with conventional medicine. The fact is that both of these are modes of treatment that can safely be taken simultaneously.

5. Artificial jewelry can be worn if you do not have an allergic constitution: Some patients feel that artificial jewelry cannot be worn when one has lichen planus. Well, some kind of artificial jewelry can be worn if you are not allergic to it and which would not irritate the skin. 

6. It usually affects middle-aged people: While lichen planus predominantly occurs in middle-aged adults, lichen planus is not limited by age, it's crucial to understand that it can affect individuals of all ages, including children and adolescents. 

7. It turns into Cancer: Despite its occasional resemblance to precancerous lesions, lichen planus is not classified as a cancerous ailment. Fortunately, the vast majority of cases do not develop into cancer.

8. Certain foods cause it: Although specific foods or allergens could exacerbate symptoms of Lichen planus in certain individuals, there is no universal dietary trigger for lichen planus. Triggers vary individually, and dietary changes may not be mandatory in all cases.

9. It is because of a weak immune system: Though lichen planus involves the immune system targeting healthy cells, it doesn't necessarily indicate an individual's weak immune system overall.  It's more about the immune system malfunctioning in a specific manner rather than being generally compromised.

10. Stress causes Lichen planus: Stress can aggravate skin conditions such as lichen planus, but it's not the only contributing factor.  Lichen planus is believed to result from various factors, including immune system responses and genetic factors.

Related Disease: 

• Atomic dermatitis
• Psoriasis
• Candidiasis
• Leukoplakia
• Alopecia areata
• Systemic Lupus erythematosis
• Pemphigus
• Hyperthyroidism