Managing Lichen Planus: A Holistic Approach to Skin Care


By Dr. Ashley Baldree, Village Dermatology, Katy Office

Lichen planus is a chronic inflammatory condition that affects the skin and often appears as itchy, red-to-purple, flat-topped bumps. While the exact cause of lichen planus is unknown, potential triggers include immune system reactions, liver conditions, and exposure to certain medications. At Village Dermatology in Katy, TX, we work closely with our patients to provide personalized treatment plans that align with their preferences, including more holistic approaches when possible. Today, I’ll discuss a recent case of a 30-year-old male with lichen planus on his foot, who is seeking a balance between conventional and holistic treatments.

Case Overview

Our patient presented for follow-up after a biopsy confirmed lichen planus on his right lower foot. He had initially reported itching and discomfort in the area, which led us to perform a biopsy to determine the cause. Following the diagnosis, he expressed interest in managing his condition conservatively.

Treatment Plan: Topical Steroids and Light Therapy

To reduce inflammation and control symptoms, we prescribed clobetasol 0.05% cream, a potent topical steroid commonly used to manage flare-ups of lichen planus. This cream is applied twice daily to the affected areas for up to two weeks, followed by intermittent use as needed for future flares. However, since overuse of potent steroids can thin the skin, we advised him to limit clobetasol application to no more than two weeks per month.

Skin Care Tips:

  • Apply clobetasol sparingly to avoid overuse.

  • Limit steroid use to two weeks at a time, with a break between treatments.

For more details on managing lichen planus with topical treatments, visit our Lichen Planus page.

Embracing a Holistic Approach

Given the patient’s preference for conservative treatments, we discussed a few holistic methods that can complement his regimen:

  1. Sun Exposure: Natural sunlight can sometimes help alleviate lichen planus symptoms. We recommended 10 minutes of sunlight on each affected area daily, while being cautious about overexposure.

  2. Light Therapy: At-home light therapy was another option we discussed. Controlled exposure, similar to natural sunlight, can reduce inflammation and itching in lichen planus.

  3. OTC Antihistamines: Since itching is a primary symptom, we suggested over-the-counter Claritin, which the patient could safely take up to two pills a day if needed.

For patients looking for alternatives to medication, incorporating these holistic options can offer some relief from symptoms. It’s essential to follow professional guidance to avoid skin irritation or sunburn.

Understanding Lichen Planus: Symptoms, Causes, and Treatment Expectations

Lichen planus can be persistent, often lasting for months, but it typically responds well to treatment. Patients should be aware that:

  • Lichen planus is an immune-mediated condition: The exact cause is unknown, but it is sometimes linked to conditions such as viral hepatitis and chronic liver disease. Certain medications, including anti-malarials and some metals, have also been associated with lichen planus.

  • Treatment aims to manage symptoms, as the condition often resolves over time.

  • Managing flare-ups is essential to maintain comfort and reduce the appearance of new lesions.

Monitoring and Follow-Up Care

We advised the patient to perform regular skin checks and to contact our office if he experiences worsening symptoms or if the lesions spread to new areas. Monitoring for changes is key to managing lichen planus effectively and ensuring the treatment plan remains suitable over time.

Our patient will return in 3-4 months for a follow-up evaluation, during which we’ll assess the treatment’s effectiveness and explore any necessary adjustments.

When to Seek Further Medical Attention

While most cases of lichen planus respond to topical treatments and sunlight exposure, some cases may require additional interventions. Patients should contact their dermatologist if:

  • New lesions appear or existing ones worsen.

  • Symptoms persist despite treatment.

  • Lesions become painful or interfere with daily activities.

Conclusion

At Village Dermatology in Katy, TX, we understand that each patient’s journey with skin conditions like lichen planus is unique. By offering personalized, flexible treatment plans that incorporate both conventional and holistic options, we empower our patients to manage their conditions in a way that aligns with their values and preferences.

If you’re dealing with lichen planus or another chronic skin condition, our team is here to provide expert guidance and support. For more information on lichen planus and treatment options, please visit our Lichen Planus page or schedule an appointment with our Katy office.

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