Are you getting strange spots and itchy blisters on your skin? It could be Lichen Planus!

Have you suddenly developed small, itchy, discolored bumps on your skin? Or have you developed white patches inside your mouth that are bothersome even when you eat? These could be symptoms of a skin condition called Lichen Planus. Many people are a little scared when they hear this name, but don't worry, it's not contagious or dangerous. Let's talk about it in detail, very simply.

What is Lichen Planus?

Simply put, Lichen Planus is a skin condition. It can affect just one area of ​​the skin, or it can affect multiple areas of the body at once. Here's where it's most common:

• Skin: Skin cancer can occur anywhere on the body.
• Inside the mouth: We call it ``oral mucosa''. It can appear on the inside of the cheeks, tongue, and gums.
• Scalp: Can appear on the scalp and in the hair.
• Nails: Fingernails and toenails can be affected.
• Genital areas: Can also occur in places like the penis, vagina, and labia.

Doctors call this a disease that belongs to the group of lichenoid dermatoses. This means that this is a group of diseases that appear as small, discolored bumps on the skin.

Is this an autoimmune condition?

This is a question that many people ask. Lichen Planus is not exactly an autoimmune condition, but rather a similar reaction that occurs in our body. It is an ``idiopathic`` condition. This means that the exact cause of it has not yet been found.

Normally, our immune system protects us by fighting off foreign invaders, such as bacteria and viruses. But in people with lichen planus, our own immune system's T cells mistakenly attack a protein found in our own skin and mucus membranes. Why these T cells do this is still a mystery.

What is the difference between Lichen Planus and Lichen Sclerosus?

The names of these two diseases are somewhat similar, which can lead to confusion. Like Lichen Planus, Lichen Sclerosus is an idiopathic condition that affects the skin. However, in Lichen Sclerosus, the skin gradually thins, peels, and eventually becomes scaly. Although it can occur anywhere on the body, it most commonly affects the genitals and the skin around the anus. It is more common in women who have gone through menopause.

The main difference is that Lichen Sclerosus rarely affects the mucous membranes of the mouth, whereas Lichen Planus is more common in the mouth.

What is the difference between Lichen Planus and Psoriasis?

Psoriasis is another disease that causes red, scaly patches on the skin. Both can be confusing for some people because they cause discolored patches. However, psoriasis has a scaly appearance and does not usually affect the inside of the mouth. Lichen Planus has a less pronounced scaly appearance.

Who gets this most often? How common is it?

Lichen Planus can affect anyone, but research shows that it is more common in women between the ages of 30 and 60. Some studies suggest that women are twice as likely to develop it as men. It is said to be more common in women in their 60s and in men in their 40s.

If you have lichen planus on your skin, there is a 50% to 75% chance that you will also develop it inside your mouth.

It is so common that it affects approximately 0.22% to 1% of the adult population. Oral Lichen Planus affects between 1% and 4% of the world's population.

How does Lichen Planus affect the body? What are the symptoms?

The symptoms of lichen planus vary depending on where on your body it is affected.

Skin symptoms

This is most often seen on the wrists of your hands, elbows (we call these flexor surfaces), the tops of your arms (dorsal surfaces), and the fronts of your legs .

• It starts as tiny, raised spots (we call them ``papules''), about the size of a pinhead (about 0.4 millimeters).
• After a while, these can grow a little larger and become as thick as a pencil (about 1 centimeter).
• These can be purple in color and have a flat surface.
• It can also be very itchy. This itching is the main discomfort for many people.
• Sometimes these can turn into sores, especially if they are scratched. These types of bumps or sores can also occur in the genital area.

Symptoms in the mouth (Oral Lichen Planus)

About half of people with lichen planus also have it inside their mouth.

• It starts as small white dots or a mesh-like pattern on the inside of the cheeks, on the tongue, and sometimes on the lips.
• Sometimes these become red and sore, and when you eat something spicy (like our chili pepper-infused food), you may experience burning and pain.
• This discomfort may also be increased by eating hot beverages, tomatoes, and citrus fruits (such as oranges and limes).

Changes in nails

Although rare, this can also affect some people's nails.

• The color of the nails changes.
• The nails split and split in two.
• Nail growth may stop, or the nail may even fall off.
• Thin lines may also appear along the length of the nail.

Lichen Planus is usually not painful. However, if you scratch and break the skin, germs can enter and cause an infection, which can be painful.

What are the causes of Lichen Planus flare-ups?

Some things can cause Lichen Planus to suddenly worsen or appear again. We call these flare-ups.

• Hepatitis C virus: People infected with this virus are at risk of developing lichen planus.
• Some types of vaccines: For example, some flu vaccines.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Some of the medications we use as painkillers.
• Some other medications: Some medications for arthritis, heart disease, and high blood pressure.
• Certain chemicals, metals, or pigments: For those who are allergic to these. For example, certain metals used in dental fillings.

Is Lichen Planus contagious?

No, not at all! Lichen Planus is not a contagious disease. It is not spread through sexual contact or skin-to-skin contact. It is caused by a change in your own immune system. So don't be afraid of it.

How to diagnose this?

Your doctor can usually diagnose lichen planus by looking at your symptoms and doing a physical exam. Doctors look for something called the "Six Ps" (`(Six Ps)`):

• Pruritic: The spots itch.
• Polygonal: The shape of the spots is one with many sharp angles.
• Planar: The top of the spots is flat.
• Purple Papules: The bumps are purple in color.
• Plaques: Raised, discolored spots.

But sometimes, if there is any doubt as to whether this is the case, the doctor may do a few more tests:

• Allergy test: Check to see if you have an allergy to something and if that is the cause of these spots.
• Skin biopsy: This involves taking a tiny piece of skin from the area where the mole is and sending it to a lab. It's then looked at under a microscope to find out exactly what's wrong. This is a minor thing, nothing to worry about.
• Hepatitis C test: As mentioned earlier, this test can also be done because there is a link between the Hepatitis C virus and Lichen Planus.

Can Lichen Planus be cured? What are the treatments?

To be honest, there is no cure for Lichen Planus yet. However, the good news is that most cases of lichen planus on the skin will resolve on their own within a few months to a few years, even without treatment.

However, there are treatments to reduce itching and discomfort:

Treatment for lichen planus of the skin

• Corticosteroid creams or ointments: These reduce inflammation and itching of the skin. These are prescribed by a doctor.
• Antihistamines: These are commonly prescribed medications for allergies. They help reduce itching.
• Phototherapy: This uses ultraviolet light, usually UVB, from special lamps. This ultraviolet light, found in sunlight, is effective for some skin conditions, including lichen planus.
• Immunosuppressants: If the disease is more severe, doctors may prescribe medications that suppress the immune system, such as oral corticosteroids, mycophenolate mofetil, azathioprine, or cyclosporine.
• Retinoids (vitamin A derivatives): These are available in pill form or as creams. They work by increasing collagen production in the skin, increasing blood vessels, and helping scars heal. However, retinoids can cause birth defects, so be sure to tell your doctor if you are pregnant or planning to become pregnant.

Management for Oral Lichen Planus

Lichen Planus in the mouth usually gets better in about five years. However, if there are any sores or ulcers in the mouth, you may find relief with these things:

• Maintaining good oral health: It is important to brush your teeth daily, floss between your teeth, and have your teeth cleaned by a dentist at least twice a year.
• Minimizing mouth sores: If you have sores inside your mouth, they can become more frequent and more painful. Therefore, it is a good idea to brush your teeth regularly, apply dental wax around your teeth if you have braces, and remove any piercings inside your mouth if you have any.
• Replacing dental fillings: Although rare, some people can be allergic to amalgams, which are metal alloys used in dental fillings. This allergy can look like lichen planus. In such cases, replacing the fillings and replacing them with hypoallergenic materials may provide relief.

What are the home remedies?

There are medications you can buy at the pharmacy and things you can do at home to stop scratching your spots.

Although these are safe for most people, it's a good idea to talk to your doctor before using them, as you may be allergic to them in some cases.

• Aloe vera: Aloe vera is a natural remedy that helps heal wounds and moisturize the skin. Some studies have shown that aloe vera can help reduce the symptoms of lichen planus in the mouth or on the labia.
• Antihistamines: These medications, which can be purchased at the pharmacy, reduce itching.
• Hydrocortisone creams or ointments: These can be purchased over the counter at the pharmacy. They are a corticosteroid combined with a painkiller.
• Oatmeal: The best way to use oatmeal for lichen planus spots is to grind it into a fine powder in a blender or food processor (this is called ``colloidal oatmeal''). Mix this powdered oatmeal with a little hot water to make a thick paste. Apply this all over the spots. Leave it on for at least 10 minutes and then wipe it off with a clean cloth.

Do symptoms increase as stress increases?

Yes, stress can worsen any skin condition, including lichen planus. When we feel stressed, it affects not only our minds but also our bodies.

Some symptoms of stress (which may worsen your lichen planus symptoms):

• Depression.
• Difficulty relaxing.
• Use alcohol, tobacco, or drugs to relax.
• Having a negative attitude towards oneself (low self-esteem).
• Constantly feeling anxious.
• Feeling like everything is too much, feeling like you can't control it.
• Difficulty concentrating.
• Getting angry quickly, mood swings frequently.

Physical symptoms of stress (these can also increase lichen planus symptoms):

• Nausea, dizziness.
• Loss of desire to have sex.
• Sleeping too much (hypersomnia).
• Sleeping less, insomnia.
• Diarrhea.
• Constipation.
• Muscle stiffness, pain.
• Body pain.

Therefore, it is very important to think about stress management techniques. Things like meditation, yoga, breathing exercises, and engaging in a favorite hobby can be of great help.

What foods and drinks should I avoid if I have oral lichen planus?

If you have oral lichen planus, it's best to stay away from spicy, acidic foods and drinks, as these can make the spots in your mouth more painful and inflamed.

• Hot peppers, salt peppers, chili-flavored foods. (In our country, these are indispensable, but you have to control them a bit.)
• Hot sauces like salsa.
• Citrus fruits (oranges, tangerines, lemons, limes).
• Tomatoes and tomato sauce.
• Alcohol.

In addition to eliminating these foods and drinks, it is very important for those who smoke to stop smoking completely.

Is there a way to prevent this?

Unfortunately, there is no specific way to prevent the development of Lichen Planus. Because the exact cause is not known, it is difficult to say how to prevent it.

What happens if you have Lichen Planus? What can you expect?

Lichen Planus is a condition that can sometimes be managed without treatment. But often, treatment is needed to reduce symptoms. If you have lichen planus on your skin, it can take months or years to get better. Oral lichen planus in your mouth can take up to five years to get better. Treatment and home remedies can help reduce your discomfort.

If you have lichen planus in your genital area, you may experience discomfort and pain during sex. However, you cannot pass it on to your partner.

When should you see a doctor?

In such cases, you should definitely see a doctor:

• If you develop new symptoms .
• If symptoms do not improve despite treatment.
• If the spots are there longer than expected .
• If the area where the spots are appears infected (red, swollen, oozing pus).

What questions should you ask your doctor?

When you visit the doctor, you can ask questions like these:

• How exactly do you tell if I have Lichen Planus?
• If I don't have Lichen Planus, what other skin disease could it be?
• How long will it take for my body to recover from this condition?
• What medication do you recommend?
• Are there any side effects to those medications?
• What home treatments do you recommend?
• Is there a special cream or ointment that I can be prescribed?
• Should I see a dermatologist or another specialist?

Take-Home Message

Lichen Planus is a common skin condition. It can also affect the mouth and nails. It can be a bit embarrassing and itchy. However, it is not a dangerous or contagious disease, and it usually goes away on its own.

The most important thing is to pay attention to your skin. If you notice any new spots or changes on your skin, see a doctor right away. That way, you can find out exactly what's going on and start treatment if necessary.

` Lichen planus, skin diseases, itchy spots, mouth spots, skin diseases, immune system, skin treatment