Lichen planus is an inflammatory condition affecting the skin and mucous membranes, often characterized by itchy, flat-topped bumps or lesions. Though it is not an actual lichen (a symbiotic organism consisting of algae and fungi), it is named for its appearance. Sometimes, these lesions can be erosive and painful. This condition can occur in various parts of the body, including the mouth, genitals, and nails, and it often accompanies other conditions, which can confuse proper diagnosis.

The exact cause of Lichen planus is unknown. However, recent evidence is beginning to suggest that there are likely several contributing factors, including certain drugs, genetic factors, stress, trauma, and various viral infections. In allopathic medicine, the condition is generally thought to be idiopathic, which means a disease having no known cause. However, new theories are being proposed which might help explain this condition. For example, some new theories suggest that it could result from a lack of microbial diversity, a low-grade infection of typically less-than-lethal bacteria (e.g., Gardnerella, Corynebacterium, H-pylori, etc.), low-grade fungal infections (e.g., Candida sp.), or some other overlooked organism, which may explain why certain antibiotics, antifungal, and antimalarial drugs work well for some people and not others. Research is ongoing, and conclusions currently remain elusive.

Potential Dangers of Lichen Planus

Lichen planus is not generally considered dangerous as it can sometimes resolve on its own. However, as it is generally considered a chronic inflammatory condition, it should be known that it can potentially have significant health consequences if left unmanaged. This is to say that the role of inflammation in both acute and chronic conditions is a potential risk factor for other chronic diseases and conditions. In this instance, and just for example:

• Infection Risk: Chronic skin inflammation can compromise the skin’s barrier function, making it more susceptible to bacterial, viral, and fungal infections.
• Skin Thickening and Scarring: Persistent inflammation can lead to lichenification, resulting in permanent scarring and changes in skin texture.
• Pigmentation Changes: Chronic inflammation can cause hyperpigmentation (darkening) or hypopigmentation (lightening) of the skin.
• Chronic Pain and Discomfort: Intense itching, burning, and pain can significantly impact quality of life.
• Emotional and Psychological Impact: The visible nature of the condition can lead to social stigma, low self-esteem, anxiety, and depression.
• Increased Risk of Allergic Reactions: Chronic inflammation can make the skin more reactive to allergens.
• Impaired Wound Healing: Inflammation can delay the healing process, increasing the risk of complications and infections.
• Comorbid Conditions: Chronic inflammatory skin diseases are often associated with other health conditions like asthma, hay fever, and metabolic syndrome.
• Increased Cancer Risk: Chronic inflammation has been linked to an increased risk of certain skin cancers. While lichen planus itself is not cancerous, there is a debated association with an increased risk of cancer in some cases.
• Systemic Inflammation: Chronic skin inflammation can contribute to systemic inflammation, increasing the risk of cardiovascular diseases and other inflammatory conditions.

Typical Symptoms of Lichen Planus

• Itchy, flat-topped bumps
• Lesions on the skin or mucous membranes
• Erosive and painful sores
• White, lacy patches in the mouth
• Discoloration of the skin
• Thinning or splitting of nails
• Hair loss if the scalp is affected

NOTE: Lichen Planus can present differently in different people for different reasons. Your healthcare provider may be able to recognize it upon examination or may conduct bloodwork or a biopsy to confirm.

When to See a Physician

• Persistent or severe itching and discomfort
• Lesions that do not improve or worsen over time
• Painful erosive lesions in the mouth or genitals
• Signs of infection, such as increased redness, warmth, or pus
• Difficulty eating, drinking, or swallowing due to mouth lesions
• Emotional distress or impact on daily functioning due to the condition

Mainstream (Allopathic) Treatment Recommendations

When managing lichen planus, mainstream medical treatments often provide the most immediate and effective relief for symptoms. These treatments focus on reducing inflammation, alleviating itching, and preventing complications. Physicians typically prescribe medications that target the immune response and help manage the condition’s severity. However, such treatments are often not sufficient to control disease. The following outlines the most commonly used treatments in conventional medicine.

• Corticosteroids: Topical or oral corticosteroids can help reduce inflammation and itching.
• Antihistamine Medicine: These can help control itching.
• Immune Response Medicines: Medications that modulate the immune system may be used in severe cases.
• Other Oral Medicines: Hydroxychloroquine, metronidazole, clotrimazole, and miconazole have shown efficacy in some cases.
• Avoiding Triggers: Identifying and avoiding potential triggers such as certain drugs, foods, allergies, or stress can help manage symptoms.

Natural Alternatives

Managing chronic inflammation through lifestyle changes and medications and addressing underlying causes is crucial to mitigate these risks and improve overall health outcomes. For example, avoiding inflammatory foods is a great first step. Similarly, adopting a physiologically aligned diet that helps to reduce inflammation is also a typical recommendation from both an alternative and allopathic perspective.

Unfortunately, many mainstream treatments can come with some serious side effects. For those seeking holistic or complementary approaches to managing lichen planus, natural alternatives can offer significant relief and support. These methods focus on reducing inflammation and soothing the skin without the side effects often associated with pharmaceuticals. Incorporating these natural remedies into a treatment plan can help manage symptoms and improve overall skin health.

• Managing Stress: Stress management techniques such as meditation, yoga, and deep breathing exercises can help reduce flare-ups.
• Coconut Oil: Its moisturizing and anti-inflammatory properties can soothe irritated skin.
• Tea Tree Oil: Known for its antiseptic and anti-inflammatory properties.
• Epsom Salt Baths: Can help soothe itching and discomfort.
• Folate and Vitamin A: Essential nutrients that support skin health.
• Turmeric: Known for its anti-inflammatory properties, it can be applied topically or taken orally.

Advanced Considerations & Remedies for Lichen Planus

Beyond standard medical treatments and common natural alternatives, there are several advanced, albeit somewhat experimental, methods and emerging remedies that show promise in managing lichen planus. These innovative approaches provide additional options for those looking to explore all available avenues for relief and healing. These options, which can be used together, are phototherapy and phenylethylamine.

Sunlight or Phototherapy

It is now understood that sun exposure can play a beneficial role in managing lichen planus. Natural sunlight, particularly its ultraviolet (UV) component, has anti-inflammatory properties that can help reduce the severity of skin lesions and promote healing. Regular, controlled exposure to sunlight can alleviate itching and inflammation, providing symptomatic relief.

However, it’s important to balance sun exposure carefully, as excessive UV exposure can cause skin damage and increase the risk of post-inflammatory hyperpigmentation and skin cancer. Moderation and protective measures, such as using sunscreen and limiting the duration of exposure, are essential to safely harness the therapeutic benefits of sunlight for lichen planus. However, while it’s important to use sunscreen to protect the skin, we should opt for sunscreens that are free of chemicals and hormone disruptors, choosing mineral-based options with natural ingredients for safer protection.

Of course, lichen planus can present in areas that might not be appropriate or possible to expose at the pool. Similarly, not everyone has access or the time necessary to receive adequate natural sun exposure. The good news is that artificial phototherapy can help to clear up lichen planus as well, and it can actually save you some time. This approach involves exposing the affected skin to ultraviolet B (UVB) light for a few minutes about 2 to 3 times a week for several weeks. Some physicians offer this service, and various lamps are available on the market for home treatment.

However, medicinal UVB lamps can get expensive, and repeated visits to the doctor can be cost-prohibitive. Another at-home alternative might be to use a simple 150-watt clamp lamp light with reflective aluminum and a 100-watt full spectrum UVA/UVB reptile basking sun lamp, positioning it approximately 6 to 12 inches from the skin for 60 seconds, 2 to 3 times a week for several weeks. This type of bulb mimics the sun’s natural output, so the same precautions should apply. Just remember that regardless of which option you choose, they all come with possible side effects, including tanning or lasting changes in skin color (post-inflammatory hyperpigmentation) even after the skin heals.

The Powerhouse of Phenylethylamine (PEA)

A strong candidate for the management of lichen planus should be Phenylethylamine (PEA), a naturally occurring compound found in various foods, such as chocolate. Unfortunately, food sources typically do not provide enough of this substance for therapeutic purposes. Therefore, for those seeking its therapeutic effects, supplementation will be necessary.

PEA is known for its mood-enhancing properties, and it is often referred to as the “love drug” or “molecule of happiness” due to its ability to elevate mood and promote feelings of well-being (chocolate). However, beyond its psychoactive benefits, PEA is also known to be a powerful anti-inflammatory nutraceutical with significant potential for managing chronic inflammatory conditions, including lichen planus.

Anti-Inflammatory Properties

PEA exerts its anti-inflammatory effects by reducing the production of pro-inflammatory cytokines, which are signaling molecules that promote inflammation. By modulating the immune response in this way, PEA helps to decrease the overall inflammatory load in the body, leading to significant improvements in inflammatory symptoms. This is important to understand because lichen planus is typically characterized by elevated levels of proinflammatory molecules, such as TNF-α, which can further exacerbate the condition if left unchecked. By addressing the underlying inflammatory processes, PEA not only offers symptomatic relief (itching, burning, and discomfort) but also helps manage the chronic nature of the disease through various mechanisms of action.

In other words, it helps to calm and balance the immune system. Best of all, by reducing inflammation, the body can allocate more energy and resources to address any underlying or stealth infection. Remember that inflammation demands significant metabolic resources, so mitigating it allows the body to better focus on fighting infections and repairing tissue.

Mechanisms of Action

PEA works through several mechanisms to exert its anti-inflammatory effects:

1. Mast Cell Stabilization: PEA stabilizes mast cells, which are immune cells involved in allergic reactions and inflammation. By preventing mast cell degranulation, PEA reduces the release of histamine and other inflammatory mediators.
2. Endocannabinoid System Modulation: PEA interacts with the endocannabinoid system, particularly the peroxisome proliferator-activated receptor-alpha (PPAR-α). Activation of PPAR-α leads to anti-inflammatory effects, contributing to the regulation of pain and inflammation.
3. Reduction of Pro-Inflammatory Cytokines: PEA decreases the production of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) and interleukins, which play a key role in sustaining chronic inflammation.
4. Neuroprotective Effects: PEA’s ability to influence neurochemical pathways involved in pain perception helps to modulate pain pathways and reduce chronic pain. This is particularly beneficial in conditions like lichen planus, where pain and discomfort are sometimes prominent symptoms.

Additional Benefits of PEA to Consider

Beyond its anti-inflammatory properties, PEA actually offers several additional benefits:

1. Appetite Suppression: PEA is believed to act as a natural appetite suppressant. It stimulates the release of neurotransmitters such as dopamine and norepinephrine, which are involved in the regulation of hunger and satiety.
2. Weight Loss: As stated in the previous listing, PEA enhances the release of norepinephrine. Norepinephrine increases the breakdown of fat stores, leading to an increase in energy expenditure. This boost in metabolic rate can help burn more calories, which can contribute to weight loss.
3. Mental Focus: Because PEA enhances neurotransmitter activity, it can also help to improve cognitive function and overall mental focus.
4. Performance Boost: By increasing energy levels and enhancing mental focus, PEA can also contribute to improved physical performance.
5. Safety and Tolerability: Best of all, PEA is considered safe and well-tolerated, with minimal side effects. This makes it a strong and viable option for long-term management of chronic inflammatory conditions.

How to Use PEA

For therapeutic purposes, PEA is available in supplement form. The recommended dosage can vary based on the severity of the condition and individual response. However, therapeutic doses are typically somewhere around 1200 mg per day. It should be noted that this upper limit is based on studies and clinical usage, and no ‘true’ upper limit has been established.

That said, while PEA has a good safety profile, as with any supplement, it is important to monitor for any adverse effects. Regardless, it is always advisable to start with a lower dose and gradually increase it under the guidance of a nutritionally competent healthcare professional. It should also be noted that PEA supplements should be taken consistently to achieve the best results in managing inflammation and pain.

Final Thoughts

While lichen planus is often not considered dangerous and can sometimes resolve on its own, it is important to understand its potential complications and manage it proactively. With a combination of mainstream treatments, natural remedies, and advanced considerations, most people can effectively manage the symptoms and improve their quality of life. Just remember that lichen planus is an effect, which means that while we may not fully understand the cause, it doesn’t mean that a cause doesn’t exist. Keep searching and keep trying to heal.

For more diet considerations, read “Nature’s Intent.”

Disclaimers

Dr. Robertson is a health researcher and educator, not a physician. The information provided here is not medical advice, a professional diagnosis, opinion, treatment, or service to you or any other individual. The information provided is for educational and anecdotal purposes only and is not a substitute for medical or professional care. You should not use the information in place of a visit, call consultation, or the advice of your physician or other healthcare providers. Dr. Robertson is not liable or responsible for any advice, course of treatment, diagnosis, or additional information, services, or product you obtain or utilize. IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY, YOU SHOULD IMMEDIATELY CALL 911 OR YOUR PHYSICIAN.

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