How are dark spots after lichen planus treated?

Inflammation can stimulate extra pigment or disturb pigment-containing skin cells. The result is a brown, grey, or darker patch where bumps or sores were present. This is different from active lichen planus, although new itching, raised lesions, or tenderness may mean inflammation is continuing. The colour can be more noticeable after sun exposure or repeated rubbing. A clinician may need to examine the area before recommending a lightening product, particularly on the face, folds, or genital skin.

First follow the plan for active disease. Prescribed topical corticosteroids can reduce inflammation in suitable areas, while oral corticosteroid treatment may be considered for more widespread or difficult disease. Once the skin is quiet, a dermatologist can decide whether a pigment-directed medicine is appropriate. Use gentle cleansing, moisturise regularly, avoid picking, and protect exposed skin from sunlight with clothing or a suitable sunscreen. Do not use unlabelled bleaching creams or strong exfoliants; irritation can deepen the mark and obscure a new rash. Take a dated photo occasionally so gradual change is easier to judge.

Book a review if dark areas are enlarging, new bumps or itch are appearing, a patch is painful, or treatment is causing burning or peeling. Seek prompt assessment for a sore that does not heal, bleeds repeatedly, or develops a firm or changing edge. Pigment alone cannot confirm whether lichen planus is active, so changing skin deserves an examination rather than self-treatment.

Ask whether the marks represent post-inflammatory pigmentation or active disease, which products are safe for the location, and how long to try them. Ask how to protect the area from sun and what symptoms would mean the inflammation has returned.