What is the first treatment for lichen planus?

Lichen planus is an inflammatory condition that can cause itchy, flat-topped or scaly purple-red bumps, though its appearance varies by body site. Topical corticosteroids reduce local inflammation and itching where they are applied. The strength, formulation and course depend on whether the area is skin, mouth, scalp or another sensitive site.

Oral corticosteroid treatment may be considered when symptoms are extensive, severe or affecting several areas. It requires medical supervision because the clinician must balance expected benefit with the person's health history and the risks of systemic medicine.

Use the prescribed topical corticosteroid in the thin layer and schedule advised, and do not extend treatment to new areas without checking first. Avoid scratching, fragranced products and unnecessary friction, since these can aggravate inflamed skin. Report mouth sores, genital symptoms, scalp hair loss or nail changes because these sites may need a different formulation or referral.

If the rash does not settle, keeps returning or covers a large area, arrange a review rather than repeatedly self-treating. The clinician may adjust the topical plan or discuss oral corticosteroid treatment.

Seek prompt care for painful mouth ulcers that limit drinking, genital sores, eye symptoms, rapidly spreading blisters or signs of infection such as pus and fever. These symptoms need assessment because the affected site changes the urgency and treatment approach.

Ask which formulation fits the affected site, how long to use it, how to taper or stop, and what symptoms would make oral treatment or a specialist review appropriate.