Lichen planus is not a curable condition. However, when it affects the skin it usually clears within several months (sometimes it may take up to 2 years). Treatment focuses on easing symptoms until the rash clears.
Mild cases require no treatment by the doctor, except for periodic observations.
Treatment for severe cases of lichen planus may include:
Antihistamines - to reduce itching. Phototherapy - with ultraviolet light. Topical medications (applied to the skin):
Steroid creams or ointments - these can be very effective in reducing inflammation and redness. The medication is applied to the itchy spots. When the spots change color to brown or gray treatment should stop.
Immunosuppressants - sometimes creams or ointments may contain a steroid-sparing immune-modulating medication (drugs to reduce the immune response).
Oral corticosteroids (steroid tablets) - for more severe cases, or when creams and ointments are not effective enough.
Cyclosporin capsules or acitretin tablets - these lower the immune system and may sometimes help. Only used in extreme cases.
Oral symptoms - the doctor may prescribe steroid lozenges or mouthwashes if mouth ulcer symptoms are uncomfortable.
Lichen planus of the mucous membranes - treatment is difficult to get right and may take years. The doctor may prescribe oral corticosteroids as well as topical corticosteroids.