Lichen Planus: My Love/Hate Relationship

In my work in herbal dermatology, Lichen Planus is actually one of my favorite conditions to treat. So why do I say I have a “love/hate” relationship with it?

First let me tell you what I love about Lichen Planus. The truth is – it’s a challenge, and I love a good challenge. Herbal medicine really shines when you can analyze the skin, take into account other symptoms, and precisely choose each ingredient that goes in to a formula.

Where western medicine may give the same few medications to everyone suffering from lichen planus, herbal treatment focuses on the precise look of the skin and location of the lesions.The Varied Appearance of Lichen Planus

As you can see in this image, some lichen planus lesions are totally flat. Others are raised. The lesions on the left are quite thick and warty looking. Also note the different colors. Lichen planus often appears purplish – but here you can see purple, gray, red, brown, white and pink aspects of these lesions.

Lichen planus also shows up often as oral or genital lesions that look totally different from the photos above.

In every way that lichen planus looks different, so too is the treatment with herbs. Different herbs are chosen for lesions that are red, purple, pink, raised, flat or itchy. Of course, there are some empirical ingredients that are just known to be effective for lichen planus. But the artistry of writing a formula comes in addressing the nuances, the precise look of the skin, the location, and the other signs and symptoms. This is the type of formula writing that I love.

So why do I both love and hate this fascinating and complex condition?

My main frustration with lichen planus is that very often it is just slow to respond to herbs. New cases can resolve quickly, but when lichen planus has been around for a while, or when it’s widespread and severe, it takes a lot of patience to start seeing results.

When I consult with patients for various skin conditions, I always like to tell them what they can expect. I try to be a straight shooter and give them a realistic picture of the course of treatment. Herbs are not “miraculous” and they don’t work overnight. But with most conditions, changes start to happen within at least the first 3 to 6 weeks of treatment. Of course, the skin won’t be completely healed in that time, but there will be enough of a difference where people can see whether or not the herbs are working for them. It’s easy to lay out a long-term plan for treatment when you are seeing consistent changes.

Lichen planus is different. Herbs can be an extremely effective treatment. But in many cases it can take well over a month to see any changes at all. Oftentimes people get frustrated and quit too soon. And of course, herbs don’t work 1% of the time. As much as I want to tell people to keep up with taking the herbs, I can’t guarantee they’ll get better. The majority of the time, though, people that stick with it do see positive results.

It all boils down to this — it takes a lot of patience to get the most out of herbal treatment for lichen planus. People who can be consistent, hunker down and stay the course are very likely to have significant improvement or a full clearing of the skin. Just know that this particular healing journey can be a long one.

I shouldn’t say I hate this aspect of treating lichen planus. I guess I just need to work on my own patience…

Learn more about our treatment of Lichen Planus with Chinese herbal medicine…

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