Brief Answer:
Sun protection and medications to apply.

Detailed Answer:
Respected Sir,

Welcome and thanks for posting your query to the forum.

I can understand your great concern regarding your wife's pigmentation.

I have gone through your complete query and I am quite empathetic to the problem of lichen planus pigmentosus.

Let me tell you certain important points regarding your wife's condition: Our skin is a mutilayered structure. Our skin also contains certain cells which are known as melanocytes. These melanocytes are the cells which regularly produces color/pigment known as melanin in the skin. These are superficially present in the upper skin known as epidermis. These melanocytes can be more active in certain conditions due to unknown causes. Till now we are not able to find the exact cause of the same.

Lichen Planus Pigmentosus is a pigmentary disorder seen in Indians with macular hyperpigmentation involving chiefly the face, neck and upper limbs and even intertriginous sites like axillae, although it can be more widespread. The color varies from slate grey to brownish black. It is mostly diffuse but but reticular and blotchy pigmentation is also seen.

Now for the treatment part there is no established therapy for these conditions as are persistent in nature and slowly extends. We try and give as many therapies for reduction of the hyper-pigmentation as well as for reducing the progression but sometimes all proves to be of little help.

I suggest you certain measures by which you can stop progression:

1. Strict sun avoidance

2. Avoid any oral medications.

3. Increase the amount of vit A and carotenoids and other related antioxidants in your food.

4. Increase the intake of fruits (all yellow will do) and green vegetables

5.Kindly reduce the stress as it can be one of he aggravating factor in all pigmentary conditions.

If I were your treating dermatologist then would have prescribed a cream (under dermatological supervision) containing Kojic acid with arbutin and mulberry extract in it. Alternatively Azelaic acid gel can be applied over the affected area of pigmentation. These are one of the best and safest creams to be applied. Apply any of these creams in a very thin layer at night time only so that these should not be visible to naked eye. Apply at night time before sleeping. Sun protection is a must and a proper sun screen should be used.

Diet is also quite important in reducing the pigmentation. Good diet not only helps in renewing the skin better as well as works best to protect our skin. You can eat a lot fruits and green leafy vegetables in your daily schedule.

Again to tell you sun protection is the most important factor in prevention of further spread of pigmentation.

I hope these informations will help you in getting rid of pigmentation marks. I will be glad to reply any further queries.

I wish best and early recovery,

With best health wishes,

Dr Sanjay Kanodia
MD- Dermatology

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Brief Answer:
LPP: various suggestions for betterment

Detailed Answer:
Respected Sir,

Welcome again to the forum and thanks for your further follow up.

Regarding the cream: In my patients I use Carofit XXXXXXX cream to be applied at night time.

For the use of Ayurvedic or homeopathy medicines: I am convinced with all these therapies as many a times these specialist say that the disease will increase and then decrease. This is not convincing for me so you can take decision accordingly.

For the use of any oral medication in treatment of LPP : As I suggested no oral medications please. It is not the right age for the same as she is taking so many other medications which are quite essential for her.

All the other medications which she is already taking for other health issue are quite essential so must take under medical supervision.

I am based at XXXXXXX so you can meet a good dermatologist at Medical College level.

I hope the information will help you.

With best regards,

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Brief Answer:
I would not prefer to give any oral medications.

Detailed Answer:
Respected Sir,

I really appreciate your concern for the LPP condition of your wife. Let you first relax yourself and then relax your wife too regarding simplicity of this condition. It is just a pigmentary condition and is not at all serious condition.

So I completely reassure you the part of apprehension of your wife.

I suggest multiple types of topical therapies only and prefer not to give any oral medications in the same. Looking at the age of your wife and other medical conditions I would not prefer to give any oral medications. So from my side if I were your wife's treating dermatologist then would have preferred to give only topical medication to apply.

Kojic acid being the safest of all so I prefer the same in all my patients as first line of therapy.

As I suggested you can meet a dermatologist at Medical college level and get a proper personal opinion regarding the condition.

I reassure you fully that the condition is very simple and not going to cause any problem though out life.

I hope these informations will help you. I will be glad to reply any further queries.

I wish best and early recovery,

With best health wishes,

Dr Sanjay Kanodia
MD- Dermatology

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