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How to reduce itching for lichen planus?

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Practicing since : 2006
Answered : 2015 Questions
How to reduce itching for lichen planus. I am taking XXXXXXX once a day. Earlier doctor gave me a course of cortisteroids over a period of 15days. Now I am on one tablet per day of sulpha drug and one XXXXXXX for itching. Still getting some eruptions every day. problem persisting from March last year. Now it has spread to the back
Posted Thu, 14 Mar 2013 in Skin Rash
Answered by Dr. Kalpana Pathak 36 minutes later
Hi Sir,
Thanks for writing to us.
Lichen planus is severely itchy chronic skin disease.
Firstly I would like you to have a brief overview of treatment

To control lichen planus initially we start with oral steroids and once the disease is under control ie existing lesions have decreased and no new lesion is coming, we add dapsone( sulfa drug) before withdrawing oral steroid as dapsone requires two to three weeks to show its response. Dapsone is added to achieve prolong control or remission of disease.
Along with this, we usually prescribe a potent topical steroid cream or lotion to apply like clobetasole or halobetasole and a good emollient or moisturising cream.
Topical and oral steroids also relieve itching . To have good control of itch, we also add oral antihistaminics.

Now to answer your question specifically,
If with XXXXXXX alone your itch is not under control, take tablet cetirizine or hydroxyzine( atarax) twice daily( morning and evening) with tablet XXXXXXX
If not using a topical steroid over lesions, begin with one.
If just getting few eruptions, nothing needs to be done we'll wait for dapsone to show its result. However if lesions are numerous then a short course of oral steroid can be given along with dapsone to control flare up.

Hope that answers all your queries. Should there be more, feel free to write back.

Should there be no more query, we may close the discussion.

Wish you a speedy recovery.

Above answer was peer-reviewed by
Follow-up: How to reduce itching for lichen planus? 18 hours later
Thank you doc for the info. My doc has prescribed a topical steroid cream (Zoflut). I have started with cetrizine as usggested by you and took one tablet last night. I got relief in itching but this morning when I took cetrizine I didnt get the same degree of relief. I have used cetrizine earlier as well. Do you think I should shift to atarax instead? There dont seem to be any further eruptions since yesterday. I am continuing with Dapsone as also presciibed by my doc. It has been only 5 days since I started on Dapsone after completing the course of Difula 6mg. What moisturising cream should I use and should I shift from Zoflut as I dont think it is as effective.
Thanks again, youve been a real help.
Answered by Dr. Kalpana Pathak 59 minutes later
Hi Sir,
Thanks for writing back.
If there is not much control of itching then stop XXXXXXX altogether and start with tablet cetirizine and tablet atarax 25 mg both to be take morning and evening. If itching still persists you may take atarax thrice in a day. As with XXXXXXX response is not much and moreover it has to be taken only once a day, I advise you to stop it. With atarax mild sedation might be noted, however control of itching is great. Once you feel that itching has reduced, you may decrease the dose of these medicines.

You have started dapsone recently only, so we will wait for its response to set in. With time eruptions and flare ups will settle.

Zoflut is a bit mild. Use diprovate lotion twice in a day( I personally prefer clobetasol but as its quite strong and follow up is required with clinical examination of lesions, I am suggesting a steroid good enough to reduce and control the disease). But if there is any lesion on face, apply zoflut over there as on face, genitals and groin area we prefer mild steroids.

Use cotaryl or moisturex as an emollient to keep the area well moisturised.

Be in regular follow up of your doctor.

Wish you a speedy recovery.
Above answer was peer-reviewed by
Follow-up: How to reduce itching for lichen planus? 22 hours later
Thank you doc. You have given me a very candid explanation and lets pursue this for some time. How long can we continue with dapsone? my doc has initially prescribed it for 30 days.
Thank you once again. Youve been a great help.
Best regards
Answered by Dr. Kalpana Pathak 10 hours later
Dapsone can be easily continued for prolonged periods from 6 month to an year. However response is usually achieved earlier and once remission is induced, we usually withdraw the drug and continue with topical creams if required.
So initially continue for a month as advised to see how much response you get
Hope that helps
Above answer was peer-reviewed by
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