Holistic TCM Dermatology: Lichen Planus


Lichen planus is a common inflammatory condition affecting the skin and mucous membranes, and can fully resolve with treatment by holistic, traditional Chinese medicine (TCM) dermatology.


The cause and etiology of lichen planus is not well understood. It is generally considered as an autoimmune disorder.


How do I know if I have lichen planus?


Lichen planus exhibits five classic diagnostic features, the five Ps: purple, planar, pruritic, polygonal, and papular. “Purple” refers the color being dark with a distinctive purplish sheen; “planar” means the lesions are flat-topped on the skin, not rounded; “pruritic” describes the itchiness of the rash; “polygonal” describes the lesions having multiple sides, following the lines of the skin, and “papules” indicates the type of skin lesion.


It most commonly appears on the wrists, ankles, forearms, lower legs, the mouth and tongue, genitalia, and sacrum. There are a number of subforms including:

  • Cutaneous lichen planus

  • Mucosal lichen planus

  • Lichen planopilaris

  • Lichen planus of the nails

  • Lichen planus pigmentosus


What would a dermatologist recommend?


There are several options for conventional treatment of localised, symptomatic lichen planus:

  • Potent topical steroids

  • Topical calcineurin inhibitors (pimecrolimus cream, tacrolimus ointment)

  • Topical retinoids (vitamin A derivative

  • Intralesional steroid injections


For systemic, widespread lichen planus, patients may consider the following:

  • Acitretin (vitamin A derivative)

  • Hydroxychloroquine (immunosuppressive and anti-parasite drug)

  • Methotrexate (chemotherapy and immunosuppressive drug)

  • Azathioprine (immunosuppressive drug)

  • Mycophenolate mofetil (immunosuppressive drug)

  • Phototherapy


How does holistic TCM dermatology treat lichen planus?


TCM has been treating inflammatory skin conditions for millennia using acupuncture, herbal medicine, and a corresponding holistic approach to diet and lifestyle. As with any condition, your practitioner will take a detailed health history and consider all systems before coming to a holistic pattern diagnosis.


Sometimes lichen planus appears suddenly at the mouth and genitals with intense itching. For others it may appear slowly, with hyperpigmentation and very little itching. One person with lichen planus may experience dry skin, intense thirst, and dizziness. Another might experience another one or two autoimmune diseases, bloating, and vaginal discharge. These differences in presentation are significant, and each case is treated differently by TCM.


TCM herbal treatment for lichen planus is potent and focused on the present symptoms. Treatment does not stop as soon as the inflammation subsides. Initially, herbal ingredients may behave much like antibiotics, manipulating bacteria in the GI tract. A second phase of ingredients will focus on reestablishing a healthy balance of bacteria and boosting immune function. With a thorough course of treatment that moves through these phases of care, lichen planus is unlikely to return again.


Am I a good candidate for holistic TCM dermatology?


It is important to understand that the causes of lichen planus are much deeper than the skin. Complete holistic treatment can take up to 6 months and cost between $100 and $400 or more. The cost for each individual will vary depending on the severity and chronicity of their condition.


It is helpful to think of this process as immune system rehabilitation. Natural, safe, and sometimes slow medicine.

If you have questions about how holistic TCM dermatology can help you, schedule a free consultation online or by calling (971) 341-9546.


Betsy Gordon Acupuncture in Portland, Oregon specializes in holistic dermatology and the treatment of digestive, autoimmune, and allergic conditions. She provides a treatment plan which brings together traditional Chinese and functional medicine approaches.

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