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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat LPP While On LA Cortico Steroid And Tacrolimus 0.03% LA With No Relief?

I have been diagnosed with LPP and adviced LA cortico steroid for 15 days to control itching and Tacrolimus 0.03% LA for a month after which i have used depiwhite to reduce the pigmentation. Its been 2 mnths but not much difference has been noticed.A month before i have also started with homeopathy treatment for the same. Kindly give me advice for the same. Thankyou.
Fri, 28 Feb 2014
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Dermatologist 's  Response
Hello,
Welcome to healthcare magic.
Lichen planus pigmentosus is a difficult condition to treat. There is no single modality which has been proven effective. It will also take at least 6 months to get a noticeable improvement with treatment.
Your treatment seems to be on the right track.
I would also suggest that you to use a broad spectrum sunscreen with SPF 30 and above every 4 hourly in the daytime. Sun protection is the most important aspect in the treatment of LPP.
You will also benefit by taking anti oxidant capsules once a day for 2-3 months.
Along with this, you could try chemical peels. They are not very effective as treating LPP (compared to treating other types of pigmentation) but it will augment the effects of other modalities.
You could also try Q switched Nd-Yag laser treatment. This is also not proven to improve LPP but there are few reports describing a good improvement.
As I mentioned earlier, LPP treatment requires several modalities and it is time consuming and sometimes frustrating. Try to reduce stress levels as this can increase the oxidative damage to the skin.

Hope this helps you.
Wishing you good health.
Dr. Johny Chacko
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How To Treat LPP While On LA Cortico Steroid And Tacrolimus 0.03% LA With No Relief?

Hello, Welcome to healthcare magic. Lichen planus pigmentosus is a difficult condition to treat. There is no single modality which has been proven effective. It will also take at least 6 months to get a noticeable improvement with treatment. Your treatment seems to be on the right track. I would also suggest that you to use a broad spectrum sunscreen with SPF 30 and above every 4 hourly in the daytime. Sun protection is the most important aspect in the treatment of LPP. You will also benefit by taking anti oxidant capsules once a day for 2-3 months. Along with this, you could try chemical peels. They are not very effective as treating LPP (compared to treating other types of pigmentation) but it will augment the effects of other modalities. You could also try Q switched Nd-Yag laser treatment. This is also not proven to improve LPP but there are few reports describing a good improvement. As I mentioned earlier, LPP treatment requires several modalities and it is time consuming and sometimes frustrating. Try to reduce stress levels as this can increase the oxidative damage to the skin. Hope this helps you. Wishing you good health. Dr. Johny Chacko