What lifestyle modifications or patient education should I provide to individuals diagnosed with lichen planus?

Lifestyle modifications and patient education for individuals diagnosed with lichen planus should focus on symptom relief, skin barrier restoration, and prevention of secondary infection.

• Advise the use of emollients regularly to provide symptomatic relief and restore the skin barrier.

• Educate patients on avoiding irritants and managing any associated urinary incontinence if present, as this can exacerbate vulval lichen planus and lead to contact dermatitis; barrier creams may help prevent this.

• Provide self-care advice tailored to the individual's symptoms and condition severity.

• Consider the use of mild topical corticosteroids for short-term symptom control, explaining the importance of adherence and monitoring for side effects.

• Inform patients about the potential need for combination treatments if secondary infection is suspected, such as corticosteroid/antifungal or corticosteroid/antibacterial preparations.

• Address and manage any underlying or associated conditions that may impact lichen planus, such as anaemia, diabetes, thyroid disorders, hepatic or renal disease, and psychological problems.

• Encourage patients to seek medical advice promptly if symptoms worsen or new symptoms develop.

Patient education should also include:

• Explanation that lichen planus is a chronic inflammatory condition requiring ongoing management rather than a cure.

• Information on the importance of skin care routines and avoiding triggers that may exacerbate the condition.

• Support for psychological wellbeing, including referral to mental health services if anxiety, depression, or distress are present.

These recommendations are based on expert opinion and good clinical practice as outlined in the 2021 European guideline for vulval conditions and related CKS topics.