lichens on the skin

The term “skin lichen” describes various types of inflammatory skin conditions characterized by a slightly peeling rash. In many cases, itching and redness of the skin also occur, making lichen extremely uncomfortable and stressful for the wearer. Scaly skin is often caused by infection with so-called “thread fungi” (dermatophytes), hereditary factors, autoimmune diseases, or infection with certain herpes viruses (“rose deprivation”).

Risk factors

There are several risk factors. In the case of psoriasis, which often occurs, may favor the onset or worsen of the disease. These include stress, poor diet, smoking, alcohol consumption, certain medications, or external mechanical stimuli such as pressure or injury. If ringworm is detected early on the skin, it can usually be treated well with topical therapy with cortisone-containing preparations or antifungals. On the other hand, some diseases such as psoriasis often take a chronic course and occur in stages. Accordingly, it is essential to avoid risk factors and take proper care of stressed skin, where naturopathy can provide useful support.

Types of lichens on the skin

The term “lichen” is used to describe various types of inflammatory skin diseases, all of which are characterized by a rash with a finely scaly surface that is clearly different from healthy skin. The name returns to the similarity with the structure of lichens (eg, on the bark of a tree) from the plant world, although they are not plants but mushrooms in the biological sense.

Planus lichen is a common variant of planus lichen; other forms include psoriasis, pityriasis rosea, and other fungal skin diseases (dermatomycoses) such as so-called “beard lichen” or soft fungus.

The colonization of fungi on the skin is, to some extent, completely normal and harmless because the body is normally able to fight unhindered reproduction through its natural defense system successfully. Fungi become dangerous only when they can multiply uncontrollably, for example, by excessive sweating or a weakened defense system due to a chronic illness, regular medication, or malnutrition.

Nodular lichen

A relatively common form of lichen is the so-called “lichen planus.” This inflammatory skin disease usually occurs between 30. and 60. years and manifests as an accumulation (initially) of reddish to (further) purple-brown, very itchy nodules on flat skin (papules) that have a waxy sheen and are sharply defined.

The papules are slightly raised and flattened in the upper part; after a few weeks, fine whitish, reticulate lines often appear on the surface. In most cases, nodules appear on the flexor side of the forearms and joints, but also in the groin area and the sacrum and lower leg. The body is less often affected, and if the disease is severe, the whole body can be “sprinkled” with knots.

A very itchy rash is usually a big burden, in addition to the fact that mechanical loads such as scratching the skin also irritate and quickly lead to worsening of symptoms and the development of new nodules on previously unchanged parts of the skin. In addition to the skin, lichen papules can also affect the mucosa (lichen planus mucosae), causing whitish or painful open areas. The mucous membranes of the cheeks and the tongue’s lateral surfaces are most often affected, but white nodules on the mouth, gums, or on the back of the tongue are also possible.

Lichen planus can also develop less frequently in the genital area, in men, often in the head, and women on the inside of the big or small lips. Also, it is possible that reticular, whitish lines or small nodules – regardless of gender – also appear in the anal area. In case of strong inflammation, injuries on the skin’s surface (erosion) can occur. Due to lichen planus in the genital and/or anal area, many sufferers suffer from very unpleasant symptoms, such as vaginal itching, itchy anus, or severe inflammation. These symptoms often occur in combination.

Hair and nail problems

In addition, hair can become infected (lichen planus follicularis or planopilaris), leading to flaky skin and sometimes hair loss. In addition, some patients show changes in the toenails and fingernails, e.g. longitudinal furrows, pits, fissures, or growth disorders. Brittle and weak nails are a less common symptom but are not ruled out.

The trigger for typical changes in the skin in planus lichens is inflammation of the skin, which occurs when certain cells of the immune system attack the lowest layer of the epidermis and destroy the cell layer. The cause of this process is currently unknown, but it is often suspected that it is an autoimmune disease, as a result of which the immune system mistakenly attacks its own skin cells.

In addition to hereditary causes, as well as the use of chemicals or drugs (eg antibiotics, drainage tablets or drugs for high blood pressure), viral liver disease (viral hepatitis), concomitant diseases such as diabetes, elevated cholesterol or uric acid levels, contact allergies ( if the oral mucosa is affected) causes are also possible.

Lichen / rash on the face

If reddish, scaly spots appear on the area of facial hair, it may indicate a lichen beard (medical “tinea barbae”), a skin disease (mycosis) caused by certain fungi and affecting only men. Fungi are so-called “thread fungi” (dermatophytes), which lead to a specific skin infection and, unlike other fungi, feed only on carbohydrates and keratin. Accordingly, dermatophytes attack only areas of the body that contain keratin, such as skin, hair, or nails, and there they cause typical round, slightly scaly reddish spots, which sometimes dew and often lead to severe itching.

Because originally round spots are often combined with hair follicles on the hairline, many men develop small nodules or pustules, which quickly develop into an abscess or even purulent inflammation of the hair follicles. Although the skin disease is called “beard deprivation,” the beard itself is not a prerequisite for development and further progress.

In most cases, filamentous fungi are species of “Trichophyton mentagrophites” or “Trichophyton verrucosum,” which are primarily transmitted by rodents or cattle. Therefore, men living in rural areas or close contact with suitable animals are often affected by beard lichen. Usually, a scratch on the cheek is enough for an infection, for example, after the infected animal is briefly touched by the hand.

To make matters worse, fungi are not only highly contagious but also survive for years and withstand external influences such as high temperatures. Accordingly, the body’s immune system plays a central role in defending against pathogens. Consequently, the infection is facilitated by immune deficiency due to diabetes, circulatory disorders, certain drugs or “immunosuppressants” (such as cortisone), etc.

Rose lichen

Another common form of skin lichen is known as “pityriasis rosea,” which is a harmless but usually very unpleasant, inflammatory skin disease. The initial oval redness is characteristic here, e.g., on the upper part of the body, approximately the size of a coin, somewhat raised and sharply demarcated, and slightly scaly. The redness usually spreads within 7-14 days, mainly on the upper part of the body and on the upper arms and thighs, face – hands and feet, usually not affected.

The upper part of the body is often almost “covered” with spots, usually barely or not at all itchy and significantly smaller than the primary medallion. Itching occurs only when the skin is deprived of moisture, e.g., frequent showering or excessive sweating. Besides, other symptoms include a general feeling of illness, constant fatigue and exhaustion, headaches, and/or loss of appetite in rare cases.

The exact causes of pityriasis rosea have also not been clarified yet, but experts often suspect infection with certain herpesviruses (HHV-6, HHV-7) and genetic predisposition. Stress and allergies are also sometimes seen as beneficial factors, but this has also not been proven. However, what is certain is that rose deprivation can occur in both children and adults, and children, adolescents, and young adults between the ages of 10 and 35 are most often affected.

Psoriasis

Besides, in the case of plexus-like skin changes, psoriasis is a common, non-communicable disease that is chronic in most cases. Here are characteristic red, raised skin areas that are covered with shiny, silvery-whitish scales. The foci of psoriasis (“plaques”) can be microscopic in some cases but are generally coin-sized and may appear isolated and sharply demarcated, as well as grow together over a large area (psoriasis geographic).

Itching is typical, and the skin is usually dehydrated and cracked. The disease occurs primarily on the extensor sides of the arms (elbows) and legs (lower legs). The scalp, buttocks, chest, back, armpits, navel, and genitals or anus may also be affected. In many cases, not only the skin is affected, but also the nails (nail psoriasis), which in turn leads to symptoms such as small, round depressions (“spotted nails”), thickened cuticles, and crumbly or extremely brittle nails.

Psoriasis is a so-called “autoimmune reaction” in which the body’s own defenses are directed against the cells of its own body. What exactly triggers this reaction has only been partially investigated. However, susceptibility to skin disease is certainly hereditary. However, the expression is not hereditary, which means that both parents may not show any symptoms, while psoriasis still appears in the child.

Consequently, hereditary activity alone is clearly not sufficient to trigger psoriasis; instead, other risk factors must be added to make it appear for the first time or intensify in the case of a pre-existing disease. These include external mechanical stimuli (e.g., pressure, skin injuries) and “internal” influencing factors such as stress, alcohol, smoking, improper diet, or drugs such as interferon drugs or beta-blockers.

Infectious diseases, obesity, hormonal changes (puberty, pregnancy, menopause, etc.), or climatic conditions can trigger triggers. Accordingly, basically, anyone genetically predisposed can develop psoriasis, which can occur at any age. However, most sufferers suffer from “type I” or “early-type” psoriasis Vulgaris, which occurs before 40. year, and peaks between 15. and 25. years. The first appearance in early childhood and older people is quite rare.

The psoriasis course varies from person to person; lichens usually occur chronically in the form of recurrent attacks. As a result, phases with severe symptoms alternate with (almost) asymptomatic phases in many affected, with an unpredictable course often leading to enormous psychological stress. Lichen often improves in the warmer months as a result of sunlight, while obesity (overweight), for example, can worsen symptoms.

Skin fungus

Circular, brownish spots on the skin, which occur mainly on the back and chest, may also indicate the so-called “soft fungus” (medical: “Pityriasis Versicolor”). This is a non-communicable fungal skin disease mainly caused by the yeast “Malassezia furfur.” In this form of lichen, the infection causes painless spots that are lighter in people with a darker complexion (pityriasis Versicolor alba) and darker in pale ones (pityriasis Versicolor Rubra) than the rest of the skin.

The spots’ sizes can vary greatly, so the sizes are just lenses, but they can also cover the skin like a map. Mild itching occurs less frequently, the affected area is usually scratched by people, and fine, bran-like scales usually separate on the surface, which is why this skin disease is known as “soft fungus.”

The yeast fungus Malassezia furfur is a part of the natural flora of almost all people’s skin, with the scalp being the main reservoir of pathogens. Here, the fungus feeds primarily on fatty substances in sebum and usually does not cause skin changes. However, in some cases, the fungus’ pathogenic reproduction occurs, which leads to the outbreak of the soft fungus.

The reasons for such a development have not yet been fully elucidated, but it is known through risk factors that can obviously promote pityriasis Versicolor. These include, for example, warm and humid climates, profuse sweating, predisposed oily skin, as well as oily creams and lotions because the fungus here finds ideal conditions for growth thanks to a large amount of fat in a warm and humid environment.

Besides, the soft fungus can be caused by stress, wearing synthetic clothing, poor hygiene or certain medications (birth control pills, antibiotics, etc.), a weakened immune system, and certain underlying diseases such as diabetes mellitus. Because the warm, humid climate promotes the reproduction of the fungus Malassezia furfur, the soft fungus is prevalent in tropical climates, where, according to the Institute for Quality and Efficiency in Health Care (IKViG), up to 40% of people are affected. . However, in countries with a temperate climate, according to IKViG, skin fungi develop only in a small percentage of the population.

If pityriasis Versicolor is treated with antifungals (antifungals), there are usually indications that you are on the right track so that the symptoms disappear and the darker or lighter areas of the skin adjust to the normal skin color. However, since lichens often recur after successful treatment, permanent treatment of the scalp is usually recommended to prevent the disease from recurring.

For example, special shampoos with fungicidal active ingredients used as common care products for daily hair washing are suitable for that. Those who are ill should also take care to avoid growth-promoting factors, such as airtight clothing, frequent sweating, or high-fat body lotions. If soft fungus therapy is not used, pityriasis Versicolor usually becomes chronic, appearing suddenly, especially in the hot summer months.

Lichen skin treatment

In the case of lichens on the skin, it is important to first perceive scaly spots as warning signals, and the dermatologist should examine their cause. A specialist doctor should visit you as soon as possible, because lichen can spread quickly and thus become a huge burden for the person in question. If the development of the disease is normal, treatment for lichen on the skin usually begins with local treatment of the affected areas of the skin. Depending on the cause of lichen, special creams, lotions and ointments with different active ingredients such as cortisol , urea, clotrimazole or methotrexate.

Other local treatments are light (PUVA bath therapy), cold (cryotherapy) or laser therapy. In the case of very difficult courses, internal (systemic) therapy may be needed, in which the active ingredients are absorbed into the body by tablets or injections and thus develop their effect in the whole organism.

In exceptional cases, a combination of local and systemic therapy may be prescribed, while other forms of skin lichen often do not require any special treatment at all. If, for example, it is lichen planus (lichen planus), in most cases, the organism will heal after a few weeks or months.

In addition, there are various therapeutic options, which can be used depending on the type and severity of the disease. For the treatment of individual, smaller areas of skin, for example, short-term cortisone ointments or cortisone patches are usually considered; in case of extensive or rash infection, cortisone tablet therapy may have a positive effect on healing and healing. However, it should generally be ensured that anti-inflammatory drugs are not used for a long time and should only be used in consultation with a doctor, in order to avoid side effects of cortisone such as thin skin or red capillaries on the face.

In addition to this, there are other local forms of treatment, such as a special form of light (PUVA therapy) or cold therapy (cryotherapy), cooling compresses, ice cubes or gel pillows often have a beneficial effect against severe itching. In some cases, antihistamines can also help, but it is especially important not to scratch the affected areas of the skin despite the strong itching so as not to worsen the symptoms.

If the oral mucosa is affected (oral lichen planus), special cortisone preparations can be used, here it is also especially important to avoid additional irritation. Accordingly, you should refrain from consuming sour, spicy and spicy foods and drinks, as well as nicotine and alcohol, and ensure thorough care of your teeth and mouth. In addition, it is advisable for the doctor to examine the denture, if necessary, because it, like tooth decay, can also promote or worsen lichen planus (“Koebner’s phenomenon”).

Scaly lichen usually heals within 8-10 weeks without further treatment and leaves no scars or the like. Bathing, showering,  should be avoided to prevent heat generation, which can lead to additional irritation of the lichen, and thus to mass itching and severe inflammation.

For example, preparations with the active ingredient polydocanol or poorly effective cortisone-containing agents can be used against itching, and in some cases light therapy (phototherapy) can support the healing process. Before red spots heal “on their own”, they should always be medically clarified, because there are numerous causes of scaly redness on the upper part of the body, so lichen rose does not always have to be the cause.

Home remedies for lichen on the skin

In addition to conventional medical approaches and procedures, there are several useful home remedies for the natural treatment of skin lichens and alleviating symptoms such as itching or redness of the skin. For example, in many cases, it helps to wash the affected areas several times a day with chamomile tea, and lukewarm compresses with tar balls or healing earth can help soothe the skin and relieve itching. Cold compresses (ice cubes, wet compresses, etc.) have also been shown to be effective against itching, as well as a paste of honey and cinnamon or honey and chopped garlic, which is applied thinly to the itchy area.

Buttermilk compresses are a well-known home remedy for psoriasis. The cloth is soaked in buttermilk and placed on the skin’s affected areas for about 20 minutes. As with neurodermatitis, a mixture of ointments or oils with real lavender oil can also have a gentle and beneficial effect, and you can use other herbs such as birch bark, hay flowers, sage, thyme, or spruce for pigtail skin problems.

The incense is used to treat the skin.

Wild pansy is very suitable for the treatment of skin lichens or acute and chronic skin diseases because it contains flavonoids and saponins, which on the one hand, speed up the metabolism, and on the other hand, have an anti-inflammatory effect. For example, for external use, a liquid is recommended, used for dressings. For that, 1.5 grams of the dried pansy plant (from the pharmacy) is steamed with 150 milliliters of water and left to stand for five minutes. For internal treatment,  tea can also offer effective help with lichen planus. Here, 250 ml of boiling water is poured over 2 teaspoons of dried pansy (1 teaspoon for children) and poured after ten minutes of soaking. Adults drink 3 to 4 cups of ready-made tea every day for eight to ten weeks; children get one cup every morning and evening for about eight weeks.

To prevent lichens on the skin as much as possible, an intact, strong immune system is important, which acts as a “protective shield” and can successfully fight pathogens. Accordingly, you should ensure a healthy, balanced diet with lots of whole grains, fruits, and vegetables and enough sleep and exercise or physical activity at all times. Stress can also damage the immune system because when stress hormones are released, the body automatically reduces defense cells’ production. As a result, susceptibility to pathogens that “would not have a chance” to survive would increase.

Even if you cannot completely avoid the hectic pace, inner turmoil, pressure, and tension in everyday life, mindfulness exercises can help reduce stress and promote a sense of inner balance. Various methods and techniques such as progressive muscle relaxation, meditation, autogenic training, or yoga are considered here; psychotherapy can also be a useful aid in some cases, such as understanding the causes of chronic stress and learning coping strategies.

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