Lichen Treatment — Excimer Laser and PRP

Physician-supervised treatment of lichen ruber planus and lichen sclerosus using XTRAC 308 nm excimer laser, PRP plasma therapy and immunomodulators (tacrolimus), with avoidance of systemic corticosteroids where possible. The excimer laser suppresses the T-lymphocyte-mediated autoimmune response driving lesion activity; PRP provides growth-factor-rich healing stimulus to affected tissue; tacrolimus immunomodulation reduces surface inflammation without steroid-associated side effects. The combination is tailored to lesion type, location and severity at consultation.

Lichen planus and lichen sclerosus are autoimmune dermatological conditions driven by T-lymphocyte activity at the dermoepidermal junction. In lichen planus, the T-cells target basal keratinocytes, producing the characteristic violaceous, flat-topped papules on skin and erosive lesions on mucosae. In lichen sclerosus — most commonly affecting the genital skin in women and men — the T-cell-mediated inflammatory process produces progressive whitening, atrophy and sclerosis of the affected zone, with itching and tissue fragility that can significantly affect quality of life. Both conditions share a corticosteroid-reliant conventional treatment approach that Derma Medical Clinic aims to reduce or replace with targeted laser and biological therapy. The XTRAC 308 nm excimer laser at Derma Medical Clinic delivers narrow-band UV energy to active lichen lesions, inducing apoptosis in the activated T-cells at the dermoepidermal junction — the same mechanism as in psoriasis and eczema treatment, but calibrated to the lesion depth and immunological characteristics of lichen. Published case series and observational studies report significant improvement in lichen planus skin lesions with excimer therapy, with clearance rates comparable to systemic immunosuppression in selected patients. PRP (platelet-rich plasma) is incorporated for its growth-factor-rich healing stimulus: PDGF, TGF-beta, VEGF and EGF support tissue repair in the chronically inflamed zones and may help restore the dermoepidermal architecture disrupted by lichen sclerosus, particularly in genital areas where tissue atrophy has progressed. Tacrolimus — a topical calcineurin inhibitor — provides surface immunomodulation without the skin-atrophying effects of topical corticosteroids, making it particularly suitable for sensitive areas and for long-term maintenance. Systemic retinoids are considered for recalcitrant cases in consultation with the physician. Treatment planning for lichen at Derma Medical Clinic is individualised: the modality combination, session frequency and expected course length depend on whether the diagnosis is cutaneous or mucosal lichen planus, lichen sclerosus, the extent of involvement and the patient's prior treatment history. The initial consultation involves a thorough review of the clinical picture and existing investigations.