Lichen Planus Treatment? This May Be The Solution
Years ago, before medical school, I suffered from oral lichen planus. It was itchy, ugly and I was at a loss how to deal with it.
Then one day, it just started getting better without me even realizing.
While that’s awesome my lichen planus went away, I wanted to know why it got there in the first place and why it went away.
Today, while reading some research papers, I ran into a key finding.
“The substantially deranged histamine metabolism and transport in oral lichen planus could, in part, contribute to the disease pathogenesis.”
Are you serious?
Yet another histamine issue.
Before we continue, here are some interesting facts about oral lichen planus:
- The #1 non-infectious oral mucosal disease
- Affects 1% – 2% of general adult population
- Women impacted more than men at a ratio of 1.4 to 1
- Occurs predominantly over age 40 but younger ages are possible
The cause of lichen planus is not really known but there are many known contributors:
- Dental materials
- Bacterial and viral infections
- Weakened immune system
- Food allergies
- High blood pressure
- Bowel disorders – ulcerative colitis, Crohn’s, leaky gut
Now that we’ve cheated a little and found that paper describing the fact that histamine seems to be a major culprit, doesn’t it make sense?!
Histamine is elevated in all of those known contributors.
Histamine is more elevated in women than men because women naturally have higher estrogen levels and estrogen stimulates histamine release.
Let’s get back to diving into the mechanisms of how histamine impacts those with oral lichen planus.
“Human oral keratinocytes (HOKs) possess a uniform H4R pattern, which is deranged in oral lichen planus.”
This means that these mucosa cells inside your mouth have the ability to secrete low amounts of histamine.
These are not mast cells. Mast cells are what typically release histamine and lots and lots of it.
These are just normal oral mucosa cells! Since when did normal cells secrete histamine!?
Well, these cells in your mouth do naturally secrete a little bit of histamine.
You think that’s not a big deal because these cells secrete just a little bit of histamine.
Well – you’re not alone. Many researchers thought the same thing until they realized that the Histamine 4 Receptor responds very well to 10,000 fold less amounts of histamine compared to other histamine receptors!
Here is what some researchers found inside the mouths of those struggling with oral lichen planus:
“L-histidine decarboxylase (HDC) and organic cation transporter (OCT)3 were increased in mRNA and protein levels in patients with oral lichen planus compared with controls. In contrast, histamine N-methyltransferase (HNMT) immunoreactivity was decreased in OLP. OCT1/OCT2 and diamine oxidase were not detectable in either tissue sections or in HOKs.”
Those with lichen planus compared to those without:
- make more histamine
- transport more histamine
- can’t break down histamine well at all
This is why it is so important to understand and know your genetics and epigenetics.
Many, many people have SNPs in their Histamine Pathway which set them up for increased susceptibility to oral lichen planus and other histamine-sensitive conditions.
The good news is there is something you can do about it.
Now, what I am proposing below is theoretical but it makes total sense given what we now know about lichen planus.
It’s a major histamine issue.
Here’s my suggested Treatment for Lichen Planus:
- Read Dirty Genes – especially the DAO, MTHFR, COMT and MAOA chapters. Why? Because these chapters deal heavily with histamine, methylation, estrogen and stress. If your DAO gene is dirty, then you have a ton of histamine issues. Those with lichen planus apparently have no detectable DAO gene activity in their mouth – and they should! If your MTHFR gene is dirty, then your methylation is dirty and your ability to clear histamine goes out the door. Add to this the fact that your ability to clear estrogen also reduces especially if you have the combination of a dirty DAO, dirty MTHFR and dirty COMT – and many do. A dirty MAOA also increases your anxiety and stress which we know predispose one to lichen planus. So read Dirty Genes – and apply what you learn.
- Reduce histamine-containing foods and drinks. This helps you support your DAO gene and keeps histamine out of your mouth. So eliminate all citrus fruits, fermented foods and drinks (wine, sauerkraut, kimchi, yogurt, kefir), aged foods (salami, pepperoni, leftovers, cheese), rinse your fish and meat prior to cooking (as histamine-producing bacteria are on meat so rinsing it off reduces your intake), tomatoes, chocolate. A more complete list is in the book Dirty Genes and elsewhere online.
- Use a Histamine-Reducing Probiotic. Many people don’t realize that there are actually certain strains of bacteria which either produce histamine, balance it or eliminate histamine.
- Use a DAO enzyme since you’re not making any.
- Add an anti-inflammatory such as curcumin. Curcumin is known to help stabilize and reduce release of histamine. So by adding curcumin directly to the affected areas of oral lichen planus, you should experience tremendous benefit.
I highly suspect that these simple tricks will greatly improve your ability to overcome oral lichen planus – and keep it away!
PS. Yes, you can do the same thing with irritated skin affected by non-oral lichen planus.
You may also do the same for eczema and psoriasis.
If you do not experience success from these, there may be deeper histamine intolerance issues. This article on histamine intolerance may help you dive deeper. Do try the above steps first though before getting more involved and making it more complicated.
- Histamine metabolism and transport are deranged in human keratinocytes in oral lichen planus
- Pathogenesis of oral lichen planus – a review
Many dentists confuse oral LP with “geographic tongue.” In my practice, I have treated this successfully with additional B vitamins. I believe there is a connection with absorption and/or methylation and lichen planus. Of course, these patients also were put on low-inflammation meal plans and their stress levels were addressed.
My father has this orally. Suggestions? Struggles with foods/liquids burning his mouth. Makes it hard to get treatment such as liquid turmeric/curcumin and such.
Was diagnosed with lichen planus on my leg. I have a patch that just isn’t responding well to steroid treatment. What can I do for lichen planus on the skin, not oral? Thanks so much!
Please know that we are not authorized to answer your personal medical questions because we are not your treating healthcare professional. Remember that health is holistic. This means that in order to determine the root cause of your issues, you need to look at multiple avenues of health including lab markers, genetics, current conditions/symptoms, lifestyle, diet, and environmental toxins. To do this, your qualified healthcare professional will need to review your full medical history, order lab testing, and determine a protocol tailored for you. Though Dr. Lynch is a naturopathic doctor (ND), he is not your treating physician, and will not have all the information he needs to give you accurate advice – sometimes, a single issue will have underlying causes that can easily be overlooked via a simple, virtual comment or question. It is the responsibility of your qualified healthcare professional to answer your questions and assign a protocol for you. We understand that not all health professionals are trained in this area of biochemistry and nutrition, and it can be frustrating if you feel they don’t answer your questions or help you solve your problems. Because of this we now offer a Physicians Directory where you can find a health professional that is familiar with StrateGene®, nutrigenomics and some of Dr. Lynch’s work. Remember from Dr. Lynch’s book Dirty Genes, health is a four letter word: work. Part of this ‘work’ is finding a health professional that you feel is listening to you and helps you in the ways that you need. We are here to guide you by providing you resources in hopes that you will take the information and put in the work that optimizes your life.
I use coconut oil topically to treat bad spots along with orally ingesting roughly 2-3 grams of turmeric a day. Also, I find drinking alcohol and not exercising exacerbate the condition. It still took roughly 1 year for all skin sores to go away. I still have minor mouth sores nearly 3 years since the OLP diagnosis. I started reading this articles after re-researching OLP in relation to the titanium dioxide warnings with Skittles and other snack foods. It is being said that titanium dioxide can effect genes and I remember being told originally OLP could be caused by exposure to metal filings inside the body. Thoughts . . .
Hello Dr. Lynch and team, Many thanks for the great protocol and researched insight for the mysterious OLP. Look forward to following up with you on how well it does with dental patients.
I saw that this is noted to be helpful for eczema and psoriasis. Is that also oral? Or applied directly to affected skin?
have dealt with Oral Lichen Planus for about 5 years and other than a mouthwash given by my dentist, no one seems to know what it is or what to do! Very informative and interesting article.
Thank You!! Will definitely buy the book tomorrow!