The best remedies for lichen

What brand of deprivation remedy is better to choose?

The choice of medication often depends on the type of pathology. Medicines for the treatment of lichen must have anti-inflammatory, antifungal or antiviral effects. External products contain components with a drying, astringent or moisturizing effect. The drug should be prescribed by a doctor after receiving the diagnostic results. Self-medication threatens the disease to become chronic, the treatment of which will take a long period. The review contains the best remedies for deprivation from the following companies:

• JSC Sintez is a large enterprise in the Russian pharmaceutical industry. The quality system covers all stages of drug production. Control of the properties of raw materials and finished products is carried out in our own laboratories. In terms of production volumes, the plant is among the top 10 companies in the domestic pharmaceutical industry.
• Bayer AG is a German chemical and pharmaceutical company. Medicines for lichen are produced by a manufacturing plant located in Italy. The company operates under the motto: “We invent and make available products that help people make their lives better.” The company's medicines are valued for their safety and effectiveness. Success is based on excellence in research and development.
• Zentiva is an international pharmaceutical company headquartered in Prague. Specializes in the development and production of generic drugs for various therapeutic purposes. High-quality medicines meet the needs of modern methods of treatment and prevention. Users note the reliability and safety of the products.
• BioNaturika is a Russian company that produces various cosmetic products for the care of hair, facial skin and body. Product lines are divided according to the age of the user. There is a separate category of products for children and teenagers. It also offers contract manufacturing services at its own factory.
• Ekaterinburg pharmaceutical factory - the company produces various medicines in the form of ointments, pastes, tinctures, drops, elixirs, extracts, alcohol solutions. Some products are produced according to the following scheme: a foreign company pays for raw materials, the production and sale of the drug is carried out in Russia.
• Janssen is a Belgian manufacturer of medicines in the field of pain management, psychiatry, infectious pathologies, and gastroenterology. It is part of the largest developer and manufacturer of healthcare products, Johnson & Johnson. The company provides innovative solutions for the treatment of socially significant diseases.
• Sandoz is a German pharmaceutical company. Produces biosimilars and generics. Its goal is to increase the accessibility of medicine for all people. The brand is trusted by healthcare professionals. Products are valued for quality, availability, and efficiency. A wide range allows you to choose a product to solve most medical problems.
• JSC FP "Obolenskoe" - the company is part of the Alvansa group of companies. It produces more than 150 types of medicines of various pharmaceutical types, including generics and innovative developments. The quality of the goods meets accepted standards.
• Akrikhin is a large Russian pharmaceutical company producing finished drugs. The main part of the range is represented by highly effective generics. The company owns its own research and development center, which is equipped with modern technological equipment and analytical instruments. Every day, employees work on the production of innovative products for the treatment of dermatological, cardiac diseases, diabetes, and tuberculosis.
• PJSC Biosintez is a group of Russian pharmaceutical enterprises. Produces more than 180 types of finished drugs in various release forms. The nomenclature includes drugs from most pharmacotherapeutic groups. Now part of the Sun Pharmaceutical Industries Ltd concern.
• Pharmstandard-Laksredstva OJSC is a Russian pharmaceutical company engaged in the development and production of high-quality medicines. The range includes more than 330 drugs, among which 60 are innovative developments, 140 are included in the list of vital drugs.
• Vips-Med Firm is a Russian company whose list of services includes the manufacture of medical and pharmaceutical products. It carries out wholesale supplies of drugs of its own production to the regions of the country, the CIS and Baltic countries. Products meet health standards.

Pityriasis rosea - symptoms and treatment

Classic form of the disease

Symptoms of the classic form of pityriasis rosea are:[4]

• The mother's plaque is a single large flat oval spot, 2 to 5 cm in size, pink or red in color with clear boundaries, covered with thin scales and larger scales along the periphery, which gives it a ring-shaped appearance. The most typical localization is the neck, torso, and less commonly, limbs. It is the initial symptom of the disease.
• “Christmas tree” - rashes in the form of small (from 0.5 to 2 cm) numerous scaly papules and plaques of an oblong oval shape of pink color with a “collar” of gray scales located along the lines of Langer’s skin tension, which gives them when localized in the chest or back area looks like tree branches. This rash occurs several days (less often weeks) after the appearance of the maternal plaque.
• Itching is not a mandatory symptom of the disease and occurs in about a quarter of patients.

Atypical forms of the disease

Atypical variants of pityriasis rosea occur in approximately 20% of cases.[5] The uncharacteristic nature is manifested in the morphology of the elements of the rash, its size and location.[4] Some authors believe that children with atopic dermatitis are more predisposed to atypical variants of pityriasis rosea than adults.

Vesicular pityriasis rosea is a generalized rash of vesicles (vesicles) with a diameter of 2-6 mm, often forming “rosettes” and accompanied by severe itching. It is most common in children and adolescents and can be localized to the scalp, palms, and soles.[6]

Hemorrhagic pityriasis rosea is characterized by a purpuric eruption that occurs on the skin and, quite often, on the oral mucosa.[7]

Urticarial pityriasis rosea presents as blistering lesions, making it similar to hives. This type of disease is accompanied by intense itching.[7]

Papular pityriasis rosea is a rare form of the disease that is more common in young children and pregnant women. It manifests itself as rashes of several small papules measuring 1-2 mm, which may be present along with classic spots and plaques.[8]

Pityriasis rosea, similar to erythema multiforme - with this type of disease, along with the classic symptoms, target-shaped lesions are noted.[9]

Follicular pityriasis rosea is characterized by a rash of follicular papules grouped into round plaques. They often occur alongside classic lesions.[7]

Giant Darier's pityriasis rosea presents as very large plaques ranging from 5 cm to 7 cm, with individual lesions reaching the size of the patient's palm.[11]

Vidal's ring-shaped ring-shaped rosacea is localized primarily in the axillary and groin areas and is characterized by large ring-shaped rashes.[12]

Hypopigmented pityriasis rosea most often occurs in dark-skinned and dark-skinned people and presents as hypopigmented scaly plaques with a typical localization.[7]

Lichen rosea inversus is characterized by rashes in the folds - axillary and groin areas, elbow and popliteal fossae.[3]

Acral rosacea presents as a typical rash on the extremities—the forearm, wrist, palm, calf, and sole.[14]

Unilateral pityriasis rosea is an extremely rare variant that occurs in both children and adults. In this form, the rashes are located on one side of the body.[15]

Blaschkoid pityriasis rosea is characterized by lesions along Blaschko's lines (pattern-shaped pigmentation).[16]

Oral lesions in pityriasis rosea occur in 16% of patients in the form of erosions, bullous or hemorrhagic eruptions, but they are usually asymptomatic.[17]

Asbestos pink lichen is a very rare form of the disease, presented in the form of plaques in the scalp area, covered with thick, dense gray scales. Clinically it mimics pityriasis amiantacea.[18]

Decapitated pityriasis rosea - rashes of only secondary small elements occur without the previous appearance of a maternal plaque. Occurs predominantly in children.[7]

Recurrent pityriasis rosea

Recurrence of pityriasis rosea occurs in 1-3% of patients.[19] Frequent relapses are considered a very rare occurrence. However, there are case reports with more than two episodes. The exact etiology is not known, but a possible cause is the reactivation of herpes viruses (varicella zoster, Epstein-Barr, types six and seven).[20]

Rating of remedies for lichen

Taking into account the cause of occurrence, 7 types of pathology are distinguished. The most dangerous are considered viral infections, which are characterized by rapid spread and long-term treatment. Therapy is aimed at alleviating symptoms, increasing immunity, and eliminating the irritant. The rating of the best treatments for lichen in an adult or child is based on the results of comparative tests of the following characteristics of the drugs:

• Pharmacological group;
• Release form;
• Indications;
• Presence and type of side effects;
• Packaging volume;
• Availability;
• Active substance;
• Number of contraindications;
• Impact on human psychomotor reactions;
• Terms of Use;
• Interaction with drugs from other pharmaceutical groups;
• Best before date.

The price/package volume ratio was taken into account. This indicator often determines the need for additional purchase of funds for a course of treatment. All top drugs are divided into 3 categories based on the release form. Each section provides a description, pros and cons of the medication according to reviews from doctors and patients.

The best antiviral agents

The best pills for lichen

In this form, medications are used in the treatment of severe forms of diseases, since the concentration of active substances in external agents is not always sufficient for a powerful effect on pathogens. Depending on the type of pathology, medications with antiviral, antifungal, antihistamine or antibacterial effects are prescribed. Based on an analysis of patient reviews, out of 7 nominees, 5 variants of tablets for lichen were included in the rating.

Acyclovir

An inexpensive antiviral agent with the active ingredient of the same name. Available in the form of white biconvex tablets with a dividing line in the center. Each contains 400 mg of acyclovir. The mechanism of action is to block the synthesis of the viral DNA chain by inhibiting the polymerase. It is effective mainly for herpes infections, so it is often prescribed for herpes zoster.

Advantages

• Low price;
• Well tolerated;
• Allowed for children from 3 years old;
• Small list of contraindications;
• Availability.

Flaws

• Concomitant use with other drugs may lead to a decrease in effect;
• Presence of sugar in the composition.

In case of mild form, you need to take the drug 2 tablets 5 times a day every 4 hours for 7-10 days. In children, the dosage is calculated taking into account weight - 20 mg/kg. Children take the medicine 4 times a day. The duration of treatment is 5 days.

Mycozoral

The medication belongs to the same group as Nizoral. The active component has a fungicidal effect on yeast fungi and dermatophytes. It is also used in the treatment of staphylococcal and streptococcal infections. The drug is used in the treatment of versicolor. The composition contains lactose, so patients diagnosed with deficiency or intolerance to milk sugar are not prescribed Mycozoral. Adults take 1 tablet 1 time per day. For children over 3 years old and weighing up to 15, the dosage is reduced by 2 times. The average duration of the therapeutic course is 10 days.

Advantages

• Average price;
• Relieves itching well;
• No unpleasant odor or taste;
• Quick results;
• The volume of the package is enough for a course of treatment.

Flaws

• Severe side effects;
• In case of liver disease, as well as over the age of 50 years, the use of the medicine is limited.

Not all users are happy with the therapy. The main complaints leave you feeling unwell on the first day of treatment. Patients report severe headaches and heart pain, which often forces them to change the drug.

Griseofulvin

The drug has a fungistatic effect. The active component blocks the synthesis of the cell wall and disrupts the connection with the messenger RNA of the fungi. Accumulates in the skin and hair, promoting the separation of infected keratin. Treatment is carried out under the control of the morphological composition of the blood. The analysis is carried out once every 10–15 days. The product is used to destroy various types of mycoses that provoke the development of lichen. Prescribed for pityriasis, shingles, ringworm type of pathology.

Advantages

• Pleasant taste;
• Average price;
• Allowed for therapy in children;
• Quick results;
• Quality.

Flaws

• Side effects;
• Large list of contraindications.

Users report good effectiveness in treating ringworm. The advantages include the possibility of use for children, but due to its high toxicity, it is recommended to drink the product strictly under the supervision of a doctor. A prerequisite is to take it after meals with 1 tsp. vegetable oil, which will eliminate irritation of the gastrointestinal mucosa.

Herpes zoster

Performed on a stationary basis

General treatment

Antiviral treatment regimens for herpes zoster in adult patients

Aciclovir is prescribed orally 800 mg 5 times a day for 7-10 days. If acyclovir is ineffective, alternative means are:

• Valacyclovir 1000 mg 3 times a day for 7 days or,
• Famciclovir 500 mg orally 3 times a day for 7 days.

If there is no effect within the specified time frame or the disease recurs, it is necessary to continue antiviral therapy until the appearance of skin rashes stops.

Treatment of herpes zoster in children

Acyclovir 20 mg/kg body weight orally 4 times a day for 5 days.

Treatment of immunocompromised patients (patients with malignant neoplasms, recipients of internal organ transplants, HIV-infected patients)

Acyclovir 10 mg/kg body weight intravenously 4 times a day. Once control of the infection is achieved, intravenous administration of the drug can be discontinued, and until the end of the course of treatment (for the underlying disease), an antiviral drug can be prescribed orally. For mild immunosuppression, oral acyclovir (800 mg 5 times a day), valacyclovir (1000 mg 3 times a day) or famciclovir (500 mg 3 times a day) is advisable.

Treatment of pain syndrome with herpes zoster

It is advisable to stage-by-stage treatment of zoster-associated pain syndrome in all its phases. Thus, in the treatment of acute herpetic neuralgia, pain therapy consists of three main stages:

• Stage 1: aspirin, paracetamol, NSAIDs;
• Stage 2: opioid analgesics, including tramadol;
• Stage 3: drugs with a central analgesic effect (tricyclic tidepressants, anticonvulsants).

An important point is to monitor the dynamics of pain in the acute stage, since increased pain over time may indicate progression of the infectious process.

Corticosteroids

The addition of glucocorticosteroid drugs to antiviral drugs for 3 weeks in a gradually decreasing dosage (60 mg of prednisolone daily for 7 days, followed by a dose reduction) leads to a reduction in acute pain. Combination therapy is most appropriate for damage to the branches of the trigeminal nerve. Along with a reduction in acute pain, patients receiving the combination treatment experienced improved sleep, return to normal activities of daily living, and a reduction in analgesic use. When prescribing glucocorticosteroids, it is necessary to take into account contraindications: arterial hypertension, diabetes mellitus, gastric and duodenal ulcers, often observed in elderly people.

Neural blockades

Sympathetic and epidural blocks are used for extremely severe pain. There are a few randomized clinical trials that have shown the effectiveness of a single epidural injection of steroids and local anesthetics in relieving acute pain. Therapy using multiple epidural injections of an anesthetic and methylprednisolone without antiviral treatment for herpes zoster resulted in a reduction in the incidence of postherpetic neuralgia compared with intravenous acyclovir and prednisolone. These data suggest that “aggressive” pain relief is quite effective for herpes zoster.

Treatment of postherpetic neuralgia

Currently, there are 5 main groups of medications for the treatment of postherpetic neuralgia: anticonvulsants, tricyclic antidepressants, lidocaine patch, capsaicin, opioid analgesics.

Anticonvulsants

Gabapentin and pregabalin are the two most commonly used anticonvulsants for the management of neuropathic pain associated with PHN. Gabapentin dosage regimen. Initial dose: 1st day 300 mg in the evening; 2nd day 300 mg 2 times (day and evening); Day 3: 300 mg 3 times. Titration: 4-6 days 300-300-600 mg; 7-10th day 300-600-600 mg; Days 11-14 600-600-600 mg. The daily therapeutic dose is 1800-3600 mg, maintenance dose is 600-1200 mg/day. Pregabalin has a similar mechanism of action to gabapentin, but does not require slow titration and is therefore more convenient for clinical use. The drug is prescribed twice a day. The initial dose is 75 mg twice, the daily therapeutic dose is 300-600 mg.

Antidepressants

Drugs in this group, especially tricyclics (nortriptyline and amitriptyline), are important components in the treatment of pain in PHN. Due to the activation of descending serotonin and norepinephrine antinociceptive systems and the ability to block sodium channels, antidepressants block the perception of pain.

5% lidocaine patch

It is applied to the affected area at the beginning of chronic pain or immediately after the diagnosis of PHN is established. The patch is applied to intact, dry, non-inflamed skin, i.e. during active herpetic eruptions.

Capsaicin

The drug, made from red pepper, has an irritating effect and is used in the form of an ointment or patch. The drug should be applied to the affected area 3-5 times a day to maintain a long-term effect.

Opioid analgesics

Oxycodone, methadone, and morphine may also be used in the treatment of PHN. They reduce neuropathic pain by binding to opioid receptors in the central nervous system or inhibiting the reuptake of serotonin or norepinephrine at peripheral nerve endings - nerve synapses.

External treatment

Aqueous solutions of dyes, ointments, creams and aerosols containing antiviral agents (penciclovir, acyclovir, oxolin, panavir, etc.) are applied to the erosions.

The best sprays for ringworm

In this form, the medicine can be used for various forms of the disease. The advantages include fast absorption and the ability to use on the scalp. The use of such products eliminates the need for a long washout and does not spoil the hair color. However, they are often contraindicated for pregnant women. Testing the characteristics of the drugs allowed us to identify the 2 best products from the 5 nominees.

Thermikon

The medicine is released in the form of a clear, colorless or light yellow liquid, 1 ml of which contains 10 mg of terbinafine hydrochloride. The substance is a chemically synthesized antifungal agent. It disrupts the biosynthesis of the cell membrane of dermatophytes and some types of fungi, which leads to death. Less than 5% of the dose is absorbed and therefore does not enter the blood. It is prescribed to children only from the age of 12. The main indications for use are lichen versicolor and fungal infections.

Advantages

• Does not affect the ability to drive vehicles;
• Ease of use;
• Average price;
• Short duration of treatment;
• Effective;
• Safe.

Flaws

• Smell of ethyl alcohol;
• Contraindications.

The dosage is determined taking into account the severity of the disease. Usually it is 2 times a day for 1 week. Spray the product onto the affected area and adjacent areas of healthy skin. The latter is thoroughly cleaned and dried before the procedure. The effectiveness of the spray was confirmed by 95% of respondents.

Terbinafine

The drug is considered the original, on the basis of which the generic Thermikon was created. Their composition, with the exception of a number of excipients, is identical. The medicine is released in a glass bottle with a dosing pump, the volume of which is 10 or 20 g. There are no data on the safety of use in children, so the spray is prescribed for this category of patients in exceptional cases. The course of treatment is also 2 weeks.

Advantages

• A decrease in the severity of symptoms is noted on the first day of treatment;
• Low price;
• The course lasts no more than 2 weeks;
• Convenient to use.

Flaws

• Risk of developing an allergic reaction.

The spray has earned only positive user reviews. It quickly and easily helps cure lichen, the volume is enough for a course, the price corresponds to the quality. All patients recommend purchasing the product.

Pityriasis rosea

Spontaneous recovery usually occurs within 4–6 weeks. Uncomplicated pityriasis rosea does not require treatment. Patients are advised to limit the use of water procedures (prohibit the use of a washcloth, rubbing with a hard towel) and exclude physical activity that leads to mechanical irritation of the skin. When the process is generalized, the exudative nature of the rashes is pronounced, allergic manifestations, eczematization, general and local therapy is indicated. For severe itching, antihistamines are prescribed:

1st generation antihistamines

• Chloropyramine (Suprastin) 25 mg. From 1 year to 6 years, 8.3 mg (1/3 tablet) 2–3 times a day, from 6 to 14 years, 12.5 mg (1/2 tablet) 2–3 times a day, adults 25 mg (1 tablet) 3–4 times a day for 7–10 days or,
• Mebhydrolin (Diazolin) 0.05;0.1 g. From 2 to 5 years – 50–150 mg per day, from 5 to 10 years 100–200 mg per day, over 10 years and adults 100–300 mg per day day for 7–10 days or,
• Hifenadine (Fenkarol) 0.01;0.025 g. From 3 to 7 years of age, 10 mg 2-3 times a day, over 7 years of age and adults, 25 mg 3 times a day for 10 days or,
• Clemastine (Tavegil) 0.001 g. Children over 7 years old 0.5–1 mg 2 times a day, adults 1 mg 2 times a day for 7–10 days.

For eczematization, hyposensitizing drugs are indicated:

Hyposensitizing agents

• Calcium gluconate 10% solution, intramuscularly 5-10 ml once a day for 10 days or,
• Calcium chloride 1–10% solution, 5–15 ml orally 2–3 times a day – 7–10 days or,
• Calcium pantothenate 0.1. Children from 3 to 14 years old 50–100 mg 2 times a day, adults 100–200 mg 2 times a day – 10–14 days.

External treatment

Prescribe indifferent powders (zinc oxide and talc, taken equally) or shaken suspensions (zinc oxide 20.0, talc 20.0, glycerin 20.0 ml, distilled water 60.0 ml), applied to the skin 3-4 times a day until inflammation decreases (6–8 days). Sometimes (in case of skin irritation) they resort to prescribing glucocorticoid creams (use in the form of emulsion, cream or ointment applications 1-2 times a day for 5-7 days):

• Hydrocortisone butyrate (Lokoid) 0.1% or,
• Betamethasone dipropionate (Beloderm) 0.025% (0.05%) or,
• Methylprednisolone aceponate (Advantan) 0.1% or,
• Alclomethasone dipropionate (Afloderm) 0.05% or,
• Combination drugs containing a glucocorticoid in combination with an antibiotic (belogent, oxycort, fucicort, lorinden C).

Physiotherapy

Mid-wave ultraviolet therapy (UVB) with a wavelength of 280–320 nm 5 times a week No. 5–10 (after acute inflammatory phenomena have subsided).

Criteria for treatment effectiveness

Complete resolution of rashes.

The most common errors in treatment

Unreasonable use of antifungal drugs. External use of irritating ointments.

Prevention

Prevention of viral and bacterial infections.

Which remedy for ringworm is better to buy?

The choice of drug depends on the type, severity of the pathology, and the age of the person. It is easier to treat children's lichen with external means, because not every child agrees to take pills. The option of sprays at this age is out of the question; they are allowed only from 12 years of age. Treatment with ointments is often used for mild pathology; in severe cases, they are used in combination with tablets. Sprays are chosen by patients for whom rapid absorption of the product is important. The following recommendations will help make the choice of medication easier:

• The best drug for the treatment of herpes zoster in adults and children is Acyclovir;
• The safest composition is Gistan;
• Inexpensive but effective remedy - Sulfur-tar ointment;
• Broad spectrum of action – Clotrimazole;
• The best ointment for lichen in children is Mikoseptin;
• The most convenient treatment option is Terbinafine;
• The best medicine for ringworm is Griseofulvin.

Each tool has its own pros and cons. How to treat lichen in children is determined by the doctor in adults after receiving the diagnostic results. All his recommendations must be followed strictly.