9-Year-Old Child Recovered from Oral Lichen Planus

Abstract

Background: Oral Lichen Planus (OLP) is a chronic autoimmune inflammatory disorder affecting the oral mucosa, often accompanied by itching, burning sensations, and recurrent flares. Pediatric OLP is rare and commonly displays a prolonged course. From an Ayurvedic perspective, this condition correlates with Charmakushta, a Vata-Kapha dominant Kshudrakushta involving Twaka, Rakta, Mamsa, and Lasika. Chronicity, allergic symptoms, and mucosal damage suggest underlying Aam (toxin) accumulation, Dosha imbalance, and compromised local immunity.

Objectives: To evaluate the clinical improvements and therapeutic safety of an Ayurvedic intervention in a pediatric patient with Oral Lichen Planus (Charmakushta).

Materials & Methods: A 9-year-old female with a four-year history of oral mucosal lesions over the buccal mucosa and inner lips, along with recurrent skin rashes and allergic episodes, was managed exclusively using Ayurvedic treatment over multiple follow-ups between September 2022 and March 2024. The treatment protocol included internal administration of Swaras Chikitsa comprising Bhoomi Amla, Shirish, and later Changeri, along with IAFA Skin Detox Drops, Aahar Amrutham Chai, and classical Ayurvedic medicine Haridrakhandam. External therapy included IAFA E-5 Cell Repair Oil, IAFA 333 Shampoo, Yasthimadhu powder paste, Chaptex, and Hiora SG Gel. Dietary regulation, oral hygiene guidance, and anti-allergic lifestyle measures were also prescribed. Therapeutic response was evaluated through clinical examination of lesion resolution, reduction in dryness and irritation, and the frequency of allergic flare-ups reported during follow-up visits.

Results: Progressive and sustained improvement was observed, including marked reduction of mucosal lesions and dryness, controlled recurrence of allergic skin manifestations, and better overall oral comfort. Significant clinical relief was documented at each follow-up, especially by December 2023 and March 2024, with no adverse reactions reported throughout the treatment period.

Conclusion: Ayurvedic management demonstrated effective and safe remission of pediatric Oral Lichen Planus through immune modulation and mucosal tissue healing, indicating its potential as a reliable long-term therapeutic approach for OLP (Charmakushta) in children.

Introduction

Oral Lichen Planus (OLP) is a chronic, autoimmune-mediated inflammatory condition involving skin and mucous membranes. It is characterized clinically by persistent oral lesions, dryness, irritation, burning sensation, and periodic exacerbations that disturb normal daily functions such as eating and speaking.

In the oral cavity, it is commonly presented as white- gray lacy streaks, i.e., Wickham’s striae, erythematous patches, or painful erosions on the buccal mucosa and lips. Although OLP predominantly affects adults, pediatric involvement is increasingly recognized and is considered clinically challenging due to prolonged disease courses and hypersensitive mucosal response.

The chronic nature of OLP reflects an underlying dysregulation of immune function in which T-cell activation leads to basal epithelial damage and ongoing inflammation of the mucosa. Co-existing allergies, as seen in this case, further aggravate mucosal sensitivity and increase the chances of flare-ups. Modern treatment approaches rely mostly on topical corticosteroids and calcineurin inhibitors, etc.

While they may reduce inflammation temporarily, they carry long-term concerns in children, including local immunosuppression, mucosal atrophy, candida infections, and high relapse rates after discontinuation. Therefore, non-steroidal but effective management strategies are urgently needed in pediatric OLP. From the Ayurvedic perspective, this condition is closely correlated to Charmakushta, categorized under Kshudra Kushta due to its symptom pattern and chronic progression.

The disease is primarily Tridoshaja dominated by Vata-Kapha vitiation, affecting Twak, Rakta, Mamsa, and Lasika, leading to discoloration, roughness, thickening, persistent dryness, itching, and irritation. Additionally, long-standing allergic tendencies and inflammatory cycle suggest the presence of Aam (toxin) accumulation, impaired tissue metabolism (Dhatvagni dysfunction), and reduced mucosal defense (Ojas kshaya).

Hence, Ayurveda emphasizes a therapeutic plan that concentrates on Raktashodhana (blood purification to reduce inflammatory load), Aamapachana (correction of metabolic toxins), Vata-Kapha Shamana (restoring Doshic balance), Ojovardhana (immune regulation), and regeneration of the mucosal barrier (Twak-Mamsa Dhatu Poshana).

Internal herbal formulations help in systemic correction, while external soothing and reparative applications aim to restore epithelial structure and comfort. Dietary guidance, oral hygiene practices, and stress-free lifestyle modifications act as essential supportive measures in sustained healing.

This case report documents the successful Ayurvedic management of pediatric OLP with sustained remission, improved mucosal health, and absence of adverse effects, making it a valuable contribution toward the integration of Ayurveda in chronic oral autoimmune disorders.

Keywords: Oral Lichen Planus, Charmakushta, Ayurveda, Pediatric, Children, IAFA, Autoimmune Disease, Case Report, IAFA Skin Detox Drops

Case Presentation

A 9-year-old female presented with chronic oral lesions over the buccal mucosa and inner lips persisting for approximately four years, accompanied by recurrent skin rashes and allergic responses since childhood.

Symptoms had a fluctuating course with dryness, discomfort during exacerbations, and a history of frequent upper respiratory complaints earlier in life. Before Ayurvedic intervention, no mention of corticosteroid or immunosuppressive therapy was documented in the available clinical notes.

1) Patient Details

Age/Sex – 9/F
First Consultation – 19/09/2022
Duration of symptoms – Approx 4 years

2) Chief Complaints

White and reddish lesions inside the mouth, especially the buccal mucosa and under the lips
Dryness and rash over the skin fold
Itching and burning during flare-ups
Recurrent allergic skin reactions since early childhood

3) Past Disease History

Repeated cough and cold at around 2.5 years of age

4) Family History

No family history of similar dermatological or autoimmune conditions was mentioned.

5) Diagnosis

Based on clinical features including chronicity, mucosal lesions, dryness, and itching, the patient was diagnosed with:-

Modern Diagnosis: Oral Lichen Planus

Ayurvedic Diagnosis: Charmakushta (Vata-Kapha predominant Kshudra Kushta)

Materials and Methods

1) Intervention Protocol

Treatment was initiated with Anta-Chikitsa (Internal therapy) to correct immune dysfunction and reduce inflammatory load. As the condition stabilized, topical mucosal repair therapies were introduced. Internal medicines were optimized over time to support tissue regeneration and maintain remission. Clinical tolerance and response were reviewed at every follow-up, and therapy was modified accordingly.

2) Ayurvedic Diagnostic Framework

Diagnosis was established as Vata-Kapha predominant Charmakushta based on chronic oral lesions, dryness, itching, discoloration, allergic triggers, and a history of recurrent respiratory issues.

Table 1. Ayurvedic Diagnostic Assessment

Samprapti Ghataka	Findings
Vyadhi	Charmakushta
Dosha	Vata-Kapha dominant
Dushya	Twak, Rakta, Mamsa, Lasika
Strotas	Rasavaha, Raktavaha
Associated Vyadhi	Allergic skin reactions and URTI history

3) Ayurvedic Treatment Protocol

Internal herbal formulations or Swarasa, like Bhoomi Amla, Shirish, and later Changeri, were administered orally for systemic immune modulation and Rakta Shodhana. IAFA Skin Detox formulations and Haridrakhandam were prescribed for Amapachana and inflammation control. External therapies such as E-5 Cell Repair Oil, 333 Shampoo, and later Yasthimadhu paste, Chaptex, and Hiora SG Gel were introduced to improve mucosal healing and prevent further irritation.

4) Treatment Progression Across Follow-Ups

Therapy was progressively escalated and modified throughout the follow-ups to match symptom shifts and healing status.

Table 2. Formulations used along with their dosage, frequency, route, time of administration, and duration

Formulation	Dosage and Frequency	Route	Timing	Duration Status
Bhoomi Amla Swaras	7.5 ml BID with equal water	Oral	15-20 min after meals	Given continuously 19/09/2022 to 04/01/2023 → then paused during 05/04/2023 to 09/09/2023 (3 months gap) then again restarted from 11/12/2023 to 30/03/2024
Shirish Swaras	7.5 ml BID with equal water	Oral	15-20 min after meals	Given continuously from 19/09/2022 to 04/01/2023 paused during 05/04/2023 to 09/09/2023 and again restarted from 11/12/2023 to 30/03/2024
IAFA Skin Detox Drops	2 ml BID in 20 ml water	Oral	After meals	Given 19/09/2022 to 04/01/2023, then stopped thereafter, replaced later with Skin Detox Tablets
Haridrakhandam	½ tsp BID	Oral	After meals	Given continuously from 19/09/2022 to 04/01/2023 paused during 05/04/2023 to 09/09/2023 and again restarted from 11/12/2023 to 30/03/2024
Aahar Amrutham Chai	1 tsp BID	Oral	Morning and evening	Added on 04/01/2023. Stopped after 09/09/2023 follow-up. Not restarted
IAFA E-5 Cell Repair Oil	Topical twice daily	External	Morning and evening	Given continuously from 04/01/2023 to 30/03/2024
IAFA 333 Shampoo	Apply and rinse	External	As directed	Given continuously from 04/01/2023 to 30/03/2024
Changeri Swaras	5 ml BID with equal water	Oral	Between meals	Added 30/03/2024 onward
IAFA Skin Detox Tablets	1 tablet BID	Oral	After meals	Added 30/03/2024 onward
Yasthimadhu Choorna	Gargle and paste application	Oral/topical	Twice daily	Added 30/03/2024 onward
Chaptex	Thin coating on the lips	Topical	As advised	Added 30/03/2024 onward
Hiora SG Gel	Apply over oral lesions	Topical (buccal)	As advised	Added 30/03/2024 onward

5) Phased Therapeutic Strategy

The Ayurvedic management in this case was given in a phased manner according to disease phase and clinical response. Each phase targeted a specific pathological layer, beginning from Dosha balancing and Ama reduction to structural mucosal repair and finally immune stabilization.

Table 3. Phased Ayurvedic Treatment Strategy

Phase	Timeline	Key Ayurvedic treatment Active in Phase	Clinical Outcome Observed	Therapeutic Objective
Phase 1 – Dosha Shamana and Amapachana	19/09/2022 to 04/01/2023	Bhoomi Amla Swaras, Shirish Swaras, Skin Detox Drops, Haridrakhandam	Reduced oral irritation, a decrease in inflammatory symptoms, and a decrease in rash intensity	Balance Vata-Kapha and reduce toxin (Ama) load
Phase 2 – Mucosal Support and Barrier Repair	04/01/2023 to 09/09/2023	Haridrakhandam continued, IAFA E-5 Oil, IAFA 333 Shampoo, and Aahar Amrutham Chai added.	Improvement in dryness, barrier integrity maintained, symptomatic comfort	Strengthen Twak, Rakta, and results in epithelial healing
Phase 3 – Relapse Control Pause Window	05/04/2023 to 09/09/2023	Swaras temporarily paused	Minor symptom fluctuations but no severe flare-ups	Observation of disease stability and reducing the medicine load
Phase 4 – Regeneration and Immune Correction	11/12/2023 to 30/03/2024	Bhoomi Amla Swaras restarted, Shirish Swaras restarted, and Haridrakhandam restarted. Newly added Changeri Swaras, Skin Detox Tablets, Yasthimadhu Choorna	Visible lesion healing, dryness almost resolved, allergic episodes rare	Dhatu- Poshana, immune modulation, tissue rejuvenation
Phase 5 – Local Repair and Remission Maintenance	30/03/2024 onward	Added Chaptex and Hiora SG Gel, E-5 Oil, and 333 Shampoo, continued	Oral mucosa stable, complete symptom control maintained	Long-term remission and relapse prevention

6) Monitoring and Evaluation Protocol

Table 4. Clinical Monitoring Approach

Parameter	Evaluation Frequency	Assessment Method	Response
Oral lesions	Every visit	Clinical visual examination	Marked regression
Lip dryness	Every visit	Patient and clinician scoring	Consistent improvement
Allergic flare-ups	Monthly review	Symptom history	Rare by the final stage
Burning or Pain	Each visit	Symptom inquiry	Minimal in the late phase
Treatment safety	Continuous	Observation for adverse effects	No adverse events

7) Dietary and Lifestyle Monitoring

Lifestyle guidance included avoidance of irritating foods (spicy, acidic), maintaining regular sleep, and adopting cooling and soothing dietary options such as fennel, cumin, and green vegetables. Hydration with lukewarm water. Avoiding harsh oral products was strictly advised.

8) Ethical Considerations

This case involves a pediatric patient; therefore, ethical precautions were strictly followed throughout the course of treatment and documentation. Informed consent was obtained from the patient’s parent/guardian before the initiation of Ayurvedic therapy, with full explanation of the treatment plan, expected outcomes, and follow-up requirements.

Results

Table 4. Clinical Outcome Assessment Across Treatment Timeline

Follow-up	Oral Lesions (Buccal Mucosa)	Lip Dryness	Skin Allergic Episodes	Burning / Irritation	Treatment Tolerance	Overall Clinical Status
Baseline (19/09/2022)	Persistent white/red lesions, visible inflammation	Severe	Frequent	Present	—	Symptomatic, chronic complaints
04/01/2023	Mild reduction in mucosal irritation	Moderate	Less frequent	Improved	Good	Initial response noted
05/04/2023	Stable condition maintained	Reduced intermittently	Occasional	Mild	Good	Progressive improvement
05/07/2023	Visible healing and less erythema	Mild	Rare episodes	Minimal	Good	Clear response, better oral comfort
09/09/2023	Continued improvement maintained	Mild	Rare	Minimal	Good	Condition stabilized
11/12/2023	Marked healing, lesions barely noticeable	Minimal dryness	No significant flare-ups	Negligible	Excellent	Significant clinical remission
30/03/2024	Near-complete resolution	Normal	Absent	None	Excellent	Sustained remission without relapse

Table 5. Conclusion of the outcome Table

Clinical Parameter	Baseline	Final Outcome (Mar 2024)	% Improvement
Mucosal Lesion Severity	High	Minimal or Healed	>75%
Dryness of Lips	High	Normal-Mild	Approx. 80%
Allergic Episodes	Frequent	Absent	100% control
Pain/Burning	Noticeable	None	100% relief
Safety/Tolerability	—	Excellent	—

Discussion

Oral Lichen Planus (OLP) in children is a rare but chronic inflammatory condition driven by an inappropriate immune response against oral epithelial cells. Persistent relapse, mucosal sensitivity, dryness, and coexistence of allergic manifestations add complexity to its management. The present case achieved sustained remission through a structured and phased Ayurvedic approach.

1) Pathophysiological Understanding

OLP is an autoimmune T-cell–mediated disorder characterized by chronic lymphocytic infiltration at the basal membrane, degeneration of basal keratinocytes, oxidative stress, and altered epithelial healing and association with allergic conditions. Chronic immune activation results in repeated mucosal damage and thus poor epithelial turnover, which ends with persistent lesions.

From an Ayurvedic point of view, the disease aligns with Charmakushta, involving Vata-Kapha predominance and deeper tissue impairment. The Dushya involvement included Twak, Rakta, Mamsa, and Lasika, indicating disrupted tissue nutrition, immune imbalance, and chronicity. Ama accumulation and Rasavaha-Raktavaha Strotas dysfunction further contributed to recurrent flare-ups, while Ojas Kshaya explained reduced mucosal function.

A phased therapeutic approach was followed to correct the pathology stage-wise. Initial treatment focused on Dosha- Shamana and Amapachana using Various Swaras orally along with detoxifying formulations, which reduced mucosal irritation and allergic frequency. Subsequent topical therapies strengthened Twak and Rakta and prevented surface irritation, resulting in improvement in dryness and lesion appearance.

Restarting Swaras along with mucosal regenerative agents promoted Mamsa dhatu repair and epithelial healing. Lasika dusti and immune hypersensitivity were addressed in later phases through immune-supportive medicines and barrier-stabilizing applications, leading to sustained remission.

2) Phase-Wise Therapeutic Protocol

Phase-1: Dosha-Shamana and Ama-Pachana Phase i.e., 19/09/2022 to 04/01/2023

Initially, the treatment plan focused on correcting the aggravated Vata-Kapha and reducing Ama formation to control the inflammatory and allergic tendencies. Internal medications, including Bhoomi Amla Swaras, Shirish Swaras, IAFA Skin Detox Drops, and Haridrakhandam, were administered to purify Rakta and restore mucosal balance. During this period, oral irritation, inflammatory response, and allergic flare episodes gradually reduced, indicating early stabilization of the disease pathology.

Phase-2: Mucosal Barrier Support and Symptom Relief, i.e., 04/01/2023 to 09/09/2023

With improvement in inflammatory signs, therapy progressed toward enhancing epithelial integrity and reducing dryness. External applications such as IAFA E-5 Cell Repair Oil and IAFA 333 Shampoo were introduced along with supportive internal formulation Aahar Amrutham Chai. This phase improved the lubrication and nourishment of the oral mucosa and skin, resulting in a noticeable decline in dryness, lesion thickness, and local discomfort.

Phase-3: Dhatu-Poshana and Epithelial Regeneration, i.e., 11/12/2023 to 30/03/2024

After partial remission, regenerative therapy was initiated to strengthen Mamsa Dhatu and correct deeper Dushya involvement, especially of Twak, Rakta, and Lasika. Bhoomi Amla Swaras and Shirish Swaras were restarted along with Changeri Swaras and IAFA Skin Detox Tablets for immunological and structural rejuvenation. Yasthimadhu Choorna was added for local healing. During this phase, oral lesions showed marked resolution with near-normal mucosal texture.

Phase-4: Immune Stabilization and Remission Maintenance Phase, i.e., 30/03/2024 onward

The final phase emphasized long-term mucosal protection and prevention of relapses. Local protective agents such as Chaptex and Hiora SG Gel were incorporated to maintain hydration, barrier function, and symptom-free status. This supported Lasika and Ojas’ stability, resulting in sustained remission without recurrence of lesions or allergic episodes.

3) Pharmacological Correlation

Table 5. Ayurvedic Medicines and Their Pharmacological Correlation

Formulation	Classical Actions	Major Active Phytochemicals	Modern Pharmacological Correlation
Bhoomi Amla (Phyllanthus niruri)	Raktashodhaka, Pitta-Kapha-Shamana	Phyllanthin, Hypophyllanthi, Corilagin	Anti-inflammatory, antioxidant, hepatoprotective, supports mucosal healing and immune regulation.
Shirish (Albizia lebbeck)	Ojovardhana, Kapha-Vata Hara, Sothahara	Triterpenoids, Saponins, Flavonoids	Anti-allergic, mast-cell stabilization, reduces histamine-mediated mucosal irritation.
Changeri (Oxalis corniculata)	Tridosha-Shamana, Deepana-Pachana	Vitamin C, Phenolic antioxidants	Improves tissue metabolism, epithelial repair, and free-radical scavenging
Haridrakhandam	Amapachana, Kapha-Vatahara, Raktaprasadana	Curcumin, Piperine	Immunomodulatory, anti-inflammatory, supports epithelial regeneration
Skin Detox Drops/Tablets	Raktashodhaka, Vata-Kapha shamana	Alkaloids, Tannins, Flavonoids	Reduces inflammatory cytokines, detoxification, and improves microcirculation
Yasthimadhu (Glycyrrhiza glabra)	Vranaropana, Pitta-Vatshara, Prashamana	Glycyrrhizin, Liquiritigenin	Mucosal protection, accelerating epithelialization, and analgesic activity
E-5 Cell Repair Oil	Twak- Poshana, Vata-Kaphahara	Fatty acids and herbal actives	Skin barrier restoration, irritation reduction, and moisture retention
Chaptex (lip barrier protector)	Snehana, Sothahara	Bioadhesive lipids	Prevents dryness-induced epithelial cracking
Hiora SG Gel (oral protective gel)	Local healing support	Bio-adhesive polymers, plant extracts	Forms protective film, promotes mucosal recovery

e symptoms has been observed. 90% of her disease on diction got cured completely and later on Dr Gupta advised to get online follow-ups for another 3 months as the medications involved not only eliminating the diseases but also boosting the immunity.

Complete Recovery

Previously all the ridges of her tongue and the roof of her mouth were filled with white patches, added to that, the swelling and itching of her outer lips. All recovered after getting safe and effective treatment from IAFA Ayurveda.

Happy Note

Source:- https://g.co/kgs/L4mGv2

Conclusion

This case of Oral Lichen Planus showed steady and consistent improvement with a phased Ayurvedic treatment approach. The therapy helped reduce inflammation, dryness, and allergic tendencies while promoting healthy healing of the oral lining.

Consult Online with Dr. Sahil Gupta (B.A.M.S., M.H.A.)

Clinical progress was maintained without relapse, and no steroids were required at any stage. Overall, the outcome highlights that Ayurveda can serve as a safe and effective option for long-term management of Oral Lichen Planus in younger individuals, with noticeable improvement in oral comfort and daily functioning.

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