For your axillae and elbow patches, consistency is key. Apply the topical tacrolimus and placental extract exactly as prescribed, and take your oral betamethasone, levamisole, and rabeprazole-domperidone diligently. Because friction can worsen patches in friction-prone areas like the elbows and underarms, try to wear loose clothing and avoid harsh scrubbing. Additionally, protect these sensitive areas from direct sunlight. Your skin takes time to regenerate and repigment, so patience is essential. Keep in close touch with your dermatologist to monitor your progress safely.

Since previous treatments like methylprednisolone (Medrol) and betamethasone (Betnesol) are no longer helping, both cyclosporine mouthwash and diode laser therapy are excellent next steps. Cyclosporine is a targeted immunosuppressant rinse that helps control inflammation. However, diode laser therapy is highly effective for resistant oral lichen planus, offering rapid pain relief and faster tissue healing with very few side effects. Many patients find laser therapy more comfortable and convenient. I recommend discussing diode laser therapy with your specialist as a highly effective, modern option to finally bring you some much-needed relief.

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Please be reassured that while oral lichen planus requires regular monitoring, the risk of it becoming cancerous is very low. I highly recommend consulting an Oral Medicine specialist or a dermatologist specializing in oral mucosal disorders. They can evaluate your response to Medrol, Kenacort, Tess paste, and Betnesol, and offer advanced targeted treatments, such as topical calcineurin inhibitors (like tacrolimus) or systemic immunomodulators, to help you find lasting relief.

Alternative treatments may include steroid eye drops, such as Prednisolone or Dexamethasone, which should only be prescribed and monitored by an ophthalmologist. Non-steroidal options, such as Olopatadine or Ketotifen eye drops, which act as antihistamines or mast-cell stabilisers, can also safely relieve itching and redness. Additionally, artificial tears can help soothe irritation. It is important not to self-medicate with oral steroids and to consult a doctor for the safest and most effective substitute.

Betnesol 0.5 mg contains betamethasone, a steroid medicine. Taking it repeatedly for a long time, such as 15 days every month for 6 years, can lead to side effects because steroids affect many body systems. Possible long-term effects include weight gain, elevated blood sugar, high blood pressure, acidity, thinning of the bones, muscle weakness, mood changes, and an increased risk of infections. It may also suppress the natural production of body steroids if used frequently or without medical supervision. You should not stop using this medicine suddenly, as it may cause withdrawal effects. It is important to consult a doctor to properly assess the cause of your throat pain and switch to safer long-term treatment if needed. Your doctor may also advise tests to check sugar levels, bone health, and other possible effects of long-term steroid use. Proper diagnosis will help avoid unnecessary repeated steroid use.