From the Research
For oral lichen planus, a recommended initial dosing for dexamethasone rinse is 0.1 mg/mL solution, used as a 5-10 mL rinse that should be held in the mouth for 2-3 minutes and then expectorated (spit out), 3-4 times daily, as supported by the most recent study 1. The patient should avoid eating or drinking for 30-60 minutes after using the rinse to maximize contact time with the affected tissues. This solution can be prepared by a compounding pharmacy or by diluting injectable dexamethasone. Some studies suggest that adding Mucolox to the dexamethasone solution may be more effective than using the solution alone 1. Treatment duration typically ranges from 2-4 weeks initially, with gradual tapering based on symptom improvement. Patients should be monitored for oral candidiasis, a common side effect, which may require antifungal therapy. Dexamethasone rinse works by reducing inflammation and suppressing the immune response in the oral mucosa, which helps alleviate the painful symptoms of oral lichen planus. The topical application minimizes systemic absorption and related side effects while providing targeted relief to the affected areas. Key considerations for treatment include:
- Monitoring for side effects such as oral candidiasis
- Adjusting treatment duration based on symptom improvement
- Considering the addition of Mucolox to the dexamethasone solution for potentially improved efficacy
- Preparing the solution through a compounding pharmacy or diluting injectable dexamethasone. It's also worth noting that other treatments, such as topical cyclosporine, may be effective alternatives or adjuncts to dexamethasone rinse, as shown in studies like 2.