Many people, when the word “lichen” is mentioned, believe that any type of this disease is dangerous and contagious. But there are many different forms of these skin pathologies, and only a few of them are contagious. The rest are skin diseases that do not look very aesthetically pleasing, but are not dangerous to others 
A whole group of skin diseases is united by the general term lichen in humans. Although the causes of all these pathologies are different, people classify them as one group. Moreover, the word “lichen” itself is used mostly according to the established historical tradition, and does not describe the essence of the biological origin or medical features of the disease.
The disease can be fungal, viral, or non-infectious in origin, and it is often difficult to outwardly distinguish one condition from another. Therefore, you cannot try to diagnose yourself on your own, using photos from the Internet. Errors can lead to the spread of the disease among family members and others, and the condition of the victim himself can greatly deteriorate.
Among the key characteristics of all lichens, several common points can be identified. These include the following:
all lichens affect the skin;
inflammatory changes in the epidermis are typical;
elements are located in different parts of the body - single or multiple;
usually round in shape, with relatively clear boundaries.
Types of lichen in humans
Different types of pathology have differences in gender and age. Various contagious forms of skin lesions (for example, ringworm) are typical for childhood, pityriasis rosea is especially common in adolescents, and shingles occurs in people over 50 - 60 years of age. This is due to the characteristics of the immune system. Some types of lichen, for example red flat lichen, are more common in women.
In men, especially those with dense facial and body hair, certain forms of the disease are more severe, which is associated with skin care habits, increased sweating and treatment difficulties.
Ringworm
This is the most contagious of all types of lichen. Usually, children who have been in contact with infected animals (street or indoor cats, dogs) are infected with it, and then the infection is generously spread to all family members in close contacts. By its nature, ringworm is a mycosis that affects smooth skin (or, more simply, a fungal infection). It is provoked by several types of fungi (dermatophytes) that parasitize the skin of animals and humans. The most common are trichophytosis with microsporia.
The skin on different parts of the body and the scalp are affected. First, pink spots form, which are covered with a halo of small bubbles along the edges. Black dots are visible inside the spot - these are stumps of broken hair. The size of the spot gradually increases, the skin turns red along the periphery, bubbles and ring-shaped elements form, but inside the ring the skin is relatively normal. If the lichen is not treated, new rings form inside the old elements - the elements become like targets.
Ringworm got its name for the typical changes in the areas of the skin where hair grows (head, chest in men). Round bald spots with stubble in their center are formed - with microsporia, the hair is broken off at a level of 4 - 5 mm from the edge of the skin and along one line, with trichophytosis - at a height of up to 2 - 3 mm and the stumps are located at different heights, some look like black dots in skin. The surface of the plaque itself is flaky and covered with small crusts. 
The disease can be fungal, viral, or non-infectious in origin, and it is often difficult to outwardly distinguish one condition from another.
Pityriasis rosea
The disease is not contagious, and its medical name is erythematous squamous dermatosis. It is impossible to establish the exact cause today; there is evidence that lichen is of infectious origin, often erupting after an acute respiratory viral infection. This is confirmed by the presence of a developed immunity to this disease for life; repeated episodes of lichen do not occur in subsequent life. But even close, long-term contacts with the patient do not lead to the appearance of similar elements in other people.
You need to know what lichen looks like in a person: the very first, “maternal” plaque, a pink round spot covered with flaky scales in the center. After about 7 - 8 days, small spots in the groin and on the arms and legs are eliminated, forming plaques up to 20 mm. As the plaques dissipate, cold-like symptoms appear, and the “mother” plaque disappears.
The typical appearance of the elements is the red edges of the plaque and a pale center covered with small scales. The spots can combine to form larger, uneven lesions that disappear within a couple of months without intervention.
The peculiarity of pityriasis rosea is that elements do not appear in the area of the face and head, feet or hands. If it is Zhiber's lichen, multiple small spots of pink color will form.
Ringworm
To be precise, it is called pityriasis versicolor or versicolor. This is a fungal disease, but not contagious. The fungus that provokes the development of lichen lives on the surface of the epithelium of any person, but in the presence of a genetic predisposition and under the influence of provocateurs it forms rashes. Fungi infect hair follicles and epithelium, multiplying and forming yellow-brown, red spots up to 10 mm in diameter. The edges of the elements have a “lace” appearance. The surface of the elements peels off, creating the feeling that they are sprinkled with bran - hence the name. The spots can merge with each other without treatment, forming elements up to 10 - 20 cm. Most often, rashes appear on the neck and back, in the shoulders and chest. Under the influence of ultraviolet radiation they disappear, leaving behind untanned areas - pseudo-leukoderma (low-pigmented areas).
Shingles
This is a kind of greeting from childhood to those who, as a child, had chickenpox. It is provoked by the same virus - herpes zoster, which has a typical feature: after chickenpox, it does not disappear from the body, but remains in the body for life. For many years it can lie dormant in the nerve ganglia without making itself known. But when the immune system is suppressed due to chemotherapy, HIV, or serious health problems, especially in older people, it is reactivated. Soreness and itching appears in the chest or back, along the intercostal nerves. Then, after a few days, blisters filled with clear liquid appear at the site of pain. The rash looks like stripes of blisters encircling one or both sides, hence the name. These places are painful, especially from rubbing clothes, and crusts gradually form. Even after the sores go away, pain may remain - this is postherpetic neuralgia. In places where there were rashes, pigmentation remains for several weeks.
And one more important point: during the period of rash, the patient is contagious to those children and adults who have not had chickenpox. The contents of the bubbles contain millions of viruses.
Lichen planus
Another non-contagious form of lichen. The elements are quite specific, they can only be similar to certain forms of psoriasis, and it is difficult to confuse them with other types of psoriasis. Polygonal plaques form on the skin, which are slightly raised above the skin, with a slight depression in the center. Typically, plaques do not grow in width, but plaques may appear in groups, are itchy, and have a surface with large scales. The color of the elements is bright - purple-violet; shine is visible in artificial light. Upon close examination, a fine mesh pattern (Wickham's sign) is visible on the surface of the plaques, due to the varying thickness of the skin lesion.
This lichen affects the mucous membranes of the genitals and mouth, forming “frosty patterns” on the surface. Fingernails and toenails may be damaged - grooves, clouding and thickening, and areas of erosion (nails crumble) form.
Lichen squamosus (psoriasis)
This is not lichen per se at all, but an autoimmune disease, which is correctly called psoriasis. Skin lesions and plaque formation are one of the symptoms of a disease that is not contagious to others and occurs as a result of a breakdown of the immune system. As a result, immune cells mistakenly attack their own tissues, forming foci of inflammation. If the skin suffers, psoriatic plaques or more extensive, large lesions form.
Foci of psoriasis look like thickened skin, delimited from healthy areas by a bright red ridge. The surface is very flaky, slight itching, formation of small bubbles, cracks, and dryness are possible.
The appearance of the rash varies depending on the location - there may be large spots in the area of hair growth, or plaques or “drops” of psoriasis on the body. 
Symptoms of lichen
All manifestations, with the exception of psoriasis and lichen planus, affect only the skin. Inflammatory foci of different sizes are formed, with peeling, blisters or itching. The external manifestations of lichen may not always be typical, so it is important to see a doctor; only a specialist can determine the exact nature of the rash.
Treatment of lichen in humans
Externally, many types of rashes are similar, especially if they are itchy and traumatic, covered with crusts. Therefore, it is important to visit a dermatologist or therapist to evaluate the appearance of the elements, associated symptoms and existing diseases.
Diagnostics
Diagnostic principles vary depending on the type of lichen.
If it is lichen versicolor, it is necessary to use the Balzer test with iodine solution. The affected and loosened areas in the area of the plaque become more stained, forming a spotted appearance. The doctor also scrapes the surface of the elements - falling particles are removed like wood shavings (positive Beignet sign). In addition, an examination is carried out under a Wood's lamp - fungal colonies will give a yellowish glow in the thickness of the skin. The last stage is the examination of scraped particles under a microscope - a fungus is detected - dermatophytosis or microsporia.
Ringworm is determined when patients indicate contact with possibly sick animals, the presence of elements in family members and the detection of typical plaques. A microscopic analysis of scrapings from the surface of the elements is also performed.
For herpes zoster, the clinical picture and indication of previous chickenpox are important. Sometimes they look at the titer of antibodies in the blood to herpes zoster.
Modern methods of treatment
In general, treatment of patients with different types of lichen will be carried out in four main areas.
The first is etiotropic therapy (that is, medications aimed at the cause of the disease): for ringworm and pityriasis versicolor these are antifungal drugs (fungicides), for herpes zoster - antiviral (Acyclovir drugs).
The second is the elimination of the symptoms of the disease through various medications: they are taken orally or applied topically.
The third is various non-drug measures (UV therapy, skin care, physiotherapy, strengthening the immune defense).
And fourth (this point is not always needed) - disinfection in hot spots (for clothes, linen and home).
The drugs that are most often used in the treatment of different types of lichen are:
antifungal creams, ointments or tablets;
antiviral injections, tablets or topical agents;
antihistamines to relieve itching and topical gels;
vitamin-mineral complexes, adaptogens.
If there are concomitant signs of depressive disorders (for example, when large areas of the body are affected), antidepressants may be required. We may sometimes recommend sedatives, as well as sleeping pills, if people are having difficulty sleeping due to itching and anxiety. If the inflammation is acute and the skin is severely affected, a short course of corticosteroid medications may be needed, but strictly under the supervision of a doctor to prevent side effects.
Some treatment features depend on the type of lichen. For ringworm, shaving the hair in the affected area is highly recommended, especially against the background of large bald spots that have appeared. This will help treat the skin more effectively and quickly eliminate the fungus. If there is only one stain, the hair can be carefully cut around, but if there are many of them, it is better to remove them all.
If this is a treatment for lichen planus, in addition to all the measures described above, the use of anti-malaria drugs and drugs from the retinoid group may be recommended. They have shown their effectiveness.
If it is herpes zoster, it is important to take a full course of Acyclovir, as well as additionally use painkillers and drugs that prevent platelet aggregation (antiplatelet agents). It is equally important to consult an immunologist and prescribe medications to stimulate the immune system.
Prevention of lichen in humans
The basis for preventing lichen is a healthy lifestyle. In addition, you need constant monitoring of the condition of the skin - a daily shower or bath, the use of delicate hygiene products, immediate treatment of all minor injuries and wounds. For contagious forms of deprivation, the basis of prevention is the separation of contacts with sick people.
Popular questions and answers
Where can you get shingles?
We can talk about contagiousness only in relation to ringworm. It is transmitted from animals that have skin lesions. Usually these are street cats, dogs, and less often other animals. Parents need to be especially careful - most often children become infected with lichen and pass it on to adults.
It would be useful to remind you that a patient with shingles is dangerous for children who do not have immunity to chickenpox.
How is lichen transmitted?
Again, this question is relevant for ringworm. The route of transmission is contact, from the fur of sick animals to the skin, especially in the area of minor defects (scratches, wounds). When people come into close contact with each other, the fungus can spread to the skin from sick people.
Is it necessary to treat clothes and bedding when treating lichen?
Yes, if we are talking about ringworm, you need to treat clothes and bed with boiling or hot steam.
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