Lichen planus is a condition that affects the skin, mouth, hair, and nails. It may sound a bit scary, especially because it has an unusual name, but it is not contagious or dangerous in most cases. Instead, it’s a long-term inflammatory condition that can cause discomfort and changes to the way your skin or mouth looks and feels.
What is Lichen Planus?
Lichen planus is a chronic inflammatory condition that affects about 1% of the population worldwide (Usatine & Tinitigan, 2011). It can show up as itchy, flat-topped bumps on the skin or as painful sores in the mouth. Sometimes, it can even affect the nails or scalp, leading to hair loss or nail damage.
The cause of lichen planus isn’t fully understood. Experts believe that it is related to the immune system mistakenly attacking the skin or mucous membranes (Scully & Carrozzo, 2008). This makes it an autoimmune condition. Some triggers, like certain medications, stress, or infections like hepatitis C, may also play a role.
Symptoms of Lichen Planus
The symptoms of lichen planus can vary depending on where it appears on the body. On the skin, it often looks like small, purplish bumps that are flat on top and very itchy. These bumps usually appear on the wrists, ankles, or lower back. Over time, they may become scaly and develop a white, lace-like pattern on the surface, which is known as Wickham’s striae.
In the mouth, the condition is called oral lichen planus, and it can be more difficult to deal with. It may cause white patches, redness, or painful sores inside the cheeks, on the tongue, or on the gums. Eating spicy or acidic foods can make the pain worse.
When lichen planus affects the scalp, it can lead to a type of hair loss called lichen planopilaris. It may also cause ridging or splitting of the nails when it shows up in the nail beds.
Who Gets Lichen Planus?
Lichen planus can affect people of all ages, but it is most commonly seen in middle-aged adults. Women are slightly more likely to develop it than men. Oral lichen planus tends to occur more often in women over 40 (Lodi et al., 2005).
There’s no known way to prevent lichen planus, but some people may be more at risk if they have certain health conditions. For instance, people with hepatitis C or other autoimmune disorders seem to have a higher chance of developing lichen planus (Ingafou et al., 2006).
Diagnosis and Testing
Doctors usually diagnose lichen planus by looking at the skin or mouth and asking about symptoms. Sometimes, they might do a biopsy, which means removing a small piece of skin or tissue and looking at it under a microscope. This helps rule out other conditions like psoriasis or lupus.
If the doctor suspects that the condition might be related to hepatitis C or a reaction to a medication, they might order blood tests or review your medication history.
Treatment Options
There is no cure for lichen planus, but there are many ways to manage the symptoms. Treatment depends on how severe the condition is and where it appears.
For mild cases on the skin, corticosteroid creams or ointments can help reduce inflammation and itching. For more serious or widespread symptoms, doctors might prescribe oral corticosteroids or other medications that suppress the immune system, such as cyclosporine or methotrexate (Usatine & Tinitigan, 2011).
In the case of oral lichen planus, corticosteroid gels or rinses can help ease the pain and reduce swelling. Good oral hygiene and avoiding spicy or acidic foods can also make a big difference.
Other treatments may include antihistamines to relieve itching, phototherapy (light therapy), and retinoid creams. Regular follow-ups with a doctor or dermatologist are important because lichen planus, especially in the mouth, can last for many months or even years.
Is Lichen Planus Dangerous?
In most cases, lichen planus is not dangerous. However, oral lichen planus can sometimes lead to complications. In rare cases, long-term oral lichen planus may slightly increase the risk of developing oral cancer (Lodi et al., 2005). That’s why regular check-ups are important, especially if you notice any new or changing lesions in the mouth.
Living with Lichen Planus
Living with lichen planus can be frustrating, especially when symptoms come and go or affect appearance. However, with the right treatment and support, many people are able to manage the condition well. Learning to avoid triggers, reducing stress, and keeping up with medical appointments are all helpful strategies.
Lichen planus is a chronic, non-contagious condition that can affect different parts of the body, particularly the skin and mouth. Though it can be uncomfortable and last for a long time, it is manageable with proper treatment. If you or someone you know is dealing with symptoms, it’s important to see a healthcare provider for a diagnosis and treatment plan tailored to individual needs.
References
- Ingafou, M., Leao, J. C., Porter, S. R., Scully, C., & Teo, C. G. (2006). Oral lichen planus: A retrospective study of 690 British patients. Oral Diseases, 12(5), 463–468. https://doi.org/10.1111/j.1601-0825.2006.01202.x
- Lodi, G., Scully, C., Carrozzo, M., Griffiths, M., Sugerman, P. B., & Thongprasom, K. (2005). Current controversies in oral lichen planus: Report of an international consensus meeting. Part 2. Clinical management and malignant transformation. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 100(2), 164–178. https://doi.org/10.1016/j.tripleo.2004.06.076
- Scully, C., & Carrozzo, M. (2008). Oral mucosal disease: Lichen planus. British Journal of Oral and Maxillofacial Surgery, 46(1), 15–21. https://doi.org/10.1016/j.bjoms.2007.07.199
- Usatine, R. P., & Tinitigan, M. (2011). Diagnosis and treatment of lichen planus. American Family Physician, 84(1), 53–60.
