A disease that causes inflammation of the skin is called lichen planus. The primary symptoms are usually a rash that may appear on the arms, legs, scalp, nails, and genital area. While most of the time, this condition disappears without treatment, in some cases, people may need some options to relieve the symptoms (such as itching).
Moreover, this condition is a lichenoid dermatosis, which is a group of skin disorders that cause firm, raised, and discolored bumps on the skin. In some cases, lichen planus can be mistaken for psoriasis because they both share similar symptoms. However, the main difference between them is that psoriasis causes scaly patches on the skin, and it does not affect the mouth.
Generally, this condition affects about 0.22% to 1% of the adult population. The oral type of this condition affects from 1% to 4% of people worldwide.
What is The Difference between Lichen Planus and Lichen Sclerosus?
While both are idiopathic disorders that negatively affect the skin (especially mucous membranes), there are some differences between them. For instance, lichen sclerosus is a chronic (long-term) condition that causes the skin to become thinner over time. It may also cause itching, sores, and scars. It usually occurs on the skin around the genitals and anus, but may also affect the skin in other parts of the body.
How Does Lichen Planus Affect My Body?
Most of the time, lichen planus affects the skin that is located around the wrists and elbows, the back of the hands, and the fronts of the lower legs. Approximately 50% of people with this condition develop oral lichen planus, which leads to spots inside the mouth and tongue. Commonly, the oral form of this disease begins with small white dots on the skin inside the cheeks or tongue.
What Are The Symptoms of Lichen Planus?
While the symptoms depend on where the condition occurs, some general symptoms of lichen planus are listed below. Examples include:
- Small, raised dots on the skin that are about the size of the tip of a pin (0.4 mm). Sometimes, they can grow up to 1 cm or develop into sores.
- White, small dots that often appear inside the cheeks, on the tongue, or lips.
- Nail color changes or cracks
If any of the previous symptoms occur and do not disappear for more than 14 days, immediately contact your healthcare professional for a diagnosis and treatment.
Causes and Risk Factors
Healthcare professionals do not fully understand what exactly causes lichen planus. While anyone can develop it, doctors have found some factors that may increase the risk. Check some examples below:
- Viral infections (such as hepatitis C)
- Vaccines
- NSAIDs (nonsteroidal anti-inflammatory drugs)
- Particular chemicals, metals, or pigments
- Certain medicines used to treat arthritis, heart disease, or hypertension (high blood pressure)
- Stress and anxiety
- Autoimmune disorders (including ulcerative colitis, alopecia areata, and vitiligo)
- Genetics – There are some genetic changes that make people more prone to lichen planus.
Furthermore, this disease is not contagious, and it cannot spread from one person to another through unprotected sex or skin-to-skin contact.
Is Lichen Planus an Autoimmune Disorder?
Generally, this is not an autoimmune condition, but it causes a similar response. In people with this condition, the immune system attacks healthy parts of the body instead of protecting them, which is similar to an autoimmune disorder. In addition, this condition cannot be prevented because doctors do not know what causes it.
Diagnosis
First, physicians will perform a physical examination to check for irregularities linked to the disease. Thereafter, they may also ask some questions about your symptoms and medical history to gather more information about your condition. If it is still not clear whether you have lichen planus, doctors will perform the following tests and procedures. These include:
- Allergy test to check for an allergy that may cause lichen planus
- Biopsy – During this test, physicians will remove a small sample of the affected skin for testing.
- Hepatitis C test – In some cases, people develop lichen planus due to viral infections (including hepatitis B, hepatitis C, and others).
Treatment
There is no way to cure this condition. However, it disappears without treatment most of the time. Check below some treatments that doctors often recommend to relieve the symptoms:
- Corticosteroid creams or ointments – These medicines are used to reduce inflammation.
- Antihistamines – This group of medications is primarily used to treat allergy symptoms (such as itching).
- Phototherapy – This option involves ultraviolet light (such as ultraviolet B or UVB) from a special lamp to help improve the symptoms.
- Immunosuppressants – In some cases, these medications may help reduce immune response and ease the symptoms. Physicians usually prescribe Azathioprine, Cyclosporine, Mycophenolate mofetil, and others.
- Retinoids – This medicine comes in a pill or ointment. It helps the body produce more collagen, which may help with skin rash. Unfortunately, they can cause birth defects. That’s why you should consult with your doctor before taking them during pregnancy.
Usually, people who develop oral lichen planus get rid of it within 5 years. Check below for some tips that may help relieve the symptoms:
- Practice good oral hygiene (including regularly brushing and flossing the teeth)
- Minimize trauma – Any injury to your mouth may increase the severity of sores and increase the frequency of flare-ups.
- Regularly replace dental fillings – In rare cases, people may have an allergy to the mixtures of different metals often used in tooth fillings.
Home Remedies
There are some over-the-counter products or home remedies that may also help relieve the symptoms of lichen planus. In any case, you should consult with your doctor before using any of them to reduce the risk of an allergic reaction. Check some examples below:
- Aloe vera – You can use wound care gel that moisturizes, heals, and treats sores.
- Hydrocortisone creams or ointments – These options may help reduce pain.
- Oatmeal
What Psychological and Physical Signs of Stress Can Worsen My Symptoms?
Check some psychological signs of stress below:
- Depression
- Low self-esteem
- Anxiety
- Feeling overwhelmed
- Difficulty focusing or concentrating
- Using alcohol, tobacco, or recreational drugs to relax
- Irritability or mood swings
Physical signs of stress include:
- Hypersomnia (sleeping too much)
- Insomnia (sleep disturbances)
- Diarrhea
- Constipation
- Muscle tension
- Aches and pains
- Nausea
- Dizziness
- Low sex drive
What Foods Should Be Avoided By People With Lichen Planus?
Physicians usually recommend avoiding the following foods if you have lichen planus (especially the oral form). Examples include alcohol, tomatoes, citrus fruits, salsas, and hot peppers.
Frequently Asked Questions
Is lichen planus contagious?
No. Lichen planus is not contagious and cannot spread through skin-to-skin contact, kissing, sexual activity, or sharing personal items. It is an inflammatory condition rather than an infection.
Can lichen planus come back after it goes away?
Yes. Although many cases resolve on their own, lichen planus can recur months or even years later. Some people experience occasional flare-ups, especially during periods of stress or after exposure to certain medications or triggers.
How long does lichen planus usually last?
Cutaneous (skin) lichen planus often clears within 1 to 2 years, although it may leave temporary dark spots after healing. Oral lichen planus tends to last longer and may persist for several years or become a chronic condition that requires ongoing monitoring.
Can lichen planus increase the risk of cancer?
Most forms of lichen planus do not increase cancer risk. However, long-standing erosive oral lichen planus has a small increased risk of developing into oral cancer. Regular dental and medical checkups are recommended, especially if mouth sores do not heal or change in appearance.
What can trigger a flare-up of lichen planus?
Common triggers include emotional stress, certain medications, viral infections, dental materials in rare cases, skin injuries (known as the Koebner phenomenon), and spicy or acidic foods (sometimes) if oral lichen planus is present.
Can children develop lichen planus?
Yes, but it is uncommon. Lichen planus occurs much more frequently in adults, particularly middle-aged adults. When children develop the condition, they should be evaluated by a healthcare professional to confirm the diagnosis and rule out other skin disorders.
Does lichen planus always cause itching?
No. While itchy skin is one of the most common symptoms of cutaneous lichen planus, some people experience little or no itching. Oral lichen planus may instead cause burning, tenderness, or pain, particularly when eating spicy, acidic, or hot foods.
Can lichen planus affect the hair and scalp?
Yes. A form called lichen planopilaris affects the scalp and hair follicles. It can cause scalp redness, itching, hair loss, and, if left untreated, permanent scarring hair loss. Early diagnosis and treatment are important to help preserve hair.
When should I see a doctor for lichen planus?
You should seek medical attention if you develop a persistent rash, painful mouth sores, genital lesions, nail changes, severe itching, or symptoms that last longer than two weeks. Prompt evaluation is also important if sores bleed, become infected, or interfere with eating or daily activities.
Can lifestyle changes help manage lichen planus?
Yes. While lifestyle changes cannot cure lichen planus, they may help reduce flare-ups and improve comfort. Managing stress, maintaining good oral hygiene, avoiding tobacco and excessive alcohol, eating a balanced diet, and avoiding foods or products that irritate affected areas can all help support symptom control. Ask your healthcare provider if you have any other questions.
