Lichen Planus

Disease database

Lichen planus is a chronic inflammatory skin condition that affects both the skin and mucous membranes. It is characterized by the development of itchy, purple, polygonal papules and plaques on the skin, as well as white lacy patches and mouth sores. In some cases, it can also lead to hair loss. While the exact cause of lichen planus is unknown, it is believed to be an autoimmune disorder, where the body’s immune system mistakenly attacks its own cells.

Itchy, Purple, Polygonal Papules and Plaques

One of the most common symptoms of lichen planus is the development of itchy, purple, polygonal papules and plaques on the skin. These lesions can appear anywhere on the body, but they are most commonly found on the wrists, ankles, lower back, and genitals. The papules and plaques have a distinct shape, resembling a polygon with multiple sides. The itching can range from mild to severe, and scratching the lesions can cause them to become inflamed and even more itchy.

White Lacy Patches

In addition to the purple papules and plaques, lichen planus can also cause the development of white lacy patches on the skin. These patches, also known as Wickham striae, have a unique appearance that resembles a delicate lace pattern. They are most commonly found on the inner cheeks, gums, and tongue. While these patches are usually painless, they can cause discomfort if they occur in areas where they come into contact with food or other irritants.

Mouth Sores

Lichen planus can also affect the mucous membranes, particularly in the mouth. This can lead to the development of painful mouth sores, also known as oral lichen planus. These sores can appear as white patches, redness, or ulcers on the inside of the cheeks, gums, tongue, or lips. The sores can make eating and speaking difficult, and they can come and go over time. It is important to note that oral lichen planus does not increase the risk of oral cancer.

Hair Loss

In some cases, lichen planus can also cause hair loss, a condition known as lichen planopilaris. This occurs when the inflammation affects the hair follicles, leading to scarring and permanent hair loss. The hair loss can be patchy or diffuse, and it can occur on the scalp, eyebrows, eyelashes, or other areas with hair. Unfortunately, there is currently no known cure for lichen planopilaris, but treatments can help slow down the progression of the condition and manage symptoms.

Treatment and Management

While there is no cure for lichen planus, there are several treatment options available to manage the symptoms and reduce inflammation. The choice of treatment depends on the severity and location of the lesions, as well as the individual’s overall health. Some common treatment options include:

  • Topical corticosteroids: These creams or ointments can help reduce inflammation and relieve itching. They are often the first line of treatment for mild cases of lichen planus.
  • Oral corticosteroids: In more severe cases, oral corticosteroids may be prescribed to reduce inflammation throughout the body. However, long-term use of oral corticosteroids can have side effects, so they are typically used for short periods of time.
  • Immunosuppressants: These medications work by suppressing the immune system to reduce inflammation. They are often used in cases where other treatments have been ineffective.
  • Antihistamines: These medications can help relieve itching and reduce the urge to scratch the lesions.
  • Phototherapy: This treatment involves exposing the affected skin to ultraviolet light, which can help reduce inflammation and improve symptoms.

In addition to medical treatments, there are also some self-care measures that can help manage lichen planus:

  • Avoiding triggers: Certain factors, such as stress, certain medications, and certain foods, can trigger or worsen lichen planus. Identifying and avoiding these triggers can help reduce flare-ups.
  • Maintaining good oral hygiene: Regular brushing and flossing can help prevent oral lichen planus and reduce the risk of complications.
  • Using gentle skincare products: Harsh soaps and skincare products can irritate the skin and worsen lichen planus. Opt for gentle, fragrance-free products instead.
  • Managing stress: Stress can worsen symptoms of lichen planus, so finding healthy ways to manage stress, such as exercise, meditation, or therapy, can be beneficial.

While lichen planus can be a chronic condition, it is important to remember that it is not contagious or life-threatening. With proper management and treatment, most people with lichen planus are able to control their symptoms and lead normal lives. If you suspect you may have lichen planus, it is important to consult with a dermatologist or healthcare professional for an accurate diagnosis and appropriate treatment plan.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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