Lichen planus is a skin rash that is triggered by the immune
system. It is not known why the immune response occurs. There may be several
contributing factors, and each case is different. Potential causes include:
- viral infections
Sometimes lichen planus occurs along with autoimmune
disorders. While it may be uncomfortable, in most cases lichen planus is not a
serious condition. It is also not contagious.
However, there are some rare variations of the condition
that may be serious and painful. It can be treated by using topical and oral
medications to reduce symptoms, or by using drugs that suppress the immune
Symptoms of lichen planus
Some of the most common symptoms of lichen planus include
lesions or bumps with flat tops on your skin or genitals
that develop and spread over the body during weeks or a few months
at the site of the rash
white lesions in the mouth, which may be painful or cause a burning sensation
which burst and become scabby
white lines over the rash
The most common type of lichen planus affects the skin. Over
the course of several weeks lesions appear and spread. The condition will usually
clear up within six to 16 months.
Less commonly the lesions can occur in areas besides the
skin or genitals. These may include:
- mucous membranes
- the scalp
There are also variations of the condition more common in
the Middle East, Asia, Africa, and Latin America.
What are the causes and risk factors?
Lichen planus develops when your body attacks your skin or
mucous membrane cells by mistake. Doctors are not sure why this happens.
Lichen planus can occur in anyone at any age, but there are
certain factors that make some people more likely to develop the condition. The
skin form of lichen planus occurs in men and women equally, but women are twice
as likely to get the oral form. It is very rare in children and older adults.
It is most common in middle-aged people.
Other risk factors include having family members who’ve had
lichen planus, having a viral disease like hepatitis C, or being exposed to
certain chemicals that act as allergens. These allergens may include:
- iodide compounds
- certain kinds of dyes
Diagnosis of lichen planus
Anytime you see or feel a rash on your skin or lesions in
your mouth or on your genitals, you should see your doctor as soon as possible.
Your primary care doctor may send you to a dermatologist if a diagnosis of
lichen planus is not obvious, or if your symptoms are making you very
Your primary care doctor or dermatologist may be able to
tell that you have lichen planus simply by looking at your rash. To confirm the
diagnosis, you may need further tests.
Tests could include a biopsy, which means taking a small
sample of your skin cells to view under a microscope, or an allergy test to
find out if you are having an allergic reaction. If your doctor suspects the
underlying cause is an infection, you may need to have a test for hepatitis C.
Treating lichen planus
For mild cases of lichen planus, which usually clear up in
weeks or months, you may not need any treatment. If the symptoms are
uncomfortable or severe, your doctor can prescribe medication.
There is no cure for lichen planus, but medications that
treat the symptoms are helpful and some may even be able to target a possible
underlying cause. Medications often prescribed include:
- retinoids, which are related to
vitamin A and are taken topically or orally
- corticosteroids reduce inflammation
and can be topical, oral, or given as an injection
- antihistamines reduce
inflammation and may be particularly helpful if your rash is triggered by an
- nonsteroidal creams are applied
topically and can suppress your immune system and help clear up the rash
- light therapy treats lichen
planus with ultraviolet light
There are other things you can try at home to compliment your
prescription treatments. These include:
- soaking in an oatmeal bath
- avoiding scratching
- applying cool compresses to the rash
- using OTC anti-itch creams
Talk to your doctor before adding OTC products to your
treatment plan. This way you’ll be certain that nothing you might take will
interact with prescription medications you’re taking.
What are the complications of lichen planus?
Lichen planus can be difficult to treat if it develops on
your vagina or vulva. This can lead to pain, scarring, and discomfort during
Developing lichen planus can also increase your risk of
squamous cell carcinoma. The increase in risk is small, but you should see your
doctor for routine skin cancer examinations.
What is the outlook?
Lichen planus can be uncomfortable, but is not dangerous. With
time, and a combination of home and prescription treatments, your rash will