
What is Lichen Planus?
Lichen Planus is a long-term disease, which can affect the
skin and mouth and, in some cases, the genital area.
It affects 1 - 2% of men and women in the UK and is more
common in people over 40-years old.
It is not a cancer or an infectious disease that can be
passed on and it does not run in families.
What is the Cause of Lichen Planus?
The cause of Lichen Planus is not known but it is probably
related to the immune system where cells that normally
fight off germs attack normal parts of the body.
Certain drugs used in the treatment of high blood pressure,
arthritis and diabetes may cause Lichen Planus-like
lesions.
Also, where the cheeks or tongue have been lying against
teeth have amalgam restorations, Lichen Planus-like
lesions may occur. Emotional stress and spicy foods or
citrus fruits can often cause symptoms to worsen.
It is not thought to be infectious.
What are the signs and symptoms?
Lichen Planus appears in a wide variety of ways and can
cause pain, burning and/or soreness in the mouth.
It can often go unnoticed and may only be recognised by a
dentist or hygienist during a routine examination. White,
net-like lines or white patches are usually seen on the
inside of both cheeks and can also appear on the tongue
and gums. These do not usually cause any discomfort.
In some cases, red patches, ulcers or blisters appear
which can be painful. The gums can also become thin, red
and shiny in appearance and it may hurt to brush your
teeth. About one third of people also get a purple, itchy
rash with raised dots on the skin, especially on the wrists
and shins. Very rarely, changes can be seen in the genital
area, hair and nails.



Photos of Oral Lichen Planus affecting the tongue & buccal mucosae
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How Is It Diagnosed?
Blood tests and a biopsy of an affected area may be
required.
How is it treated?
As long as there is no pain, treatment is not usually
necessary. In all cases, it is important to keep your
mouth clean, as it stops the Lichen Planus from getting
infected.
There are many different treatments available for treating
the condition if it is causing a problem.
The usual treatment is steroid medication and / or
antiseptic / pain-relieving mouthwashes. These are not
absorbed into the body as they only work on the area
they are applied to and therefore cause no side effects.
It may be an idea to try to identify factors that make the
problem worse, e.g. stress, spicy food such as chillies,
citrus fruit and strongly-flavoured toothpastes (containing
cinnamonaldehyde).
In severe cases, the hospital doctor will prescribe some
stronger medication.
Prognosis.
Most lichen planus is benign. There are some forms of
lichen planus that may rarely, after years, lead to a
tumour; in this case, have yourself checked regularly if
the specialist advises.
Last Updated 2nd November 2011
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Treatment Algorithm for Oral Lichen Planus
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