Lichen planus: This common skin disease often develops on the wrist.
Many people get lichen (LY-kin) planus (PLAN-us). This disease can develop on one or several parts of the body. It can appear on the skin or inside the mouth. Sometimes, it appears in both places. Lichen planus can even change the way a person’s fingernails or toenails look. It also can appear on the genitals or a person’s scalp.
Lichen planus is not contagious. You cannot get this disease from someone else, and you cannot give it to anyone.
Lichen planus is not a type of cancer.
The signs and symptoms of lichen planus depend on where it appears on the body.
On the skin, lichen planus often causes bumps that are shiny, firm, and reddish purple. Sometimes the bumps have tiny white lines running through them. These lines are called Wickham’s striae.
Lichen planus: When bumps appear on the skin, the bumps are often shiny, firm, and reddish purple.
Most people get a few bumps. Some people get many bumps, which can appear on different parts of the body. The most common places for these bumps to appear are the wrists, lower back, and ankles, but they can appear anywhere on the skin, including the genitals.
On the legs, the bumps tend to be darker.
Lichen planus: Some people get many bumps on their skin.
New bumps may appear as older bumps clear.
When lichen planus develops on the skin, a person can have the following:
Mouth (oral lichen planus)
When lichen planus appears inside the mouth, it most commonly occurs on the insides of the cheeks. It also can appear on the tongue, lips, and gums. Inside your mouth, you may have:
Oral lichen planus: On the tongue, lichen planus can cause patches of tiny white dots. On the gums, lichen planus can cause redness and sores.
When lichen planus appears on the nails, it often appears on just a few nails. Sometimes it appears on all of the nails on a hand or foot. You may see:
Scalp (lichen planopilaris)
It is rare, but this disease can develop on the scalp. If it does, you may have the following on your scalp:
Who gets lichen planus?
Anyone can get lichen planus. It is most common in middle-aged adults. Women get lichen planus in their mouths more often than men do.
What causes lichen planus?
What causes most cases of lichen planus remains unclear. One theory is that lichen planus is an autoimmune disease. This means the person’s immune system reacts as though the skin and other parts of the body are foreign. When this happens, the body starts to attack itself. To find out whether lichen planus is an autoimmune disease, we need more research.
We do know the following:
How do dermatologists diagnose lichen planus?
A dermatologist often can tell whether you have lichen planus by looking at your skin, nails, and mouth. To make sure that you have lichen planus, a dermatologist may remove a bit of skin. This skin will be examined under a microscope to make sure. Your dermatologist may call this a biopsy. Sometimes, you may need blood tests to rule out other diseases.
Dentists often find lichen planus in the mouth during a checkup.
How do dermatologists treat lichen planus?
There is no cure for lichen planus. It often goes away on its own. If symptoms are bothersome, treatment often brings relief and may speed healing. Treatment for the skin may include:
Ask your dermatologist about possible side effects (health problems that can result from the medicines).
When lichen planus develops in the mouth, it often does not cause pain or other symptoms. If this is the case, treatment may not be necessary. When lichen planus causes pain, burning, redness, blisters, sores, or ulcers, it can be treated. Some medicine is applied to the sores. Other medicine comes in pill form.
Any mouth disease can lead to gum disease. It is important to brush and floss as directed by your dentist. You also should keep all appointments with your dentist and get cleanings at least twice a year.
Many cases of skin lichen planus go away within 2 years. About 1 in 5 people will have a second outbreak. In some people, the skin problem may come and go for years.
As lichen planus heals, it often leaves dark brown spots on the skin. Like the bumps, these spots may fade without treatment. If they do not go away, dermatologists can lighten the spots with creams, lasers, or other treatments.
Lichen planus in the mouth often lasts longer than lichen planus on the skin. In the mouth, it can be harder to treat.
You may be able to stop lichen planus from getting worse by doing the following:
If you have lichen planus in your mouth, you may have a higher risk of getting cancer in your mouth (oral cancer). Here are some things you can do to reduce that risk:
Scalp and nails
If you have hair loss or nail problems, you should see a dermatologist. Without treatment, these may not regrow.
If you have red areas or open sores, you need treatment. Dermatologists treat lichen planus on the genitals.