Lichen planus

What is lichen planus?

Lichen planus is an inflammatory condition that affects the skin and mucous membranes, this can include the mouth, vulva, vagina and penis. It is a condition treated by maxillofacial surgeons/oral medicine specialists and dermatologists as it has such a wide variety of presentations.

Why have I got it?

It is not an inherited disease, and you cannot pass it to someone else. It is more common in middle aged patients, and slightly more common in women than men. The exact cause of lichen planus is not understood, but it is quite common. Some patients tell us that it is made worse with stress, but it is not caused by a food allergy or intolerance or deficiency - though some foods will irritate the areas affected by lichen planus.

What does it look like?

There are a variety of different presentations of lichen planus - most patients present with the 'reticular' variety, with a lacy white 'rash' inside the cheeks or on the sides of the tongue. It is usually bilateral - ie present on both the right and left. There are however a number of other presentations - including 'plaque' type and 'erosive'. Your surgeon will explain to you which type you have.

How is it diagnosed?

Sometimes the diagnosis can be made by an experienced clinician looking inside your mouth (or at your skin), but some patients require a small biopsy specimen to be sent to a pathologist in order to confirm the diagnosis.

How will I be treated?

Some patients don't require any treatment at all as they don't have any symptoms and are merely referred by their dentist or doctor to confirm the diagnosis. Other patients have very sore mouths, and require treatment with steroids (usually as a mouthrinse).

Will it go away?

Sadly we cannot cure lichen planus, but we can help you to manage it. Some patients require a number of different medications before they find one that is helpful - but your surgeon will explain this. Occasionally your symptoms (if you have any) will disappear for a long time, only to return many years later. This is difficult to predict.

Apart from medicines, what else can I do?

Avoid foods that make your symptoms worse, and try changing your toothpaste to a children's variety - this is less likely to upset the delicate skin inside your mouth. Some patients have a 'rash' or condition that looks like lichen planus, but is related to metal fillings. Sadly even if the metal filling is removed and replaced, this does not mean that the 'rash' will go away.